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Newborn Tory™ S2210

1. At the end of the calibration process the wizard reports the average peak pressure and duration values for the procedure Click Save to store the calibration settings Do not perform mouth to mouth ventilation Doing so may lead to formation of mold in the airway The airway itself cannot be sanitized or cleaned Real CO2 Exhalation Optional Newborn Tory can exhale real CO2 via a CO2 cartridge Once a CO2 cartridge is installed use the software controls to adjust vol ume of CO2 exhaled Tory can also be operated without a CO2 cartridge installed A virtual CO2 value is displayed on the virtual monitor PC Due to shipping regulations CO2 cartridges are not included with the system The required 8g threaded CO2 3 8 24UNF 1A cartridges can be purchased at most bicycle or hardware stores Review the safety and warning checklist information before using the CO2 feature Failure to comply with the warnings listed below and those included with the original cartridge packaging may result in serious per sonal injury Always follow the manufacturer s safety and warning information included with the CO2 cartridge package Never point a CO2 cartridge at yourself or others Do not use damaged CO2 cartridges Do not puncture the cartridge CO2 seal manually Do not expose the CO2 cartridges to high temperatures as indicated on the product s packaging Newborn
2. HR 140 BP 80 51 RR 50 O2 Sat 98 Muscle Tone active Transition Time 45 sec End A 2 P 2 G 1 A 2 R 2 9 Newborn Tory S2210 User Manual Labor Scenarios 53 Scenario 4 Cynthia s Baby Newborn Tory Male infant with central cyanosis limp flaccid and requires immediate resuscitation No spontaneous movement of the right arm is noted Stat CXR reveals a fractured right clavicle and right pneumothorax Newborn HAL 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 Crying none Muscle Tone Limp HR 80 BP 45 30 RR 30 O2 Sat 85 Right Lung Disabled HR 20 BP 20 O2 Sat 80 Transition Time 30 sec Perform ventilations and needle decompression Wait Indefinitely for actions Crying Muscle Tone Reduced Lungs Enabled RR 50 O2 Sat 86 HR 20 BP 20 Transition Time 30 sec Perform fluid resuscitation Wait Indefinitely for action Muscle Tone Active HR 135 BP 80 55 O2 Sat 98 Transition Time 45 sec End A 0 P 1 G 1 A 0 R 1 3 A 2 P 2 G 2 A 2 R 2 10 Newborn Tory S2210 User Manual 54 Labor Scenarios Scenario 5 Elaine s Baby Newborn Tory This baby is born with a moderate asphyxia and will require CPR and oxygen to bring the vitals t
3. other modes is that the simulation can be allowed to go in any direction and it will be possible to choose the response on a case by case basis Other learning exercises require a higher degree of automation For such 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 Newborn Tory S2210 User Manual 64 Appendix 7 Appendix 7 1 Troubleshooting Communication Power Issues Communication with the simulator cannot be established or signal strength is weak Battery is discharged or damaged Plug in the charger and if communication is established then charge battery as per procedure explained in the manual Controlling computer is too far away from simulator Minimize the distance between simulator and the tablet Interference caused by physical obstructions Maintain line of sight with the simulator and direct the RF module towards the simulator Attempting to communicate with a different simulator Configure UNI to connect to the simulator
4. 5 Working with UNI 5 1 Getting Started Initiating the Simulator After reading the manufacturer s care and caution information press the power button to turn on the Tablet PC The UNI software initializes the simulator Double click the UNI icon on the tablet s home screen to start The simulator selection menu is shown Select Newborn Tory and click Start The wireless link between UNI and the simulator is established within 1 minute The available profiles for each simulator will be displayed when the simulator is selected For more information about man aging and creating new profiles refer to the UNI digital User Guide Newborn Tory S2210 User Manual Working with UNI 35 5 2 UNI Interface The UNI software is used to control the simulator monitor the vital signs and evaluate the provider s performance The simulation technician or instructor carrying out the simulation operates the UNI software The UNI 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 Connection Status The communication indicator displays the status of the radio link between the tablet s USB RF module and the simulator
5. Connectivity 1 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 2 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 above To troubleshoot connection issues between the virtual monitor computer and the controlling tablet refer to the Appendix Newborn Tory S2210 User Manual Newborn Tory Setup 13 Gaumard Monitors 1 After the wireless connection is estab lished 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 UNI control software For more information about the Gaumard Monitors software please refer to the Gaumard Monitors user guide Newborn Tory S2210 User Manual 14 Working with Newborn Tory 4 Working with Newborn Tory 4 1 Airway Nasal And Oral Intubation Airway management techniques can be practiced on the newborn Tory including BVM nasal oral intubation and suctioning Endotracheal tubes NG tubes and LMAs can be used Procedure Recommended Device Size Intubation Blade
6. 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 However if the repairs are not covered by this limited warranty then the first purchaser will be liable for all repair costs in addition to costs of shipping and handling 8 2 Gaumard Cares Service Plans In addition to the standard one year of coverage we offer a range of service plans through our Gaumard Cares program For more information about Gaumard Cares Service Plans please contact customer service Newborn Tory S2210 User Manual Contact Gaumard 79 9 Contact Gaumard 9 1 Contacting Technical Support Before contacting Technical Support you must 1 Have the simulator s serial number 2 Have access to the simulator for possible troubleshooting Technical Support Email support gaumard com USA 800 882 6655 INT 01 305 971 3790 9 2 General Information Sales and Customer Service E mail sales gaumard com USA 800 882 6655 INT 01 305 971 3790 Fax 305 971 3790 Post Gaumard Scientific 14700 SW 136 Street Miami FL 33196 5691 USA Office Hours Monday Friday 8 30am 7 30pm EST GMT 5 4 Summer Time Gaumard ZOE Michelle Mike PED
7. O2 Sat 98 Muscle Tone Active Transition Time 30 sec End A 1 P 1 G 1 A 1 R 1 5 A 2 P 2 G 1 A 2 R 2 9 Newborn Tory S2210 User Manual 58 Labor Scenarios Scenario 9 MAS Newborn Tory Meconium Aspiration Syndrome Newborn HAL MAS Meconium Aspiration Syndrome Muscle Tone limp HR 60 BP 35 20 RR 0 O2 Sat 70 Apply suction intubate and supply 100 O2 Wait Indefinitely for actions HR 150 BP 84 55 RR 50 O2 Sat 98 Muscle Tone Reduced Transition Time 45 sec End A 2 P 2 G 2 A 1 R 2 9 Newborn Tory S2210 User Manual Labor Scenarios 59 Scenario 10 RDS Newborn Tory Newborn with mild Respiratory Distress Syndrome gets a pneumothorax after oxygen is given Newborn HAL RDS Newborn with mild Respiratory Distress Syndrome gets a pneumothorax after oxygen is given HR 140 BP 80 53 RR 80 O2 Sat 80 UA Sound grunting Muscle Tone Reduced Administer Oxygen Wait indefinitely for action O2 Sat 98 Transition Time 15 sec HR 180 RR 100 O2 Sat 85 Right Lung Disabled Muscle Tone limp Transition Time 15 sec Apply needle aspiration Wait Indefinitely for action HR 160 RR 50 O2 Sat 95 Transition Time 15 sec End A 0 P 2 G 1 A 0 R 0 3 Newborn Tory S2210 User Manual 60 Labor Scenarios Scenario 11 TTN Newborn Tory Transient Tachypnea of the Newbo
8. Tory S2210 User Manual 18 Working with Newborn Tory Install threaded cartridges only 3 8 24UNF 1A Do not attempt to install a cartridge that does not meet the specifications listed in this document Do not over tighten the cartridge into the simulator s cartridge harness Always verify that the CO2 cartridge is empty using the software diagnostics before removing it Do not remove the CO2 cartridge if the simulator is not fully operational Installing the Cartridge 1 Securely hold the bottom of the CO2 Cartridge protective case with one hand and open it by twisting its top count er clockwise with the other hand Continue to twist the protective case s top until it comes off 2 If there is a cartridge inside already please refer to the Removing the Cartridge section below 3 Align and lower the new cartridge into its slot on the bottom half of the protective case Insert the co2 cartridge into the case ensuring that the threads are aligned 4 Screw the CO2 cartridge into the case until it stops and it s tightly secured The cartridge will feel cool to the touch as the case pierces the cartridge seal Note Once you have started screwing in the cartridge do not stop or attempt to unscrew the cartridge The casing will puncture the cartridge seal during the tightening process Hand tighten only Do not over tighten Do not unscrew t
9. User Manual Appendix 67 Miscellaneous Issues Intubation is falsely detected Intubation sensor requires recalibration Remove any adjuncts from the airway and complete the reset procedure outlined Refer to digital UNI User Guide under Menu gt Help gt Instruction Manual Artificial ventilations are not properly detected or not detected at all Ventilations are not calibrated See the Calibration Wizard Refer to digital UNI User Guide under Menu gt Help gt Instruction Manual Chest does not rise with artificial ventilation e g BVM Simulator is not running Turn the simulator on Air is escaping between the mask and the simulator s skin Maintain a tight seal between the BVM mask and the simulator Low chest rise or no chest rise at all while breathing Respiratory pattern is set to apnea Change the respiratory pattern to a healthy pattern Newborn Tory S2210 User Manual 68 Appendix Chest compressions are not detected Heart rhythm is set to sinus Set the heart rhythm to a critical heart rhythm such as VFib or Asystole Compression sensor is not calibrated Calibrate the chest compressor using the UNI calibration menu Refer to digital UNI User Guide under Menu gt Help gt Instruction Manual Korotkoff sounds do not match systolic and or diastolic set values BP sensors are offset Recalibrate BP cuff sensors on the simula
10. arms and left leg with fill drain sites Intraosseous access at tibia Sub Q and IM injection sites Chest compressions are measured and logged ECG monitoring using real devices ECG snap connectors Umbilical pulse fontanel pulse and bilateral brachial pulses synchro nized with ECG Pulses varying with blood pressure are continuous and synchronized with the ECG monitoring Bowel sounds Neural Responses Color responds to hypoxic events and interventions healthy mild cya nosis severe cyanosis Forearm movements reveal muscle tone active medium limp Newborn Tory S2210 User Manual Introduction 7 2 3 Other Vital Signs Monitor Optional Controlled via wireless touchscreen tablet PC Newborn vital signs Use selected configuration or create your own configuration to mimic the monitors used in your facility Customize alarms User Interface Powerful and intuitive UNI software Includes a library of preprogrammed scenarios which can be modified by the instructor even during the scenario Create your own scenarios and edit the preprogrammed scenarios Change simulator s condition during the scenario Assess APGAR score of the newborn Changes in condition and care are time stamped and logged View the actions of up to 20 care provide
11. connectors and stoppers included in your simulator s packaging The threaded ports located on both lower arms and left lower leg of the newborn are used for filling and draining the IV system Newborn Tory S2210 User Manual Working with Newborn Tory 27 2 Fill the modified syringe and the fill tubing with water or diluted Gaumard simulated blood Procedure Recommended Device Size IV Access 23 gauge needle 3 Connect the fill and drain luer connectors to lower arm leg threaded ports as shown in the adjacent pic tures Do not over tighten the luer connectors into the newborn s ports 4 Connect the drain tube with clamp to one of the connec tors and the fill tubing with syringe to the other connec tor 5 Leave the drain tube s clamp open and depress the syringe until air has been purged from the IV system and fluid runs from the drain 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 Newborn Tory S2210 User Manual 28 Working with Newborn Tory Use flashlight to detect dorsal pedal injection site on the left foot veins 6 When finished with the IV simulations flush and drain the IV vasculature and leave the stoppers connected to avoid leakage of any residual fluids Intramuscular injection sites
12. disconnect the left lower leg 6 To install the new lower arm left leg to the upper arm upper leg reverse the steps as instructed above Newborn Tory S2210 User Manual Appendix 76 Newborn Tory S2210 User Manual Appendix 77 7 4 Consumables List Item Description Price Color Code Lower Left Leg 125 00 Light S2210 027 L L 125 00 Medium S2210 027 L M 125 00 Dark S2210 027 L D Umbilical Cord Kit 250 00 Light S2210 137 L Set of 3 250 00 Medium S2210 137 M 250 00 Dark S2210 137 D I O Leg Skin Cover 40 00 Light S2210 029R L 40 00 Medium S2210 029R M 40 00 Dark S2210 029R D Lower Left Arm 140 00 Light S2210 023L L 140 00 Medium S2210 023L M 140 00 Dark S2210 023L D Lower Right Arm 140 00 Light S2210 023R L 140 00 Medium S2210 023R M 140 00 Dark S2210 023R D Item Description Price Code Battery 74 00 S2210 010 I O Tibia Bones Set of 7 125 00 S2210 031 Mineral Oil 10 00 S2210 181 Pricing and availability are subject to change Prices are valid through December 31st 2015 Please contact Gaumard for more information regarding consumables Newborn Tory S2210 User Manual 78 Warranty 8 Warranty 8 1 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 produ
13. or advice Gaumard does not warrant guarantee or make any representations regarding the use or the results of use of the software or written materials in terms of correctness accuracy reliability currentness or otherwise and the entire risk as to the results and performance of the software is assumed by you If the software or written materials are defective you and not Gaumard or its dealers distributors agents or employees assume the entire cost of all necessary servicing repair or correction other than expressly described above C Neither Gaumard nor anyone else who has been involved in the creation production or delivery of this product shall be liable for any direct indirect consequential or incidental damages including damages for loss of 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 r
14. position for greater accuracy during normal use Wireless Communication USB Module The controlling computer transmits the startup and control commands to the simulator through the USB RF communication module 1 Connect the RF communica tion module to an available USB port on the tablet and secure the RF communication module to the tablet using the Velcro patch The tablet is now ready to communicate with the simulator wirelessly For information about the signal strength indicator go to the Working with UNI section Never disconnect the communications module while the Newborn Tory software is running Doing so can seriously damage the module 3 4 Virtual Monitor Optional The Gaumard Monitors software displays newborn s simulated vital signs in real time The interactive monitoring software is already installed on the virtual monitor PC Newborn Tory S2210 User Manual 12 Newborn Tory Setup Virtual Monitor PC Setup 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
15. size Miller 0 LMA Size 1 Nasal Intubation 8 Fr catheter Oral Intubation ETT 3 0 no cuff 6 Fr suction catheter Do not introduce liquids when performing nasal and oral intubation Doing so can permanently damage the system Always lubricate the tubing using mineral oil prior to performing any nasal or oral intubation Newborn Tory S2210 User Manual Working with Newborn Tory 15 Intubation Sensor Once intubated sensors detect the depth of the intubation tube The detection notification is displayed on the Log Panel If the tube is inserted too deep the left lung is disabled automatically realistically demonstrating right mainstem intubation Correcting the tube position enables the left lung Airway Sounds Newborn Tory has multiple upper airway sounds and crying synchronized with the breathing 4 2 Breathing Respiratory Patterns Users can control rate and depth of respiration and can choose independent right and left lung sounds which are synchronized with selectable breathing patterns periodic breathing apnea and normal Lung Sounds Listen to the lung sounds using a stethoscope Multiple independent right and left lung sounds are available on Newborn Tory normal none inspiratory stridor grunting wheeze and crackles Newborn Tory S2210 User Manual 16 Working with Newborn Tory Pulmonary Ventilation The airway contains nominal landmarks per
16. software will halt and the module may be damaged Newborn Tory S2210 User Manual 2 Introduction IV Arm Vein tubing material is latex free Only use Gaumard s provided simulated blood Any other simulated blood containing sugar or any additive may cause blockage and or interruption of the vasculature system The use of needles larger than 22 gauge will reduce the lifetime of the skin and veins Always purge with clean water and then drain the vein reservoirs at the end of the simulation session Doing so will retard the formation of mold and prevent clogging of the system We recommend flushing veins with 70 30 solution of clean water to isopropyl alcohol IPA at least once per month to prolong the life of the vasculature When the skin and or veins require replacement refer to the Consum ables section of this guide For more information regarding the replacement of veins and other consumable items please contact customer service Operating Conditions Operating the simulator outside these ranges may affect performance Temperature 50 95 F 10 35 C Humidity 5 95 non condensing Storage Conditions Storage temperature 32 113 F 0 45 C Humidity 40 60 non condensing Do not stack or store heavy materials on top of the simulator boxes Procedures Do not attempt to intu
17. the Gaumard menu bar go to Monitors gt Configuration Set the adapter to Wireless network connection Verify the controller name and port number match the settings on the Gaumard monitor s Comm Setup menu PRO only From the Gaumard menu bar go to Monitors gt Configuration Set the adapter to Local Area Connection Verify the controller name and port number match the settings on the Gaumard monitor s Comm Setup menu USB communication module is not connected Connect the Communication module to the control computer and restart the software Virtual monitor option is not activated On the menu bar click Setup gt Options gt Environment tab and set the connection mode to FIXED then enter the simulator s serial number and save the settings Return to the Options menu and select the Add ons tab Checkmark the Use vir tual monitors option and enter the activation code Finally restart the software Sensors are off On the UNI menu bar go to Monitors gt Sensors gt and click All on Newborn Tory S2210 User Manual Appendix 71 Recording and Debriefing Issues PRO cameras are not detected in the camera setup menu The wireless camera s power supply is not connected to a power outlet Connect the camera to the power supply and restart the PRO PC The PRO internal wireless antenna is o
18. Full bars indicate excellent communication i e normal operation Newborn Tory S2210 User Manual 36 Working with UNI Battery Indicator The battery indicator displays the battery charge information An exclama tion sign is shown when there is no communication with the simulator and battery information cannot be retrieved When the battery icon is depleted the simulator is set to STAND BY mode automatically to protect some of the simulator s internal components Internal battery duration is approximately 3 hours Turn Simulator OFF before replacing the battery Failure to do so could result in serious damage to the system Simulator will not initialize until connected to the charger or the battery is replaced with a fully charged spare Session Clock The session timer allows the facilitator to maintain a chrono logical record of individual simulation sessions The session timer can be reset from the file menu when a new simulation session begins or by clicking the session time icon and then choosing the Reset Session Clock option Events during the simulation are logged in accordance to the session time Power Stand by Button The standby button is located on the bottom right corner of the UNI software Use the stand by feature to conserve battery during lectures Newborn Tory S2210 User Manual Working with UNI 37 Quick Launch The UNI in
19. I Susie Simon Susie Simon Code Blue SIMA Models SIMA GYN AID Virtual Instruments Code maker Code Blue NOELLE Simulation Made Easy HAL eCPR Zack RITA Chloe Seatbelt Susie Krash Kids Premie UNI Omni SmartSkin are trademarks of Gaumard Scientific Company Always dispose of this product and its components in compliance with local laws and regulations www gaumard com 800 882 6655 305 971 3790 Fax 305 971 3790 sales gaumard com 2015 Gaumard Scientific All rights reserved Patented other patents pending MADE IN THE U S A
20. IM sites are located on the quadriceps for placement and technique exercises Intraosseous Access The intraosseous access allows for infusing fluids blood and or drugs directly into the bone marrow of the tibia This system allows for continu ous intraosseous infusion 1 To drain the fluids connect the I O draining tube to the back of the lower right leg 2 Between exercises reseal or replace the bone to avoid leaking from previous puncture holes Procedure Recommended Device Size IO Access 18 gauge needle Newborn Tory S2210 User Manual Working with Newborn Tory 29 Replacing tibia bone and skin To replace the tibia bone and skin follow the instructions 1 Unsnap the lower right skin connector 2 Pull off the skin to access the tibia bone 3 Remove the tibia bone and replace it with a new one To replace the skin remove it completely form the lower right leg 4 6 Systemic Urinary Catheterization Perform catheterization exercises via exchangeable male and female genitalia Procedure Recommended Device Size Urinary Catheterization Lubricated 5 to 8 Fr Maximum Capacity 8 ml Newborn Tory S2210 User Manual 30 Working with Newborn Tory Instructions for Use 1 To fill the urine reservoir remove the female male genitalia by pulling the insert from the bottom as shown in the picture 2 Locate the bladder filling tube shown i
21. Newborn Tory User Guide User Guide 15 7 1 2015 Gaumard Scientific All Rights Reserved www gaumard com Newborn Tory S2210 User Manual Table of Contents iii Contents End User License Agreement vii 1 Introduction 1 1 1 Specifications 1 Newborn Tory 1 Virtual Monitor 1 1 2 Care and Maintenance 1 General 1 IV Arm 2 Operating Conditions 2 Storage Conditions 2 Procedures 2 Cleaning 3 Electrical Therapy 3 2 Overview 5 2 1 Features 5 2 2 Newborn Tory 5 Airway 5 Breathing 5 Cardiac 6 Circulation 6 Neural Responses 6 2 3 Other 7 Vital Signs Monitor Optional 7 User Interface 7 3 Newborn Tory Setup 8 3 1 Initial Setup 8 Simulator Placement 8 3 2 Newborn Battery 8 Battery life 8 Charging the Battery 8 Using the Power Supply 9 Newborn Tory S2210 User Manual iv Table of Contents 3 3 Control Tablet PC 10 Using the Stylus 10 Calibrating The Stylus 11 Wireless Communication USB Module 11 3 4 Virtual Monitor Optional 11 Virtual Monitor PC Setup 12 Virtual Monitor Wireless Connectivity 12 Gaumard Monitors 13 4 Working with Newborn Tory 14 4 1 Airway 14 Nasal And Oral Intubation 14 Intubation Sensor 15 Airway Sounds 15 4 2 Breathing 15 Respiratory Patterns 15 Pulmonary Ventilation 16 Real CO2 Exhalation Optional 17 Chest Rise 21 Chest C
22. Newborn Tory Setup The power supply adapter will NOT re charge the battery Avoid using the power supply adapter when the simulator s battery is completely depleted To operate the newborn using the power adapter 1 Ensure the battery is fully charged 2 Disconnect the Charger and connect the Power Supply adapter 3 3 Control Tablet PC The tablet PC is preloaded with the UNI control software used by the facilitator to initialize the simulator and control the vital signs The Newborn Tory control computer package includes Tablet PC with stylus Bump Case for Tablet PC RF communication module Before turning on the computer for the first time please review the documentation included with the product for important care and warning information Using the Stylus The tablet s stylus is a pen shaped input device used to interact with files and programs Left click Tap screen with the pointer Tap twice rapidly to double click Right click Tap and hold a highlighted item or hold the button near the tip of the stylus and tap the item or text Newborn Tory S2210 User Manual Newborn Tory Setup 11 Calibrating The Stylus 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 holding the pen in a natural writing
23. Scenario 8 Helen s Irene s Baby Newborn Tory 57 Scenario 9 MAS Newborn Tory 58 Scenario 10 RDS Newborn Tory 59 Scenario 11 TTN Newborn Tory 60 6 3 More About Scenarios 61 Thinking In Terms of Palette Items 61 Smart Scenarios 61 Newborn Tory S2210 User Manual vi Table of Contents 7 Appendix 64 7 1 Troubleshooting 64 Communication Power Issues 64 Miscellaneous Issues 67 Virtual Monitor Connection Issues 69 Recording and Debriefing Issues 71 7 2 Wireless Communication 72 Wireless Network 72 7 3 Consumables 75 8 Warranty 78 8 1 Exclusive One Year Limited Warranty 78 8 2 Gaumard Cares Service Plans 78 9 Contact Gaumard 79 9 1 Contacting Technical Support 79 9 2 General Information 79 Newborn Tory S2210 User Manual End User License Agreement vii 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 UNI the software media you agree to be bound by the terms of this agreement If you do not agree to the terms of this agreement promptly return the uninstalled media and accompanying items to Gaumard at the address indicated below 1 Grant of License Gaumard hereby grants to you an individual or institution the right to install and activate the software on one computer for us
24. and program the cyano sis visible on the simulator Use the Hypoxia model to automate the change in cyanosis as the provider intervenes For more information on the hypoxia mod el go to the Working with UNI section 4 5 Circulation Palpable Pulses Newborn Tory s palpable pulses fontanel brachial and umbilical are dependent on blood pressure Use the software controls to disable distal pulses and simulate severe hypotension Newborn Tory S2210 User Manual Working with Newborn Tory 25 Manual Blood Pressure Use the modified sphygmomanometer included with the system to mea sure blood pressure readings which are controlled by UNI In addition auscultate the Korotkoff sounds using a stethoscope Instructions for Use 1 Place the cuff around the simulator s upper right arm with the cuff mark at the medial site of the bicep brachii about an inch two cm above the anterior elbow 2 Connect the Luer Lock fitting on the end of the extra branch to the Luer Lock port on the simulator s right shoulder Placing the cuff differently might give an incorrect reading 3 Inflate the BP cuff and auscultate Korotkoff sounds as you would a normal patient Manual Blood Pressure Calibration Before starting the calibration process place the blood pressure cuff on the simulator as it would be placed on a real human patient To calibrate the blood pressure fea
25. ay have other legal rights This limited warranty applies only to the first purchaser of the product and is not transferable Any subsequent purchasers or users of the product acquire the product as is and this limited warranty does not apply This limited warranty applies only to the products manufactured and produced by Gaumard This limited warranty does not apply to any products provided along with the Gaumard product that are manufactured by third parties For example third party products such as computers desktop laptop tablet or handheld and monitors standard or touch screen are not covered by this limited warranty Gaumard does not provide any warranty express or implied with 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
26. bate without lubricating the airway adjunct with mineral oil lubricant Do not use silicone oil as lubricant Failure to lubricate the device will make intubation very difficult and is likely to result in damage to the simulator Mouth to mouth resuscitation without a barrier device is not recommended as it will contaminate the airway Treat the simulator with the same precautions that would be used with a real patient Do not attempt to birth Newborn Tory with Victoria Newborn Tory S2210 User Manual Introduction 3 Cleaning The simulator should be cleaned with a cloth dampened with diluted liquid dish washing soap Remove all traces of any lubricant Do not clean with harsh abrasives Do not use povidone iodine on the simulator Dry thoroughly The simulator is splash proof but not water proof Do not submerge or allow water to enter the interior of the simulator Electrical Therapy Newborn Tory s ECG snap connectors 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 NEVER deliver a shock to ECG snap connectors marked green in figure 1 Doing so will not create a fire hazard nor is there risk of shock to the pro vider but internal damage to the simulator will result This situation is consi
27. by serial number under Menu gt Setup gt Options Refer to digital UNI User Guide under Menu gt Help gt Instruction Manual RF module is not detected by the controlling PC Close the software and disconnect the RF module for at least five seconds then plug it back in and restart the software Connect the RF module in a different USB port Newborn Tory S2210 User Manual Appendix 65 Controlling multiple simulators from a single controlling PC Select different channels for each of the simulators and then try to turn them on one at a time which means to wait until a link has been estab lished between the tablet and the first simulator Only after that start the User Interface software for the second simulator and so on for the rest of the simulators To do so go to menu Setup gt Options gt Environment and then check the Check noise in channel box or simply manually select a desired channel AC adapter is damaged Verify the power adapter LED to ensure the adapter is working Disconnect the power adapter from the wall and the simulator and inspect the connector for damage or broken pins All Others Close the User Interface software and unplug the RF module for at least 5 seconds then plug it back in Restart the software and wait for initialization Commands are taking longer than usual to take effect or simulator is not reporting every a
28. cenario you may edit the scenario description This is the best place to put patient history and any other longer notes and instructions 3 Assume that providers will do the right thing Usually a scenario should be created with the assumption that the provid ers will perform correctly As long as they do the scenario can be allowed to continue Newborn Tory S2210 User Manual Labor Scenarios 63 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 punctuat ed by Wait Indefinitely items In other cases the simulation will require more direct control by the facilitator via either the Palette or Status De tails panel 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 environ ments 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
29. ct 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 accident 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 m
30. ction Signal strength indicator is low Distance between computer and manikin is reaching its limit or there are too many obstructions in between walls etc Get simulator closer to computer or move away from obstructions Newborn Tory S2210 User Manual 66 Appendix There s too much RF inter ference either from another Gaumard tetherless simulator in the vicinity or an RF radiator Try changing the RF channel by going to Menu gt Setup gt Options gt Environment Simulator does not run on internal battery power Battery is old or not charged properly When plugging in the charger make sure the LED indicator goes through the complete charging sequence described in the charger s label Replace battery Batteries would last between 2 3 years depending on use Battery life is dramatically reduced if it hasn t been charged at least once every 3 months UNI has set the power mode to STAND BY automatically The battery on the manikin is depleted Turn off the simulator and plug in the charger Simulator doesn t respond to any command although signal strength is excellent UNI has established commu nication with a different simula tor Configure UNI to connect to the simulator by serial number under Menu gt Setup gt Options Refer to digital UNI User Guide under Menu gt Help gt Instruction Manual Newborn Tory S2210
31. dered improp er use and is NOT covered by the newborn warranty The system will require repair at our facility WARNING Newborn Tory does not accept real electrical therapy Do not pace or defibrillate Newborn Tory with real electrical equipment Figure 1 Newborn Tory S2210 User Manual 4 Introduction Newborn Tory S2210 User Manual Introduction 5 2 Overview 2 1 Features Tetherless remains fully functional even while in transit Seamless smooth and supple skin covers newborn from head to toe Newborn with seamless joints endoskeleton and realistic full term weight and length provide postural support range of motion and resistance Anatomical landmarks include palpable fontanels and sutures Realistic rotation of the shoulder and hip joints with human like range of motion allows practice of newborn assessment techniques Programmable conditions for APGAR assessment Internal rechargeable battery with fast charging adapter ECG snaps allow the application of real electrodes to track cardiac rhythms Simulator receives commands from a wireless tablet PC and operate at distances up to 300 feet Simulation Made EasyTM 2 2 Newborn Tory Airway Neck hyperextension sensor detection and logging Oral and nasal intubation Use an ET tube or LMA Sensors detect depth of in
32. deteriorate the cardiac and respiratory vital signs gradually Pause Model will pause at the current state Improve Trend the vital signs to a healthy state Deteriorate Trend the vital signs to a severe cyanotic state Ventila tions are detected when the respiratory rate is at 0 Cyanosis Levels Select the cyanosis level to move to any of the following states imme diately Healthy Pedi is pink with adequate oxygenation Mild Cyanosis Pedi is slightly blue and the vital signs are starting to deteriorate Severe Cyanosis Pedi is blue apneic and vital signs are rapidly wors ening Newborn Tory S2210 User Manual 47 Modeled Therapy The modeled therapy menu provides additional intervention options Improve Gain Adjust the slider to increase or decrease the cyanotic response to ventilations Oxygen Adjust the slider to administer oxygen to the fetus in liters per minute Epinephrine Administer epinephrine to the model Set the epineph rine dose and then click add Administering epinephrine increases the heart rate Reset Click Reset to clear the oxygen flow and the epinephrine dose onboard Newborn Tory S2210 User Manual 48 Labor Scenarios 6 Scenarios 6 1 Manual Mode Flowcharts Quick Start Scenarios Manual Mode SCENARIO Clinical Condi
33. e 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 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
34. e virtual monitor PC 11 Click the V menu near the top left corner and then select Comm Setup The Comm Setup window is displayed 12 Enter the controller name from the UNI software and verify the port number 13 Click Connect to accept the incoming connection 14 Verify the network status and network name then click Connect to begin transmitting the vital signs information 15 Write down the Controller Name and Port number 16 Start the Gaumard Monitors software on the virtual monitor PC 17 Click the V menu near the top left corner and then select Comm Setup The TCP Comm Setup window is displayed 18 Click Connect to accept the incoming connection Newborn Tory S2210 User Manual Appendix 75 7 3 Replacing Consumables IV Arms and Left Leg Replacement To replace the IV lower arms and left lower leg follow the instructions listed below Gather the following items Allen Key Replacement lower arms and left leg 1 Attach the drainage tube to the drainage port on the lower arm of the simulator and purge the system of any fluids that may remain from prior use 2 Remove drainage tube after the arm has been purged 3 Use the Allen key provided to unscrew the lower arm as shown in the picture 4 Completely separate the lower arm from the upper arm 5 Follow the same steps to
35. en in the picture To enable the temperature sensor detection feature go to Setup gt Options gt Neonate features Tab Checkmark Use temperature sensor option and click OK to save The log panel detects the placement of the sensor Newborn Tory S2210 User Manual Working with Newborn Tory 33 4 7 Other Vital Signs Monitor Optional The virtual vital signs monitor simulates a vital signs monitor attached to the simulated patient The vital signs are synchronized through a wireless network between the facilitator s tablet and the computer running the monitor You can customize each trace independently users can set alarms time scales boundaries and grid options For more information refer to the UNI digital user guide PRO OPTIONAL The Pro system is an all in one session recording and simulator control solution for facilitators in a lab or mobile environment The built in UNI software allows the facilitator to control Newborn HAL while recording care provider interactions and event logs The upgrade replaces the standard tablet with a convertible touchscreen laptop loaded with the Pro system and UNI 2 Wi Fi enabled cameras 1 motorized 180 view USB camera and carrying case For more information on using the Pro system refer to the documenta tion included with the upgrade option Newborn Tory S2210 User Manual 34 Working with UNI
36. eserved by Gaumard ACKNOWLEDGMENT By installing the 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 the license described herein End User License Agreement Newborn Tory S2210 User Manual viii End User License Agreement Newborn Tory S2210 User Manual Introduction 1 1 Introduction 1 1 Specifications Newborn Tory Weight 6 Lb Length 21 75 inches Battery charger Power input 100 240 VAC 50 60 Hz 0 35 A Power output 7 5 VDC 1 A Virtual Monitor Wireless connectivity Wireless 802 11 ad hoc mode 1 2 Care and Maintenance WARNING Damage caused by misuse is not covered by your warranty It is critical to understand and comply with the following guidelines General Avoid contact of rings and sharp objects to the simulator s skin Ball point pens ink and markers permanently stain the skin Do not wrap this or any other Gaumard product in newsprint Marks made with ballpoint pens ink or marker cannot be removed Never disconnect the communications module while the UNI software is running The
37. et respiratory rate to zero none will be Sounds are synchronized to the breathing cycle What you are really setting here when you choose a lung sound is the condition of the lungs given respiratory drive That is if the patient s respiratory rate was changed from zero what sound would be heard As suming 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 facili tators to neglect the importance of notes in the scenario The facilitator may 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 s
38. ff Set the PC s wireless capability switch to the On position The wireless network name has been changed On the PRO wireless network properties change the wireless name back to the factory default Camera is detected in the camera setup but there is no feed on the main window Main view distribution is not configured Click the Main view setup icon and select the active video and monitor feeds Events are not listed on the PRO event panel during the scenario RF Module is not connected Connect the RF module and restart the software PRO is not recording On the UNI menu bar click File gt New Session to start a new scenario Newborn Tory S2210 User Manual 72 Appendix 7 2 Wireless Communication Wireless Network Instructions with USB Router USB Router Setup These first steps of the instructions will apply to customers receiving the router as an upgrade If you received the Gaumard Monitor computer with the router already attached please proceed to step number 4 1 Add Velcro to USB router and VM 2 Connect Router to USB pow er supply Computer can be packaged with router con nected 3 Open the Wireless Network Connection on the Monitor Computer and connect to the default network which name will be GaumardSimulatorSerialNumber Example GaumardB0000001 4 Open the Wireless Network Connection on the simulator control com pu
39. fine 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 a selection for each available setting on the Status Details panel 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 simulator s condition will always be the same when the scenario starts regardless of how he was doing previously Likewise the transition duration of the first step in the scenario should be zero indicating that changes are applied immediately There is one point that can cause confusion and warrants further explana tion It is an extension of the above discussion of partial states The issue is best illustrated through the following example Newborn Tory S2210 User Manual 62 Labor Scenarios 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 s
40. g with UNI 43 When the palette is needed click the Load button to select the palette from the library Select the palette item from the Load Palette Item menu and click Load Make changes to the palette by clicking on the specific parame ter Newborn Tory S2210 User Manual 44 Working with UNI Click the apply option to submit the changes Body View The Body View mode displays an interactive model of the simulator The model is a representation of the simulator and its internal organs Newborn Tory S2210 User Manual Working with UNI 45 Use the Body View controls on the top to rotate move re center and zoom the model Place the cursor over the body to view the model s internal organs Also navigate to the desired category in the list view clicking over the body view Sensor Panel The body view includes the sensor panel which detects the action performed and shows active sensors highlighted in green Newborn Tory S2210 User Manual 46 5 5 Hypoxia Model Use the Hypoxia tab to evaluate the effectiveness of provider intervention on an apneic patient The model adjusts the cardiac oxygen saturation and cyanosis settings dynamically in response to effective ventilations The model also responds to the administration of epinephrine and oxygen Hypoxia Model State The hypoxia model options improve or
41. he cartridge once the seal is broken Newborn Tory S2210 User Manual Working with Newborn Tory 19 5 When the cartridge is completely and firmly in its slot place the top of the cartridge s protective case back into position and twist it back on firmly Connecting The Cartridge to Tory 1 Secure the cartridge to Tory s leg by using the Velcro strap 2 Bring the CO2 connecting tube to the left upper back of Tory s shoulder and secure it into the port The port is se cured with a Luer lock fitting and requires just a quarter turn to fasten it in place 3 Ensure that all of the connections are firmly secure and locked in before proceeding OPTIONAL If you wish to place the cartridge in a location further away from the manikin Please use the 24 white extension tube The extension tube can be at tached between the Tory and the connecting tube Newborn Tory S2210 User Manual 20 Working with Newborn Tory Removing the Cartridge 1 Before replacing the car tridge please ensure that you have exhausted the contents of the cartridge To exhaust contents of CO2 cartridge please turn the feature on and allow to run until no CO2 can be measured 2 Securely hold the bottom of the CO2 Cartridge protective case with one hand and open it by twisting the top counter clockwise with the other hand Continue to twist the protective case until the top c
42. ions or scenario types to be stored under this feature Newborn Tory S2210 User Manual Working with UNI 39 Status Details Controls 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 The Status Details tab displays the vital signs controls in a list format Systems 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 Newborn Tory S2210 User Manual 40 Working with UNI Changing Vital Signs To adjust numerical values click and drag the slider control e g heart rate blood pressure respira tory rate etc Alternatively use the keyboard for manual entry and click the green checkmark to confirm the change To change patterns sounds and rhythms click on the specific control to display the library e g EKG rhythms heart and lung sounds respiratory patterns etc Click the slider control below the sound library to adjust the volume of the sounds Newborn Tory S2210 User Manual Working with UNI 41 Applying Changes No changes will be made to the simulator s condition until the new settings are submitted using
43. ity Charging the Battery The simulator s battery can only be recharged using the battery char ger In addition the simulator must be off The battery charger does not recharge the battery while the simulator is in use nor does it keep the battery from discharging Newborn Tory S2210 User Manual Newborn Tory Setup 9 To charge the battery 1 Ensure the simulator is turned off 2 Remove the charger power supply cover 3 Connect the adapter labeled Newborn Tory Charger to the battery port located on the simulator s right foot 4 Allow the simulator to charge for 2 3 hours or until the charger dis plays a green light The charger indicator light will show red during the charge period and green once the process is complete 5 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 The power supply adapter allows the simulator to operate through long simulations sessions by drawing power from the wall outlet 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 Newborn Tory S2210 User Manual 10
44. mitting either BVM or intubation exercises including the use of a LMA The trachea extends to the bronchi and lungs Ventilations volume and duration are measured and logged with the new effective CPR eCPR evaluator Refer to the UNI digital user guide under the software Menu gt Help gt Instruction Manual for information Ventilation Calibration Before using the feature for the first time please calibrate the ventilation sensor by following the instructions outlined below The ventilation calibration wizard records the performance average of five ventilations as the benchmark for a correct ventilation Perform the actions requested by the calibration wizard prompts The CPR window evaluates provider performance based on the benchmark recorded during the calibration process To calibrate the ventilation performance benchmark using the UNI software 1 Click UNI Menu gt Setup gt Calibration gt Ventilations and click Next 2 The wizard prompts to perform ventilation 1 3 Perform the first ventilation A green filled oval indicates that the ventilation was recorded successfully Newborn Tory S2210 User Manual Working with Newborn Tory 17 4 Perform ventilation 2 as prompted by the wizard A green filled oval indicates that the ventilation was recorded successfully 5 Continue through the calibration wizard to record a total of five ventilations
45. n the picture and the syringe 3 Fill the syringe with fluid and connect the bladder filling tube 4 Insert the bladder filling tube to the urethral opening 5 Fill the bladder with fluid up to 8 ml 6 Reattach the female male genitalia Newborn Tory S2210 User Manual Working with Newborn Tory 31 Umbilical Cord 1 Catheterize or inject the um bilical cord 2 To fill the umbilical cord with fluid locate the syringe with the tip adapter from the Fluid Filling Kit provided 3 Inject any of the three blood vessels with 2 mL of water For catheterization exercises use a 6 Fr urethral round tip catheter lubricated with mineral oil 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 File gt Exit or set the simulator on STAND BY mode After the simulator is powered down the umbilical cord can be removed safely For information about ordering replacement umbilical cords go to the Appendix Bowel Sounds Auscultate the abdomen for normal and hyperactive bowel sounds Newborn Tory S2210 User Manual 32 Working with Newborn Tory Temperature probe placement detection The temperature reading on the vital signs monitor is displayed when a temperature probe is placed on the lower right quad rant of the abdominal area circled in gre
46. o a healthy state Newborn HAL Elaine s Baby This baby is born with moderate asphyxia and will require CPR and oxygen to bring the vitals to a healthy state Muscle Tone Limp Crying none HR 60 BP 35 20 RR 0 O2 Sat 70 Administer 100 O2 with bagging Wait Indefinitely for actions HR 152 BP 82 60 RR 55 O2 Sat 85 Transition Time 30 sec RR 51 O2 Sat 98 Muscle Tone Active Transition Time 1 min End A 0 P 2 G 2 A 1 R 2 7 A 2 P 2 G 1 A 2 R 2 9 Newborn Tory S2210 User Manual Labor Scenarios 55 Scenario 6 Francine s Baby Newborn Tory This baby was born through a C Section and is responsive but needs some attention after a while all vital go to a healthy state Newborn HAL Francines s Baby This baby was born through a C Section and is responsive but needs some attention after a while all vitals go to a healthy state Crying Muscle Tone Reduced HR 140 BP 70 52 RR 60 O2 Sat 80 Warm baby apply suction and administer O2 Wait Indefinitely for actions End BP 79 55 RR 50 O2 Sat 95 Muscle Tone Active Stops Crying Transition Time 45 sec A 2 P 2 G 2 A 2 R 2 10 Newborn Tory S2210 User Manual 56 Labor Scenarios Scenario 7 Gloria s Baby Newborn Tory The baby is born with mild asphyxia but no matter how good the interventions are this disastrous intrapartum complication resul
47. omes off 3 When the top comes off of the protective casing you will see the cartridge 4 With the cartridge complete ly spent twist the cartridge counter clockwise to unfas ten it for removal 5 Remove cartridge Do not ever point the CO2 Cartridge at yourself or others Adjusting CO2 Output After the cartridge is installed adjust the Lung CO2 parameter in the UNI software to increase or decrease the volume of exhaled CO2 If a new CO2 Cartridge has been installed and lung CO2 has been set to a value above 0 but exhaled CO2 is not being detected by your equipment please check your equipment and the simulator s connection to the cartridge case Newborn Tory S2210 User Manual Working with Newborn Tory 21 Chest Rise Lungs expand normally permitting realistic chest rise When starting the UNI the pre programed profiles will load Newborn Tory with a healthy respiratory pattern with normal chest rise Enable or disable the right or left lung independently Chest Compressions Select a cardiac dysrhythmia such as ventricular fibrillation or asystole and instruct the provider to perform chest compressions Monitor the depth and frequency of chest compressions from the CPR trainer window Compression Calibration Before using the feature for the first time please calibrate the compression sensor by following the instructions outlined below The com
48. ompressions 21 4 3 Cardiac 22 Heart Sounds 22 ECG Monitoring and Electrical Therapy 22 4 4 Cephalic 24 Muscle Tone and Seizures 24 Cyanosis 24 4 5 Circulation 24 Palpable Pulses 24 Manual Blood Pressure 25 IV Arms 26 Intramuscular injection sites 28 Intraosseous Access 28 4 6 Systemic 29 Urinary Catheterization 29 Umbilical Cord 31 Bowel Sounds 31 Temperature probe placement detection 32 Newborn Tory S2210 User Manual Table of Contents v 4 7 Other 33 Vital Signs Monitor Optional 33 PRO OPTIONAL 33 5 Working with UNI 34 5 1 Getting Started 34 Initiating the Simulator 34 5 2 UNI Interface 35 Connection Status 35 Battery Indicator 36 Session Clock 36 Power Stand by Button 36 Quick Launch 37 Status Details Controls 39 Systems List View 39 Changing Vital Signs 40 Applying Changes 41 Creating Palette Items 42 Body View 44 Sensor Panel 45 5 5 Hypoxia Model 46 Hypoxia Model State 46 Cyanosis Levels 46 6 Scenarios 48 6 1 Manual Mode Flowcharts 48 Scenario 1 Alice s Baby Newborn Tory 50 Scenario 2 Asphyxia Newborn Tory 51 Scenario 3 Beth s Donna s Baby Newborn Tory 52 Scenario 4 Cynthia s Baby Newborn Tory 53 Scenario 5 Elaine s Baby Newborn Tory 54 Scenario 6 Francine s Baby Newborn Tory 55 Scenario 7 Gloria s Baby Newborn Tory 56
49. pped with ECG snap connectors that allow the attachment of real ECG lead wires This feature permits the user to track cardiac rhythms and events with their own equipment just like with a human patient Newborn Tory S2210 User Manual Working with Newborn Tory 23 Do not pace or defibrillate the simulator Doing so will not create a fire hazard nor is there risk of shock to the provider but internal damage in the newborn may result This situation is considered improper use and is NOT covered by the newborn Tory warranty Use the virtual shock panel to simulate the administration of electrical therapy via software To open the virtual shock panel window click on the Shock Pacer icon as shown in the picture Instructions for Use 1 Turn on the simulator Refer to the Equipment Set Up section 2 Connect the ECG lead wires to Tory s ECG snap connectors 3 Connect the ECG lead wires to the ECG monitor 4 Turn on the ECG monitor Newborn Tory S2210 User Manual 24 Working with Newborn Tory 4 4 Cephalic Muscle Tone and Seizures 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 Cyanosis Control
50. pression calibration wizard records the performance average of five compressions as the benchmark for a correct compression Perform the actions requested by the calibration wizard following the most current CPR guidelines The CPR window evaluates provider performance based on the benchmark recorded during the calibration process To calibrate the compression performance benchmark using the UNI software 1 Click Setup gt Calibration gt Compressions and click Next 2 Select the target compression depth for the chest compressions calibration criteria 3 The wizard prompts to perform compression 1 Newborn Tory S2210 User Manual 22 Working with Newborn Tory 4 Perform the first compression A green filled oval indicates that the compression was recorded successfully 5 Perform compression 2 as prompted by the wizard A green filled oval indicates that the compression was recorded successfully 6 Continue through the calibration wizard to record a total of five compressions At the end of the calibration process the wizard reports the average peak pressure and duration values for the procedure Click Save to store the calibration settings 4 3 Cardiac Heart Sounds Newborn is equipped with several realistic heart sounds which are synchronized with the user defined heart rate and cardiac rhythm ECG Monitoring and Electrical Therapy Newborn Tory is equi
51. rn Newborn HAL TTN Transient Tachypnea of the Newborn Crying HR 140 BP 85 61 RR 50 O2 Sat 80 Muscle Tone Reduced Apply suction and deliver O2 Wait Indefinitely for action Not crying Immediate Transition RR 80 O2 Sat 91 UA Sound Grunting Transition Time 20 sec End A 2 P 2 G 1 A 1 R 2 8 Newborn Tory S2210 User Manual Labor Scenarios 61 6 3 More About Scenarios Thinking In Terms of Palette Items As described previously palette items represent complete or partial groups of settings that have been stored as a single item 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 should try to create items that are as generally applicable as possible and can be applied to a wide range of scenarios The key is to only include in your palette items the settings that are directly related to the physiological event represented by that palette item Smart Scenarios After reading the Details Palette and Scenarios sections of this guide it should be clear how to build a scenario You may have already tried building your own or modifying some of the factory presets The following four guidelines will re
52. rs using a responsive menu or write narrative Generate and share diagnostic lab results File sharing Links with optional recording and debriefing system integrate the event log with cameras and patient monitor Supplied with wireless tablet PC Newborn Tory S2210 User Manual 8 Newborn Tory Setup 3 Newborn Tory Setup 3 1 Initial Setup Simulator Placement Prepare the simulation area prior to unboxing the simulator Remove the simulator from the box 3 2 Newborn Battery Newborn Tory includes two separate power adapters labeled Newborn Tory Charger and Newborn Tory Power Supply Please review the use for each adapter below before using the simulator for the first time Battery life Newborn has a maximum battery runtime of approximately 3 hrs Total runtime is dependent on breathing rate volumes seizures and muscle tone The battery charge is displayed on the software panel after the connec tion with the simulator is established For more information about the battery indicator refer to the Working with UNI section Do not store the simulator with a discharged battery It is good prac tice to re charge the battery at the end of every simulation session If the simulator will not be used for an extended period re charge the battery at least once every 60 days Doing so will prevent a reduction of the battery s total charge capac
53. ter and connect to the same network name GaumardB0000001 Configure the Vital Signs Broadcast Complete next steps to configure the transmission of the vital signs infor mation after the wireless connection is established between both comput ers 1 Verify that both computers are connected to the GaumardB0000001 t network using Windows wireless connection menu If the comput ers are not connected select the network name and click Connect manually Newborn Tory S2210 User Manual Appendix 73 2 Start the UNI control software on the control computer 3 On the UNI menu bar click Monitors gt Config uration The simulator Virtual Monitor Setup window is displayed now 4 Set the adapter to Wireless network connection 5 Verify the network status and network name and then click Con nect to begin transmitting the vital signs information 6 Verify that the IP Type is set to automatic if not From the menu bar go to Help gt Cre ate ad hoc Wireless Network 7 The Controller Create Ad hoc Wireless Network window is displayed Select the Set Dynamic IP to set the IP automatic and close this window Newborn Tory S2210 User Manual 74 Appendix 8 On UNI menu bar click again Monitors gt Configuration 9 Write down the Controller Name and Port number 10 Start the Gaumard Monitors software on th
54. terface opens up showing the quick launch page for the scenarios This page is used to readily access the preprogrammed scenarios saved on each profile System and Clinical Condition The scenarios are categorized by system clinical condition as shown on the left of this page i e Respiratory Ear Nose Throat would be a system and Asphyxia Pneumothorax etc would be the clinical conditions Select the scenario type as show below Notice that one or more scenario types can be selected at one time and the list of scenarios on the right will display only the scenarios included on the selected categories Selecting the Scenario 1 Click on one of the sce narios listed to highlight it and the scenario can be started immediately or loaded Newborn Tory S2210 User Manual 38 Working with UNI 2 Click on the drop down arrow to the right to read a scenario description Clicking Start Scenario loads the appropriate scenario and starts playing it without the user having to do anything else with the control computer Favorites Favorites is a feature added to the quick launch program This feature allows users to reduce the number of scenarios highlighted to those within the categories that will be used most frequently Enable the Favorites feature by click ing the start icon Select the systems and clinical condit
55. the Apply panel After the list of changes is created click NOW to update the vital signs instantly Alternatively click a trending time to update numerical vital sign parameters e g heart rate blood pressure gradually Vital signs can be edited by clicking on the specific parameter Newborn Tory S2210 User Manual 42 Working with UNI Also use the edit and remove tabs to edit a new parameter or remove an existing one Notice that until the Apply option is selected the vital signs in the Status Details panel will not reflect the new changes Enable the Instant Apply option and click the control to change the vital sign to a new value without the need to use the Apply panel Vital signs under going change blink in yellow Creating Palette Items A palette item stores one or more vital 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 using the details controls and click Save Enter a name for the palette a description and choose a color code Click Save to create the new palette Item Palette items are stored in the active profile Newborn Tory S2210 User Manual Workin
56. tion PAGE 1 Alice s Baby Normal Healthy 50 2 Asphyxia Respiratory Asphyxia 51 3 Beth s Donna s Baby Respiratory Asphyxia 52 4 Cynthia s Baby Respiratory Pneumothorax 53 5 Elaine s Baby Respiratory Asphyxia 54 6 Francine s Baby Cesarian Delivery 55 7 Gloria s Baby Respiratory Failure Asphyxia 56 8 Helen s Irene s Baby Respiratory Asphyxia 57 9 MAS Meconium Aspiration Syndrome 58 10 RDS Respiratory Distress Syndrome 59 11 TTN Transient Tachypnea of Newborn 60 Newborn Tory S2210 User Manual Labor Scenarios 49 Automatic Mode Meds Profile Automatic Linear 1 Adenosine OD 2 Adenosine SD 3 Adenosine UD Quick Start Newborn Modeling Automatic Linear 1 Variations A 2 Uterine Rupture A 3 Shoulder Dystocia A 4 Preeclampsia A 5 Healthy Baby B Baby was delivered SVD and is fairly vigorous 6 Healthy Baby A It is vigorous and earns good APGAR 7 Faye baby 8 Embolism Baby A Quick Start Newborn Modeling Automatic Branching 1 Variations branching Newborn Tory S2210 User Manual 50 Labor Scenarios Scenario 1 Alice s Baby Newborn Tory Healthy Baby Newborn HAL Alice s Baby Healthy baby NSR HR 140 BP 85 61 RR 30 O2 Sat 80 UA Sound none Crying Reduced Muscle Tone Stops crying Immediate Transition O2 Sat 95 Transition Time 30 sec End Apply suc
57. tion and O2 Wait Indefinitely for actions A 2 P 2 G 2 A 1 R 2 9 Newborn Tory S2210 User Manual Labor Scenarios 51 Scenario 2 Asphyxia Newborn Tory Baby has an asphyxia attack and the providers need to give ventilations to help bring back the vitals to a healthy state Newborn HAL Asphyxia Baby has an asphyxia attack and the providers need to give ventilations to help bring back the vitals to a healthy state Crying none NSR HR 140 RR 40 BP 83 54 O2 Sat 95 HR 20 BP 20 O2 Sat 80 Transition Time 30 sec Muscle Tone limp RR 0 O2 Sat 70 HR 55 BP 35 20 Transition Time 30 sec Ventilate and perform chest compressions Wait indefinitely for actions HR 140 BP 83 54 RR 40 O2 Sat 95 Transition Time 1 min End Apply suction and O2 Wait indefinitely for actions A 0 P 2 G 0 A 2 R 2 6 A 2 P 2 G 2 A 2 R 2 10 Newborn Tory S2210 User Manual 52 Labor Scenarios Scenario 3 Beth s Donna s Baby Newborn Tory Baby is born with a mild asphyxia that needs attention Once ventilations are started the baby s vitals go to a healthy state Newborn HAL 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 Crying none RR 0 O2 Sat 80 HR 80 BP 45 30 Begin PPV Wait Indefinitely for action
58. 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 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
59. tor as per Calibration section Wrong placement of BP Cuff See correct cuff placement under section Circulation No brachial pulse Brachial pulses are disabled Enable the radial pulses using the details controls Blood pressure values require calibration Refer to digital UNI User Guide un der Menu gt Help gt Instruction Manual to recalibrate the blood pressure Newborn Tory S2210 User Manual Appendix 69 Preprogrammed scenarios are not available Incorrect profile is loaded Load the Quick Start Newborn Tory profile To switch between profiles without exiting the software Click File gt Profile on the menu bar The simulator s audible features heart lung Korotkoff etc are low or cannot be heard at all Audio feature volume is set to mute or low Adjust the volume levels on the status panel Virtual Monitor Connection Issues Vital signs are flatlined or not updating PC and virtual monitor are not connected to the wireless network Tablet only Exit the UNI software and the Gaumard Monitors software and connect to the GaumardNet network Restart the Gaumard software PRO only Exit the UNI software and the Gaumard Monitors software and connect to the PRO network Restart the Gaumard software Newborn Tory S2210 User Manual 70 Appendix UNI is not broadcasting the vital signs information Tablet only From
60. ts in neonatal death Newborn HAL 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 Muscle Tone active Crying none HR 80 BP 45 30 RR 0 O2 Sat 80 Begin PPV Wait Indefinitely for action Muscle Tone limp HR 50 BP 35 20 RR 0 O2 Sat 70 Transition Time 30 sec Begin PPV and chest compressions Wait Indefinitely for action HR 30 Transition Time 30 sec Asystole Immediate Transition End Administer Epinephrine Wait Indefinitely for action Baby appears cyanotic Suction has already been applied and O2 is being administered A 0 P 1 G 1 A 2 R 0 4 Newborn Tory S2210 User Manual Labor Scenarios 57 Scenario 8 Helen s Irene s Baby Newborn Tory The 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 Newborn HAL 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 Crying none HR 30 BP 35 20 RR 0 O2 Sat 70 Muscle Tone Limp Begin PPV Compressions and Epinephrine Wait Indefinitely for actions HR 160 BP 75 54 RR 45 O2 Sat 92 Transition Time 1 min Muscle Tone Reduced HR 135
61. tubation Unilateral chest rise with right main stem intubation Multiple upper airway sounds synchronized with breathing Breathing Automatic chest rise is synchronized with respiratory patterns Independent left and right lung sounds synchronized with breathing Ventilation may be assisted using BVM ETT or LMA Ventilations are measured and logged Chest compressions generate palpable blood pressure wave form and ECG artifacts Newborn Tory S2210 User Manual 6 Introduction Detection and logging of ventilations and compressions Simulated spontaneous breathing Variable respiratory rates and inspiratory expiratory ratios Bilateral chest rise and fall Normal and abnormal breath sounds Anterior auscultation sites Real CO2 exhalation using replaceable cartridge Cardiac ECGs are generated in real time with physiologic variations never repeating textbook patterns Heart sounds may be auscultated and are synchronized with ECG Heart sounds include a normal heart as well as atrial and ventricular septal defects Circulation Measure blood pressure by palpation or auscultation in the right arm Use modified BP cuff to measure blood pressure Korotkoff sounds audible between systolic and diastolic pressures Pulse sites synchronized with BP and heart rate Bilateral IV
62. ture using UNI software 1 Click Menu gt Setup gt Calibration gt Blood pressure and click Next 2 Set the pressure on the BP cuff to 0 i e cuff valve open as prompted by the calibration wizard 3 Click the OK button to record the current cuff pressure A green filled oval indicates the pressure was recorded successfully Newborn Tory S2210 User Manual 26 Working with Newborn Tory 4 Set the pressure on the BP cuff to 20 mmHg as prompted by the wizard and then Click OK to record 5 Continue increasing the BP cuff pressure as indicated by the prompt until the pressure of 300mmHG is recorded 6 At the end of the calibration wizard click Finish to close IV Arms Bilateral IV training arms allow simulator s intravenous infusions as well as drawing fluids Do not attempt to fill IV system without the drain connector in place Always leave the drain port connected when injecting fluids into the system 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 Always flush the IV system with distilled water at the end of every simulation Filling the Vasculature 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

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Newborn Tory™ S2210