user-created Laerdal Simman 3G manual
Contents
1. Sten td Check your computer security Thtne ant multiple tetuedy problems wath ypu iamput Click this notiicstion te fi these problerns It is not uncommon to have sound issues with Device Configuration Sim Man 3G when starting the Instructor ee ee io Devices Application before plugging in the headset and or unplugging and then replugging the Output Device Wee akM aee m term e ite dele ee headset when the application is already Input Device Microphone Line In SigmaTel High Definition Audio CODEC running To avoid possible problems it is S P kenna deen 5 recommended that the debriefing is saved to a i flash drive and shown on a different laptop The Proper Configuration for the Voice Conference Application Left click on the Voice Conference Application located on the lower Windows bar 1 Ifthe lower Windows bar isn t displayed press the Windows key on the keyboard for the bar to appear 3 When the Voice Conference Application 2 window opens select Options and Select Device from the tool bar 4 When the Device Configuration window 3 opens ensure that the correct Output 4 and Input 5 devices are selected Uncheck the Use new audio device automatically check box 6 6 Select the Apply and then the Close buttons NO A Kaiser Permanente SCAL Region 2011 The webcam can be connected to either the QuickCam The valve is clo2. 4 Camera w stand 5 Blood Concentrate 6 Board w wheels 7 SimMan Scenarios 8 Blood Fill Unit w pink tubing 9 Fluid Fill Unit w blue tubing 10 Gray Belt 11 Black handle 12 Guide references 13 SimMan Shirt 14 SimMan Pants 15 SimMan Boxers 16 Logitech CD 17 Logitech Guide 18 Probe Interface 19 Wounds Kit 20 Pulse Ox 21 Genitals Penis Vagina 22 Pleura Chest Drain 23 Non Gender Perineum 24 Large Black Cord 25 Neck Skin 26 O rings yellow 27 Gray Cord 28 Teeth 29 B P case 30 In line Fluid Filters 31 Small tools 32 Defib electrode 33 Arm Adapter 34 Pneumothorax bladders 35 IM pads 36 Large Tools 37 Patch Cable 38 Cricothyroid Tape green Not Pictured Lubricant Drug Binder Verified by _ gt Verified by Verified by pi Comments Verified by Returning on Comments Stacey LCutler kp org OC Staff Education 18March 2010 This page is intentionally left blank
3. Headphones 4 Camera w stand 5 Blood Concentrate 6 Board w wheels 7 SimMan Scenarios 8 Blood Fill Unit w pink tubing 9 Fluid Fill Unit w blue tubing 10 Gray Belt 11 Black handle 12 Guide references 13 SimMan Shirt 14 SimMan Pants 15 SimMan Boxers 16 Logitech CD 17 Logitech Guide 18 Probe Interface 19 Wounds Kit 20 Pulse Ox 21 Genitals Penis Vagina 22 Pleura Chest Drain 23 Non Gender Perineum 24 Large Black Cord 25 Neck Skin 26 O rings yellow 27 Gray Cord 28 Teeth 29 B P case 30 In line Fluid Filters 31 Small tools 32 Defib electrode 33 Arm Adapter 34 Pneumothorax bladders 35 IM pads 36 Large Tools 37 Patch Cable 38 Cricothyroid Tape green Not Pictured Lubricant Drug Binder 1 SimMan 3G 2 Gown 3 B P Cuff 4 Gray Cable 5 Power Cord 6 Arm Drain attached blue tubing Accessory Box 2 of 2 1 Patient Monitor w power cord 2 Instructor PC w power cord 3 Headphones
4. gt BR New Folder searen e AE E ial Name Date taken Tags Size immel Bf Default Radiology Fi Vi User Radiology Files j p HE Desktop Cardiomeg CostaFract CrusFracture FemurFract FluidLevels a er FracturaVer HipLuxation HumerusFr 5 Select the file folder with the desired image in this case Normal Pelvis Then choose the desired image in that Prepared for transfer C NormalPe lal folder Tono a _ e 6 Once the file has been selected it will be shown in the Transfer media files window figure 4 7 The selected file will be also be displayed in the Preview window 8 To send the file immediately to the patient monitor keep the Show immediately when transfer box checked and select Transfer to learner s monitor If the box is unchecked participants will have to manually bring up the radiology on the patient monitor 9 Select Close when done Importing Scenarios into Sim Man 3G Vista Computers 1 Right click the Start yA button and select Explore Adobe from the menu Reader 8 Open Explore M Scan Properties Open All Users Explore All Users d Client hk My Saved Session 2 Double left click patients SimMan3G di profiles di Server 3 Double left click Baccini r 4 Double left click SimMan3G di ACLS ED3G Classic View Scen 5 Double left click ED 3G Scen
5. ray folders Double left click X ray etc Double left click the appropriate folder to contain your media Copy and paste the imported media to the window on the right side of the screen 10 Your imported media is ready for the next time you run a scenario SIM MAN 3G 8 blood Oboard fill unit Q fuid fill w wheels w tubing unit w tubing 5 blood concentrate 1 patient instruc tor it pc w monitor cod w cords 6 Am L1 black Drain handle w blue tubina 12 guide references pneumothorax bladders S Power Cord L om i F D lt feel l a defib hoad a A d 21 genitals logitech Penis inte rf guide 30n Vagina interface line fluid filters 17 A hoo be ee Sm Man 3G Check Out Date Date Checked out to Checked in by Checked out by Checked in to Inventory Inventory SimMan 3G 1 of 2 SimMan 3G 1 of 2 Check In Accessory Box continued Accessory Box continued 1 SimMan 3G 2 Gown 3 B P Cuff 4 Gray Cable 5 Power Cord 6 Arm Drain attached blue tubing Accessory Box 2 of 2 1 Patient Monitor w power cord 2 Instructor PC w power cord 3
6. Kaiser Permanente Sim Man 3G Operations Manual Mark Meyer MD FAAEM Darin Bowers MA NY KAISER PERMANENTE thrive Revised Sept 2011 This page is intentionally left blank KP Sim Man 3G Operations Manual Dec 2011 Table of Contents Table of Contents 3 Sim Man 3G Quick Start Guide for Sim Man 3G 5 Proper Configuration of 3G s Voice Conference Application 6 In depth 3G User s Guide 7 Sim Man 3G GUI Orientation 11 Participant Orientation to 3G and Touch Screen Monitor 12 amp 13 Displaying Radiology Images During a Scenario 14 Importing Scenarios into Sim Man 3G 15 Importing Media Files into Sim Man 3G 16 sim Man 3G Inventory 17 Sim Man 3G Check In Check Out Form 18 This page is intentionally left blank 8 9 Quick Start Guide for Sim Man 3G Checklist for the Start up of 3G Plug in Sim Man 3G Close the drain valve on the posterior upper right leg perpendicular closed parallel open Turn on Sim Man 3G the startup process will take 2 3 minutes Turn on the laptops Instructor Laptop and Patient Monitor Laptop Log onto the laptops password SimMan3G Attach the mouse webcam and microphone headset to the Instructor Laptop This must be done before the 3G software application is opened Open the Logitech software and adjust the angle of the webcam Close the Logitech software once finished Once Sim Man 3G begins breathing and blinking his eyes and the LED over his power button is
7. SimBaby and SimNewB Fig 10 SimMan 3G View can be used as well Fig 11 By default the scenario will be paused If you wish to run the scenario at this time press the space bar or select the Start session button Instructor Mode scenano Healthy patent 3G We A e a oe Fig 10 am Patient Monitor Setup Once the laptop is powered on you must login to each computer Type in the password SimMan3G case sensitive Click the Patient Monitor icon Fig 12 and the Select Manikin box Fig 13 will open When using the software but not the manikin choose the virtual manikin If running scenarios click on the l manikin named in a format like SimMan3glltp paraa ee gee The patient monitor should now appear on the Patient Monitor PC It functions exactly like the monitor for the rest of the sim family Debriefing after a Scenario Click on the End Session button in the lower left corner of the GUI and the End Session box Fig 14 will appear You have multiple choices at this time Click Save Session if saving for debriefing on another laptop Click Debrief to debrief on the Instructor PC Click Start new session to start a new scenario without saving Would you like to save this session Click Quit to close the instructor application ra Save session What do you want to do Los Cancel 5 User s Guide For SimMan 3G Nov 2010 Shutting down the Manikin
8. and Laptops Page 4 4 At the Patient Monitor laptop scroll the mouse icon to the Main Setup button on the lower right hand side of the screen Left click the button another window will pop up and select Shutdown Monitor from this window Another window will pop up again and select Really shutdown The patient monitor program will now close Turn off the laptop as you would any other computer At the Instructor laptop scroll the mouse icon to the upper left hand side of the screen Select File and Exit A window will pop up asking you if you want to quit without saving Select Yes The instructor application will now close Turn off the laptop as you would any other computer At the manikin press the power button located on the lower left side of the manikin s stomach Wait about 30 seconds and the manikin should power down Open up the air tank drain valve on the backside of the upper right leg Figs 3 amp 4 on page 1 You will hear a rush of air Store your manikin as appropriate with the policies of your facility f you have fluid inside your manikin for secretions you will need to drain this before you turn off power to the manikin Explained further in another section SimMan 3G GUI Orientation va 7b ic onscious Sedation SimMan3G drug library 00 00 07 Simulation control 00 00 00 Scenario started AFIB WITH RVR 00 00 00 Simulation resumed Arway am
9. arios userdata d PPSP ACLS J trends 6 Double left click p userdata common p Window layouts scenarios 7 Copy and paste the imported scenarios to the window on the right side of the screen 8 You can now run the scenarios with the Instructor Application software Importing Radiology etc into Sim Man 3G Vista Computers Right click the Start button and select Explore from the menu gt Public 4 jE Computer 4 amp Local Disk C ii dell Intel a F Cisco d Common Files gt Dell 5 di EloTouchSystems TT Wb IDT he Intel Laerdal Medical B Laerdal Connection Service Laerdal Debrief Viewer gt ro a SimMan3G gt AuxiliaryTools Common files E gt d ERER d Documentation do InstructorApplication ManikinUpdate gt di PatientMonitorApplicatio fer patients profiles d progress userdata userdata_ common gt i Media t vocal sounds gt b X ray Window layouts gt ServerApplication VoiceConferenceApplicat SimNewB SimNewB Common Microsoft NET m eS se YS N a Adobe Reader amp Open Explore M Scan Properties Open All Users Explore All Users Double left click Program Files Double left click Laerdal Medical Double left click Sim Man 3G Double left click ri Double left click userdata_ common you will have a choice of media vocal sounds or X
10. ation if connected to CO2 tank remind them to use EZCAP d Tongue edema oropharyngeal edema trismus e Laryngospasm is possible remind them not to force tube past cords to avoid damaging mannequin f Soft teeth can be changed out for hard teeth NECK a Decreased cervical range of motion b Cricothyrotomy possible c Carotid pulses remember all pulses require firm pressure to activate sensors QESST Speakers for heart sounds lung sounds are major limitation and participants Should be given opportunity to hear normal vs abnormal Giving all participants time to listen is time consuming but usually worthwhile If time is Short limit demo to physicians b The auscultation feature of Sim Man 3G will stop all internal noise except for body sounds that can be ascultated c Lung speakers be sure to demo normal wheezes rales ronchi and what absent sounds are like Recommend one side set as normal and the other abnormal and cycle participants through both d Heartsounds are limited in value and would recommend against diagnosis or critical actions being based on abnormal heart sounds e Needle thoracostomy possible bilaterally f Monitor leads 4 chest leads these will send signal to wherever the leads are connected in addition to touch screen monitor g Defibrillation etc There are 2 contacts for attaching adaptors for electricity Participants should actually charge and deliver shock and pace i There are metal discs kept
11. en your voice is being transmitted to SimMan 11 Orienting Simulation Participants to Sim Man 3G 15 minutes 1 Take the time to do a thorough orientation If participants do not know the limitations of the simulator and what represents abnormal they will be less likely to respond to critical cues You may do a less thorough orientation depending on the training level of participants and the complexity of the case 2 ALWAYS USE GLOVES WHEN TOUCHING SIMMAN OUR SKIN OILS CAN DAMAGE HIS SKIN If there is a critical cue be sure to cover it in your orientation E g ifa case involves a pneumothorax be sure the physician has the opportunity to hear what it sounds like when one lung is down 4 The biggest limitation of the simulator is what is defined as responsive vs unresponsive We all know what a real unresponsive patient looks like but SimMan 3G Is always cold pale and does not move Remind participants that as long as SimMan 3G responds to cues with a verbal response than he Is responsive The moment he no longer Speaks he is by definition unresponsive OJ 5 Startat the head and work down Consider using ABC approach so that you cover all the critical features of SimMan 3G a Eyes Eyes blink eye lids can be half open closed one open and one closed Pupils accommodate to light and the size of his pupils are adjustable b Fluids Sweat from forehead tears runny nose droll froth from mouth and fluid from ears c Intub
12. green start the Instructor Application on the instructor laptop Select the appropriate manikin from the list do not select virtual manikin 10 Once the next screen opens double left click on Start Instructor Mode Scenario 11 Select the appropriate scenario from the list 12 Go to the patient monitor laptop and start the Patient Monitor Application 13 Select the appropriate manikin from the list do not select virtual manikin O Checklist for the Shutdown of 3G Left click the Main Setup button on the patient monitor screen Select Shutdown Monitor and then Really Shutdown Shutdown the patient monitor laptop like any other computer Close the Instructor Application on the instructor laptop by selecting File and Exit If a window asks you to if you would like to quit without saving select yes Shutdown the instructor laptop like any other computer Press the power button on the manikin and wait 30 seconds When the LED over the power button turns off open the air compressor drain valve on the upper right leg Unplug the manikin and store the equipment in accordance with local policies Kaiser Permanente SCAL Region 2011 Proper Configuration of the Sim Man 3G Voice Conference Application Insuas patient maniti Cader contros ji npea Merophone Line in Gages Tel High Clelintion Audo CODEC lhe res pde deee Blo Fame B You
13. in tool bag that can be used if you wish to use defibrillator paddles ABDOMEN a Bowel sounds are possible again demo the speaker if necessary b Fluid tank can be filled and Foley catheter can be placed Urination is possible if fluid tank is filled c Male or female genitalia can be used EXTREMITIES a Wetarm RUE is only location for IV access The IV is already started and no additional IV access is possible with 3G IV access can be used for IV fluids and medications b Pulses Bilateral radial Left arm brachial bilateral femoral bilateral popliteal pedialis and tibialis c Speaker in L antecubital fossa can be used for manual BP measurement this requires calibration with laptop and unless you are particularly interested in this skill would not recommend using it Updated a Touch Screen Monitor Onentation This monitor may function differently than ae uit 01 23 2008 08 41AM aise ed monitor used in the participants clinical care q area and can therefore become an additional X challenge during the scenario It is therefore important to go over the function of this monitor BEFORE starting any scenarios You should be ready to help them R during the scenario if they are struggling with the monitor Manual awRR IPE 1 Attach cardiac leads and then touch here BP No Cuff BS x H 2 Connect SimMan or SimBaby pulse Touch when cuff attached oximeter Waveform amp reading will occur without touching sc
14. p breathing Oickformenu CPR performance gt gt Technical status gt gt Preset Custom v Compliance Res ae 0 L 0 i 1 2 E 3 3 v Allow stomach distention Exhale CO2 Cirgilation amp fluids Convulsions None None Fow 0 laa v Upper port Arterial E Lower port SO a Arterial 7 gi Gi pP E gt Bi 0O Secretions a Sweat Eyes Mouth Urine E Ears C Nose L Froth Onormal OPolyuria OMicturition Sounds sa sounds E ario SystolicMurmu Vocal sounds Automatic learner events amp messages t acen L Lung Scenario Crackles Cough Difficult breathin M oan R Lung Scenario Crackles X Vomit Bowel Scenario Normal More body sounds Auscultation focus Korotkoff volume Auscultation gap chet gt ti on More sounds Respiratory amp Airway Control Instructor Monitor Control Cardiac Rhythm Control Circulation amp Fluid Control Eyes Control Sounds amp Vocal Control Event Windows a ABC b Miscellaneous c Medication IMD OF DA W N FO 8 Trends a History p Future c Parameters 9 Debrief Log 10 Scenario Control 11 Running Trends 12 Running Handlers 13 Trend amp Handler Control Press the S peak button on the GUI or press and hold F5 to talk for SimMan When the Speak button turns gre
15. reen Be sure to cover loss of waveform due to displacement of pulse oximeter vs BP which is too low i e Saturation Signal Low 3 Connect BP cuff and touch here Once cuff attached press Start Stop on lower menu bar and BP will be displayed 4 Press 12 Lead ECG and this will be displayed 5 Press double right arrows to open additional menu bar with options noted below 6 The radiology button displays images if they have been included in the scenario If not a request will come to the GUI operator for a study A j ma ay A lt a a PY Sience Pause ORS Alarm ae Alarms Volume Volume Radiology Displaying Radiology Images during Scenarios Sim Man 3G Only File Simulation control View Tools Help Instructor mode Health ne a 1 Leftclick the File drop down menu in the left spi R upper corner of the GUI figure 1 oad session 2 Select Transfer media files This will open Go to Debrief Viewer ji r Wo i pT the Media Files window figure 2 a A a Figure 1 a ma Vasoactive Agents Fa oioay Mutimeda Lab ruts 3 teen ea 3 Select the appropriate media tab in this case Radiology will be used 4 Select the Add files button This will open the Open window figure 3 which allows you to choose the type of radiology image Preview window Figure 2 v ri gt userdata common gt X ray
16. sed when the valve indicator User s Guide For SimMan 3G Nov 2010 Starting the Manikin and Laptops Page 1 4 Webcam Setup Fig ae Logitech Logitech QuickCam Patient Monitor PC or the Instructor PC By default the profile is setup to connect to the Patient Monitor PC Changing this profile requires going into the profile editor and creating a new profile Fig 2 Plug in the USB webcam to the Patient Monitor laptop if you wish to record the scenario Once the camera is plugged in double click the Logitech QuickCam icon on the desktop Fig 1 Once the QuickCam toolbar opens select the Quick Capture button Fig 2 You will have an image of what your camera will record Adjust the orientation of the camera to your liking and close out the Logitech window and toolbar 3G Start Up If not using secretions during the scenario close the air tank drain valve on the right leg adding fluid to the reservoir for secretions is explained in a later section Fig 3 points perpendicular to the long axis of the leg The valve is open when the valve indicator points parallel to the long axis of the leg The valve should be opened when filling the fluid reservoir and at the end of each day s simulation session Fig 4 Plug in the power cord for the manikin underneath the skin flap on the lower right side of the manikin s stomach area Fig 5 The manikin can theoretically run on batteries for 4 hours b
17. structor laptop The headset has two plugs one for the microphone and one for the headphones If ei hic aied you do not use the headset mute the sounds on Q isesi the instructor laptop to avoid feedback When you plug in the microphone headphones you may see the Audio System Event box Fig 5 Choose the microphone icon and press OK Click the Instructor Application icon Fig 6 and the Select Manikin box Fig 7 will i open When using the software but not the Instructor Patient manikin choose the virtual manikin If EPPEN MOnt running scenarios click on the manikin named in a format like SimMan3glltp Once connected to the manikin click on the Start Instructor Mode Scenario button Fig 8 l Don t show me this again simMan 3G 11 2 ver_010200 Budd 7900 Fig 8 User s Guide For SimMan 3G Nov 2010 Starting the Manikin and Laptops Page 3 4 Instructor PC Setup Continued E By default you will be taken to the Default ret patent dase Scenarios If you wish to run a scenario on the fly you can select either Healthy patient 3G or Healthy patient classic Fig 9 To run a scenario that you created or imported from another person Fig 9 select My Scenarios from the drop down menu on the left side of the screen towards the top Double click on the scenario you wish to run and the simulator GUI will open We recommend using SimMan Classic View as this similar to Classic SimMan
18. ut connecting the manikin to power between scenarios is recommended Turn on the manikin by pressing the power button to the far left of the power cord outlet Fig 5 Leaving the manikin powered on for more than gt 4 hours even if connected to power may cause connectivity problems It is recommended that the laptops and manikin are shut down between am and pm sessions Manikin Fig 5 Battery Status Battery Charging Status Indicator User s Guide For SimMan 3G Nov 2010 Starting the Manikin and Laptops Page 2 4 3G Start Up Continued Once the power button has been pressed the manikin will blink twice and go through its startup protocols The manikin acts as the Patient Monitor server of the wireless network needs approx 2 3 minutes to startup You will know the manikin has finished when it starts to breath has spontaneous eye blinking and the manikin SimMan 35 SimMan 3G status light turns green You are now ready to connect to the laptop computers At this time turn on the Instructor laptop and ad JO sul g uo wape the Patient Monitor laptop you can differentiate the two laptops by the labels on lower left side of the laptop lid and the lower left side of the opened laptop Fig 4 Fig 4 Instructor PC Setup abs Once the laptop 1s powered on you must login to each computer Type in the password SimMan3G case sensitive it dated chace iret ted plese unplug Plug in the headset to the In
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