Home

User Guide

1. Headphone jack Used to plug in headphones or an iPhone compatible headphone microphone combination Microphone jack Used to plug in a standalone microphone Red power light Indicates when the unit is powered on by blinking Also indicates when the Mute button is activated by solidly staying on Green connection light Indicates an RF link connection between the handset and base station by blinking Green connection light Figure 3 WVL Front View The following features are located on the side of the WVL devices Battery compartment Houses two AAA batteries and the DIP switch DC power jack Accommodates a 5VDC 0 2A power source e ON OFF switch Turns WVL handset power on or off Lineout jack Connects the WVL to the simulator s audio amplifier Volume mute dial Controls microphone gain and microphone mute on the handset See Special Handset Settings on page B 10 warm compartment FC BV 02A CHEG c i LINER 4 a uj Lio OUT CE A a A Volume mute dial Handset ON OFF switch Kk Volume mute dial Base Station On the WVL handset the volume mute dial controls the microphone volume or mutes the microphone See Special Handset Settings on page B 10 Figure 4 WVL Side View On the WVL base station the dial serves as the volume control for the speakers inside the simulator Moving the dial toward the plus sign increases the volume Moving the dial toward th
2. 140 Using TouchPro 3 Click the empty waveform field The Wave Vital Selection menu appears Wave Vital Selection ECG I ECG II ECG III ECG V1 ECG V2 ECG V3 ECG V4 ECG V5 ECG V6 ECG aVL ECG aVR ECG aVF ABP PAP CVP Pleth Capnogram Blank Set Alarm Set Color Set Scale J The Wave Vital Selection Menu 4 Select the desired waveform from the Wave Vital Selection menu The new waveform is reflected on the screen 141 Using TouchPro METIman Adding a Numeric Display The TouchPro software contains four numeric display fields All four numeric display fields are located on one row beneath the waveform displays When fewer than four numeric readouts are being displayed the remaining fields are blank To add a numeric to a blank display field 1 Click a blank numeric display field HR iin EN PEN EE FPEM PEE PES TEN EN TUN ES 7X o aes teu essc ue t as eco Aunt scade 104 A blank numeric field The TouchPro Display The Numeric Vital Selection menu appears Numeric Vital Selection ABP TAxial TBlood TBody CVP C O EtCO2 HR ICP MAP NIBP PaCO2 PACO2 PaO2 PAO2 PCWP PAP Pulse Set Color The Numeric Vital Selection Menu 2 Select the desired numeric The new numeric vital display is reflected on the screen 142 Using TouchPro Moving a Waveform or Numeric Display Waveforms and numerics can be moved on the screen to suit the user s needs
3. 5 Enter a name for the new Patient in the Enter the new patient name field 6 Click Save The new Patient is saved and available for selection from the Base Patients Library when creating a new SCE 76 CAE Healthcare Using Muse Resetting a Patient Resetting a Patient brings the Patient back to its original physiological state before any scenarios were applied or modifications were made Any running scenarios are paused However the SCE time is unaffected Additionally the reset appears in the Event Logs NOTE If baseline physiology settings have been selected they are removed when the Patient is reset To reset a Patient 1 While running an SCE click Patient at the bottom of the Run screen The Patient Button The Patient pop up menu appears The Reset button The Patient Pop Up Menu 2 Click Reset The Reset the Patient dialog box appears stating that the patient s physiology will be reset to its state at load time and all running scenarios will be paused Reset the Patient This will reset the patient to the physiology at load time and pause all currently running Scenarios The Reset button The Reset the Patient Dialog Box 3 Click Reset The Patient returns to its original physiological state at the Start of the SCE 4 To resume any paused scenarios click the loaded scenario on the left side of the screen The Scenario Management pop up menu appears 5 From the Scenario
4. CAE Healthcare Appendix A Parameter Descriptions Heart Sounds Normal and abnormal heart sounds are selected using this parameter Heart sounds are synchronized with the cardiac cycle Heart Sounds Default Normal NOTE The volume control slider may be used to adjust the amplitude of the sound A 21 Appendix A Parameter Descriptions METIman Speech Sounds Speech Sounds include a male or female voice based on the gender of the active patient that can utter pain rating indicators from 0 to 10 various phrases and a series of other utterances Unlike Vocal Sounds Speech Sounds only play once Speech Sounds To play a Speech Sound click the Speech balloon A list of Soeech Sounds appears Select the desired sound The sound plays once and the list disappears To replay the last sound click the Play button in the Speech balloon A 22 CAE Healthcare Appendix A Parameter Descriptions Throat Sounds The Stridor throat sounds option from the simulator is selected using the Throat Sounds parameter The stridor is synchronized with ventilation of both lungs Default None NOTE The volume control slider may be used to adjust the amplitude of the sound A 23 Appendix A Parameter Descriptions METIman Vocal Sounds To have the simulator emit the various vocal sounds select the one desired It immediately begins to play in a continuous loop until None is selected A variety of programmabl
5. 3 Assign the user to a group by selecting a group from the Group menu NOTE A user can only be assigned to one group 4 Click Create The new user is created and the New Account Creation panel disappears Editing a User To edit a user s information or privileges 1 On the User Accounts panel select the user to edit 2 Click Edit The user fields become editable 3 Make the desired changes 4 Click Save Deleting a User To permanently delete a user from the User Accounts panel select a user and click Delete When the User Deletion Warning box appears click Yes The user account and the data associated with it are deleted However the administrative user deleting the account becomes the owner of any SCEs scenarios or patients created by the user being deleted i e the SCEs scenarios and patients created by the deleted user are moved to the deleting user s account 122 J CAE Healthcare Using Muse Groups Users are assigned to groups to define access privileges To access the Groups panel from the System Administration screen click Groups The Groups panel appears Content Management User Accounts Groups Maintenance System Settings The Groups tab Groups Privileges Administrators 000 Educators Deactivated Users The Groups panel The New button The Delete button The Save button The Groups Panel NOTE Groups functions are available only to users with the User Management or System Man
6. METIman Optional Prepare the Bleeding System ONLY distilled water or distilled water containing food coloring should be used with the secretion system A mixture of no more than 29 mL 1 oz red food coloring with 3 8 liters 1 gallon of distilled water should be used to create simulated blood The blood mixture should be created in advance in a separate distilled water container NOTE The higher the ratio of food coloring the greater the possibility of staining Using the Trauma Fill Tank The Trauma Fill Tank is used to fill the on board blood reservoir CAUTIONS and WARNINGS Carefully follow all instructions for using the Trauma Fill Tank Pay particular attention to the following cautions and warnings e ALWAYS read and follow instructions for creating trauma fluids e g blood e ALWAYS protect eyes skin and clothing against accidental exposure e After use ALWAYS release pressure and clean the tank e ALWAYS release tank pressure before servicing e DO NOT modify the tank or any assembly component e DO NOT store liquids in the tank e NEVER transport or ship in a pressurized and or full state e NEVER leave a pressurized tank unattended e NEVER fill the tank with more than 6 liters 1 6 gallons of fluid e NEVER exceed 35 strokes while pressurizing the tank 3 CAE Healthcare Setup Attaching the Overflow Bottle to the Trauma Fill Tank Assembly The overflow bottle is used to collect overflow w
7. Step 5 Access the Software from the TouchPro Computer a On the TouchPro computer launch the web browser e g Safari b Enter the IP address obtained in Step 2 into the browser s address field The M se Start screen appears The M se Start Screen The TouchPro software can now be launched OPTIONAL From your web browser a bookmark can be created on the TouchPro computer for ease of access to the M se or TouchPro software Please consult your web browser s help menu for aid in creating a bookmark IMPORTANT The Instructor Workstation MUST remain on and connected to the METIman network for the TouchPro computer to be able to operate 40 CAE Healthcare Using Muse USING MUSE The Muse software is a browser based application that can communicate directly with the simulator With the software users can run SCEs create scenarios and SCEs import and export educational content and perform administrative functions NOTE For optimal Muse performance no other software programs should be open while Muse is running IMPORTANT Only one Muse application window or tab and one TouchPro window or tab can be used per Instructor Workstation at a time IMPORTANT Do NOT use any of the browser s navigational tools i e back and forward buttons while operating M se Starting the Application Once the simulator is powered on and the Instructor Workstation is connected to the simulator network the M se software
8. To connect the air hose 1 Connect the External Compressed Air Kit to a CAE Healthcare compressor using the Quick Coupler attached to the regulator Other compressed air sources have their own adapters Locate the adapter for your compressed air source 2 Connect the other end of the External Compressed Air Kit to the EXTERNAL AIR port on the left shoulder The EXTERNAL AIR port METIman Prehospital s Left Shoulder The EXTERNAL AIR port METIman Nursing s Left Shoulder 24 CAE Healthcare Setup Optional Insert the CO Canister Prehospital Only Some SCEs include the simulation of CO exhalation The following instructions show how to safely connect the CO canister to the simulator WARNING Careful handling including the use of eye protection is required when using CO canisters Please read and understand all the important cautions and warnings on removing canisters as well as safety steps that must be used when handling CO canisters Use of CO Canisters e Store the CO canisters in a dry location between 32 and 104 F 0 to 40 C e Do not expose the CO canister to heat above 140 F as rupture may occur e Never point the CO canister toward your face or someone nearby e Use only CAE Healthcare specified CO canisters Do not remove the canister from the regulator base until empty The canister end is punctured when screwed into the regulator base e Never ship the CO canist
9. To move a waveform or numeric click the desired waveform or numeric and drag and drop the display to a desired location A dragged waveform The TouchPro Display 143 Using TouchPro METIman Saving a Layout Once a layout has been configured it can be saved and reused To save a layout 1 Ensure the desired waveforms and numerics are in place 2 Click Settings The Settings menu appears 3 Click Save As The Save Layout window appears 4 Inthe Save Layout window in the Layout Name field enter a name for the layout Layout Name New Layout The Layout Name field The Save Layout Window 5 Click Save 6 Click the Close button to exit the Settings menu Saved layouts can be deleted from the Settings menu by dragging and dropping them in the Trash NOTE When a layout is saved it is available for use only with the current SCE To enable the layout for use with any other SCE enable the layout from the TouchPro Setup panel for the desired SCE 144 Using TouchPro Sounds All sounds can be silenced by clicking the Mute button in the bottom left corner of the TouchPro display cS The Mute Button To set up the audio for the TouchPro from the Settings menu click Audio Setup Audio Setup Pleth SpO2 ECG Art The Audio Setup Menu From the Audio Setup window select a waveform to set it as the pulse sound Once a waveform is selected the Audio Setup window aut
10. Use the TouchPro Setup link to access the TouchPro Setup panel From the TouchPro Setup panel TouchPro layouts can be enabled or disabled for the selected SCE When a layout is enabled it is available to be used in the TouchPro software with the selected SCE When a layout is disabled it is unavailable to be used in the TouchPro software with this SCE Click the On Off switch next to a layout to enable or disable it Lnd TouchPro Pre selected Layout O The On Off switch EMS ED Telemetry ICU Arterial Line Only ICU OR NO CVP ICU OR The TouchPro Setup Panel 89 Using M se METIman Patient Status Display To configure the Patient Status Display displayed on the Run screen click Patient Status Display under the SCE Configuration heading on the SCE Editor The Patient Status Display screen appears Patient Status Display Available Widgets The Available Widgets panel Patient Status Display spaces The Patient Status Display Screen To modify the Patient Status Display drag and drop the desired waveform numeric or volume widgets from the Available Widgets panel to an available Patient Status Display space NOTE Waveforms occupy two spaces Once the desired widget is placed click the widget to change the physiologic parameter displayed 90 CAE Healthcare Using Muse Adding a Scenario from the SCE Editor SCEs incorporate scenarios that contain preprogrammed
11. e KEEP all original shipping materials including BOXES warranty and repair items must be return shipped to CAE Healthcare in their original packaging When unpacking METIman for the first time careful use of a box cutter protects both the packaging and the product A Setup Map included with the unit covers these same steps in abbreviated fashion CAE Healthcare Setup Step 1 Place METIman in the Work Area Select a work area with enough room for all equipment providing ample space for easy access to the simulator At a least 10 x 12 3 meter x 4 meter work area is recommended for movement and positioning of components around the simulator Positioning METIman METIman and the Laptop or Tablet Instructor Workstation can be operated from their batteries allowing for wireless use In a lab environment make sure a multi plug AC power outlet exists within the workspace to recharge the simulator s battery and its powered components Before placing the simulator on a surface be certain the surface can easily support 200 pounds NEVER lift the simulator by the LIMBS When lifting be sure to support the torso and head of the simulator while lifting 15 Setup METIman Step 2 Connect the Lower Legs to METIman NOTE Use extreme care when handling the sensor cables and pulse tubes NEVER let a leg hang off a surface without the locking pin securely in place Doing so can seriously damage the sensor cables and pulse
12. 4 Refresh the screen by clicking the Home button in the Muse software and then return to the Learning Modules panel The learning application appears on the Learning Modules panel and is available for use To delete a learning application from Muse 1 Select a learning application from the Learning Applications panel 2 Click the Remove button The Remove Learning Module warning appears Remove the Learning Module The associated SCEs and scenarios will be removed The Remove Learning Module Warning 3 Click Delete The learning application and all its SCEs are deleted NOTE Preconfigured learning applications cannot be deleted If a user attempts to delete them a failure message appears 115 Using M se METIman SCEs From the Content Management options click SCEs to access the SCEs panel The SCEs panel appears The SCEs link The Import SCEs button The SCEs Panel All user created SCEs are listed in the SCEs panel On the SCEs panel users can review copy delete import and export the SCEs they have created NOTE SCEs purchased from CAE Healthcare CANNOT be exported Click Import SCE to import an SCE from an external device or the hard drive location where the SCE file is saved Click Export to export an SCE to an external device The SCE file extension is sce 116 CAE Healthcare Using Muse Base Patients From the Content Management options click Base Patients to access the
13. Body Temperature EMS ED Telemetry preconfigured with a waveform and numeric readout for ECG Lead II and numeric readouts for SpO and noninvasive blood pressure NIBP ICU OR No CVP preconfigured with waveform and numeric readouts for ECG Lead II ECG Lead V ABP PAP and Pleth and numeric readouts for NIBP Thermodilution C O Blood Temperature and Body Temperature ICU OR preconfigured with waveform and numeric readouts for ECG Lead ll ECG Lead V ABP PAP CVP and Pleth and numeric readouts for NIBP Thermodilution C O Blood Temperature and Body Temperature Saturation Pulse preconfigured with numeric readouts for SpO and pulse 137 Using TouchPro METIman To select a preconfigured layout click Settings select the layout from the Layouts panel and click the Close Settings button The Close Settings button The Layouts panel ICU Arterial Line Only ICU OR NO CVP ICU OR a Saturation Pulse G Save Layout 7 Audio Setup NIBP Cycling fi Patients fm About ape The TouchPro Settings Menu NOTE Preconfigured layouts must be enabled in the M se TouchPro Setup for the currently running SCE to be accessible in the Layouts panel For more infomation about enabling preconfigured layouts see Modifying the TouchPro Setup on page 89 138 Using TouchPro Changing a Waveform or Numeric Display Waveforms and numeric displays can be changed to suit the user s
14. Physiology and and Scenarios Clinical Signs Spontaneous Normal tidal breathing and pathophysiological None required but None required Breathing conditions such as atelectasis pneumothorax adjustable asthma and COPD VIEW Respiratory Exhaled CO Measure the presence or absence of CO during None required CO canister is Prehospital only positive pressure ventilation inserted Pneumothoraxor Increase in intrapleural volume leading to None required but None required Hemothorax asymmetrical breathing adjustable VIEW Respiratory CONTROL Intrapleural Volume Left or Right Chest Excursion Synchronized with ventilation spontaneous or None required None required positive pressure ventilation Excursion depth proportional to tidal volume Breath Sounds Normal and abnormal breath sounds are None required but None required independently synchronized with ventilation of adjustable the right and left lungs Breath sounds can be auscultated over anterior and posterior anatomic VIEW Sounds locations Bronchial Completely obstructs right and or left mainstem VIEW Respiratory None required Occlusion bronchi simulating a lower airway obstruction e g mucus plug This yields an inability to ventilate the lungs and asymmetric chest excursion Pulse Oximetry Oxyhemoglobin saturation SpO automatically None required but SpO probe is correlates with the oxygen concentration in the adjustable attached
15. SaveState Done Clear The Event Recorder 74 CAE Healthcare Using Muse b Click the Delete button next to each event to be removed The events are removed from the Event Recorder c Click Done The Delete buttons are hidden 4 Click Save State The New State Name window appears New State Name T a The Save button The New State Name Window 5 Enter a state name 6 Click Save The state is saved to the State Library and can be accessed via the Scenario Designer For more information about the State Library see Saving States to the State Library on page 109 75 Using M se METIman Creating a New Patient When an additional patient with specific physiological characteristics is needed for repeated use a new patient can be created from the Run screen To create a new Patient 1 From the Home page run an SCE that has a Patient with the same gender as the Patient to be created 2 From the Run screen apply the desired conditions and set the necessary parameters 3 Once complete click the Patient button at the bottom of the Run screen The Patient Button The Patient pop up menu appears The Save button The Patient Pop Up Menu 4 Click Save The Save a copy of the Patient dialog box appears Save a copy of the Patient The Enter the Saves this patient s current physiologic state new patient The Save button The Save a Copy of the Patient Dialog Box
16. The Profile Editor 2 Set the Patient s name age gender and weight by filling in the appropriate fields 3 Click the Change Picture button to change the patient s picture optional 4 Click Save IMPORTANT No part of the patient s profile can contain any special characters such as V gt 85 Using M se METIman Setting a Patient s Baseline To set the Patient s Baseline 1 From the SCE Editor click Baseline The Baseline button The SCE Editor Screen The Patient Baseline screen appears The Complete button The Patient Baseline Screen 2 Set the Patient s baseline physiology by modifying the desired parameters 3 Click Complete When the SCE begins the Patient presents with the selected baseline settings 86 CAE Healthcare Using Muse Content Management SCE Content is entered from the SCE Editor using the Overview Background Preparation and Notes buttons under the Content Management heading Content Management Overview Background Preparation Notes The Content Management Buttons Each button accesses a screen that allows users to enter information for the chosen section Overview Background Preparation or Notes Click the Edit button of each section on the SCE Editor to access a rich text editor that enables data entry IMPORTANT Text can be copied and pasted into the fields from TextEdit or Notepad only Jma Faaa E The Rich Text Ed
17. To print from the Instructor Workstation consult your network administrator for assistance connecting to a printer 4 When finished saving or printing the PDF close the browser window containing the PDF to return to M se CAE Healthcare Using Muse Running an SCE To run an SCE from the Home screen select an SCE and click the Run button The Run screen can also be accessed from the Scenario Designer or SCE Editor by clicking the Run button near the top of the screen The Run Button The Run screen appears Patient Records The Stop button SCE time controls Physiological display widgets Condition Medications and Interventions palettes Scenarios va Event Logs A The Event Recorder The Run Screen From the Run screen users can manage the SCE perform interventions view physiological status and events save events as states save the Patient and associate records with the Patient 51 METIman Using M se Using the Patient Status Display On the Run screen there are widgets that display the patient s physiological status The Patient Status Display widgets can be changed to reflect the user s needs There are six available display spaces for the widgets Waveform widgets utilize two display spaces Patient 5tatus Display The Setup button E The Mute All EPN e d i 1 LN Ht E ai z button Widgets br min The Patient Status Display Widgets Use th
18. appropriate food coloring if desired to the IV FILL port on METIman s right shoulder and firmly inject all 60 mL This primes the arms and charges the system for Flashback and Venipuncture support WARNING If a flash does NOT occur do NOT inject any fluid and remove the needle immediately Repeat the priming directions and ensure you have injected the needle properly and into the simulated vein METIman s Right Shoulder Fluids and medications can be administered intravenously Approximately 50 mL of fluid may be infused To support infusion of larger volumes connect an empty IV bag or other receptacle to the IV DRAIN port located on METIman right shoulder NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal 185 Using METIman METIman Fluids METIman is capable of bleeding simultaneously at two sites from an internal tank Arterial and venous bleeding can be simulated Venous settings produce a continuous bleed at three user adjustable flow rates Arterial settings produce a pulsing flow synchronized with the cardiac cycle at three user adjustable flow rates The flow rate is determined by the selected bleeding vessel size and the blood pressure In addition the simulator features auto sensing of hemorrhage control e g tourniquet application or direct pressure Bleeding results in an automatic loss of blood from the ph
19. then Click the DECLINE button below and your access to the Software and Data is prohibited 1 DEFINITIONS AND INTERPRETATION 1 1 The preamble forms an integral part of this License 12 Terms with a capital letter defined in the Preamble have the meaning indicated in the Preamble Whenever used in this License the following terms have the meaning set out below a Confidential Information means any and all scientific and technical information which is in the possession of or belonging to CAE Healthcare and relating to the Product including without limitation all Data Software trade secrets know how processes methodologies samples components analyses compilations guides and other information or documents prepared by CAE Healthcare its subsidiaries and affiliates and or their officers servants agents representatives employees or advisers which contain or are otherwise generated from or reflect any CAE Healthcare proprietary information whether or not covered by intellectual property rights or explicitly designated as confidential or proprietary which is disclosed by any means in written oral electronic or any other form b Purpose means the use of the Software and the Data solely for the operation and maintenance of the Product and the use of the Product solely as an educational tool 2 LICENSE 2 1 In consideration of Licensee s agreement and compliance with the terms and conditions contained in the HEPGTC and
20. 15 mp 1o dose options 70 mg IO 5 mg IM 10 mg IM The Medication Dose Menu 64 CAE Healthcare Using Muse 4 Select a dose option This can be done one of two ways a Choose a pre defined dose Morphine Intramuscular IM Intravenous IV Intraosseous IO 1 mq IV 2 5 mg IV 5 mg IV 10 mq IV 15 mg IV BowgN E an The 5 mg 10 predefined dose options 10 mg 10 15 mg 10 20 mg IO 5 mg IM 10 mo IM The Medication Dose Menu The dose is applied and appears in the patient s physiology OR b Choose a route of administration to administer a custom dose O Morphine Intramuscular IM The custom dose options Intranssenus ICH L mg ly 2 5 mg TV 5 mg iv 10 mg Iv 15 mg IV 20 mg IV mg TO 2 5 mug IO 5 mg 10 10 mg IO 15 mg IO 20 mq IO 5 mg 1M 10 mq TM The Medication Dose Menu 65 Using M se METIman The Custom Dose Administration menu appears Morphine Intravenous Tv The Administer button The Custom Dose Administration Menu 5 Enter the desired dose and click the Administer button The dose is applied and appears in the patient s physiology NOTE Not all medications affect the patient s physiology but all are logged 66 CAE Healthcare Using Muse Using the Interventions Palette There are two ways to perform and or administer interventions using the Interventions palett
21. 4 Attach the blood pressure adapter to the connectors An Attached Blood Pressure Cuff Adapter 177 Using METIman METIman To get a blood pressure reading connect the extension from the T fitting on the blood pressure cuff adapter to either of the NIBP ports on METIman s left and right shoulders NIBP LEFT port o 9 METIman Prehospital s Left Shoulder METIman s Right Shoulder 178 CAE Healthcare Using METIman Connect the T fitting extension to the hose Take the non invasive blood pressure reading using the return to flow technique Attached Blood Pressure Cuff At appropriate cuff pressures Korotkoff sounds are produced and the radial pulse disappears 179 180 Using METIman METIman Heart Rate To manually adjust the heart rate from the Cardiovascular view click Heart Rate Set the rate by dragging the arrow up or down Click Accept to exit and save the changes The switch is now orange indicating a change has been made To return to the programmed physiologic model click the switch and turn the Override switch to Modeled Five Lead ECG On METIman a 5 lead ECG is emitted from the appropriate positions for display on a standard monitor A contact is available on METIman s chest for each of the five cables Five Lead ECG sites 5 Lead ECG Sites The simulator generates a normal sinus ECG as well as a broad range of abnormalities such as myocardial ischemia sinus tachy
22. 5562 or 866 233 6384 For customer service please contact CAE Healthcare Customer Service Headquarters United States and Latin America Monday Friday from 7 00 a m to 6 00 p m ET Phone 1 866 462 7920 Email customerservice caehealthcare com Customer Service Canada Monday Friday from 8 00 a m to 5 00 p m ET Phone 1 877 223 6273 Email can servicegcaehealthcare com Customer Service Europe Middle East Africa India Asia and Australia Monday Friday from 8 00 a m to 5 00 p m CET Phone 449 0 6131 4950354 Email international service caehealthcare com Customer Service United Kingdom and lreland Monday Friday from 9 00 a m to 5 00 p m GMT Phone 44 0 800 917 1851 Email uk servicegcaehealthcare com 2013 CAE Healthcare 165K360000 v 2 1
23. Anaphylaxis Mild Anaphylaxis Moderate Anaphylaxis Severe Anaphylaxis Epinephrine Administered Condition Improves The Jump to State Menu 4 Select the desired state The scenario transitions to the selected state and the state is highlighted on the Scenario screen NOTE Double click on the states to expand to the full view 5 Click the Close Window button to return to the Run screen SCE Time Controls The SCE time controls are located at the top of the Run screen The Fast Forward The Timeline bar button Ihe Pause button The Play The Bookmark button button 00 00 29 y Bookmark The SCE Time Controls The Timeline bar shows the amount of time that has elapsed and bookmarks that have been created The Bookmark button creates a bookmark at the current point in the SCE The bookmark can be used later to return to this point in the SCE resetting the patient s physiology to what it was when the bookmark was created The Play button starts the SCE if it has been paused The Pause button pauses the SCE time The Fast Forward button accelerates the SCE time at a 4 1 ratio 72 CAE Healthcare Using Muse Using Bookmarks To create a bookmark click the Bookmark button An orange bookmark appears on the Timeline bar A bookmark The Timeline bar The Bookmark button 00 02 14 n F Bookmark 5 Q Qo The SCE Time Controls To return to a bookmarked time in the SCE 1 Click the orange
24. Base Patients panel The Base Patients panel appears The Base Patients link The Import Patient button The Base Patients Panel All Patients are listed in the Base Patients panel From the Base Patients panel users can rename review delete and export Patients they have created by clicking the respective buttons next to each Patient Click Import Patient to import a Patient file from an external device or the hard drive location where the SCE file is saved Click Export to export a Patient file to an external device The Patient file extension is pat NOTE Preconfigured CAE Healthcare Base Patients CANNOT be exported 117 Using M se METIman Scenarios From the Content Management options click Scenarios to access the Scenarios panel The Scenarios panel appears Learning Modules SCIES Base Patients The Scenarios link The Create The Import New Scenario Scenario button button The Scenarios Panel All Scenarios are listed in the Scenarios panel From the Scenarios panel users can rename review delete import and export Scenarios they have created by clicking the respective buttons within each scenario Locked Scenarios can only be reviewed Users can also create new scenarios from the Scenarios screen by clicking the Create New Scenario button Click Import to import a scenario file from an external device or the hard drive location where the SCE file is saved Click Export to exp
25. Exhalation Prehospital Only Whether supplied via a portable canister or from an external source the simulator exhales CO during positive pressure ventilation NOTE An optional regulator kit must be purchased to use CO from an external source To use the CO Exhalation feature connect the CO canister to the CO canister socket or connect the external source on the simulator s right shoulder and METIman Prehospital exhales CO gas There are approximately 15 minutes of CO gas available once the canister is connected CAE Healthcare Using METIman Positive Pressure Ventilation When positive pressure ventilation is administered the process is automatically detected by the simulator and the physiologic model is sensitive to the volume administered Gastric Distention Prehospital Only During esophageal intubation or overly aggressive bag valve mask ventilation gastric distention Occurs Gastric distention is relieved by putting pressure on the abdomen Chest Tube METIman Prehospital METIman Prehospital has the ability to simulate chest tube drainage The Chest Tube sites are located bilaterally in the fifth intercostal space For supported chest tube size see Recommended Clinical Supply Sizes on page 221 Ensure all fluids have been removed from previous uses before each new use to prevent overfilling Please refer to the Care and Maintenance section for directions on fluid removal To simulate continuous chest tube dr
26. FV AC A E E E A E E A T 180 Cardiovascular Interventions Therapy seessseesessseeserssseeeosseeeoesseessossseesonsssererssseroossseerosssnerorssnens 181 Subclavian Catheter Nursing Only ssepe ea REPRE DETUR IEEE PE REEF EER PRU RID 184 Intramuscular MO CUO ROO 184 VESTI uU M 185 Xl 186 XIX Table of Contents METIman GaASthOINTOSUIMAD Me 189 Gastrointestinal Gavage Lavage and Suction Nursing Only sss 189 Genrtouihary ys EOD cao eee o e SO ERES T MEET CORE POA ER A entertain 191 Urinary COTDOUSFIZOELOLL scere PFIRC SEHR UIEEPERIIUERREE DER ETURURE HIVER EUER EPI EESEDUELREONERIV OE REUS er RU YES 191 SHIRE Urine OUI TR IDEEN 192 Changing the Simulator s Genitalia assess sced etico irt esr res amie TREE SEo SEP UH err Po FELER EPIS ets tss 193 IL H 194 ilr CT N 194 MINEO AG SONGS cuoco timebat A A E and nnb A 199 Diea tn OLN cocos ero HEBR HII UMEN NU IM UNE 200 son E 201 WU M 202 Tia Pur T E E E 203 METIma li Warranty Programs ooocceces vri UXORI REREYS UAR RES PO YE FOREN TEX VV CX INE ERU HR S YES EE U SEX XRR VE UE FUHR M 204 General HRS ETE RI LR RI OTRO 204 Units Out of A
27. NOT exceed 80 characters Additionally SCE file names CANNOT contain any special characters suchas lt gt 4 Click Save Once the SCE is saved it is stored and can be edited and reviewed at any time including creating a Patient Profile and content determining settings and programming scenarios 83 Using M se METIman The SCE Editor The SCE Editor can be used to review preconfigured SCEs and to create or edit custom SCEs To access the SCE Editor click the Review button in the SCE Summary Panel or create a new SCE Anaphylaxis The SCE title The Return button The Print button p a A amu The Run button Content A Management sess Patient profile SCE contraton a Preloaded fr iii Scenarios The SCE Editor The buttons in the upper right corner of the SCE Editor provide options for running the SCE generating a printable PDF of the SCE or returning to the Home page The Content Management SCE Configuration and Preloaded Scenario links in the left panel are used to review the SCE content and configuration and to view scenarios applied to the SCE 84 CAE Healthcare Using Muse Editing a Patient s Profile To edit the Patient Profile 1 From the SCE Editor in the Profile section click Edit Gunshot Wound The SCE Editor Screen The Profile Editor appears Stan D Ardman II Stan D Ardman 11 The Change Picture button EE The Save button
28. The Defib parameter is used to simulate a specified amount of energy discharged via an external cardiac defibrillator Setting this parameter results in the characteristic spike in the ECG followed by a return to the pre defibrillation rhythm Defib has no direct effect on the electrical conduction system of the heart Thus synchronized cardioversion may be done on the fly or scripted using the Scenario Designer Default 0 Joules Range 0 Joules 360 Joules Pacing Current The Pacing Current parameter is used to simulate a specified amount of current discharged via an external cardiac pacer Setting this parameter results in the characteristic pacing signal on the ECG waveform when the pacing current is at or above the capture threshold Also see Pacing Capture Threshold Default 0 mA Range 0 mA 200 mA Pacing Rate The Pacing Rate parameter determines the cardiac rate in beats minute when the pacing current is at or above the pacing capture threshold Also see Pacing Current and Pacing Capture Threshold Default 80 beats per minute Range 0 beats per minute 119 beats per minute Appendix A Parameter Descriptions METIman A 14 Pacing Capture Threshold The Pacing Capture Threshold parameter determines the minimum pacing current necessary to pace the heart via an external cardiac pacer Also see Pacing Current Pacing current values below the pacing capture threshold have no effect on the patient s heart rate
29. Trauma Fill Tank and fill with approximately 1 liter of clean distilled water Pump this fluid into the simulator Repeat Steps 3 through 7 and 9 through 15 until the fluid exiting the simulator runs clear Empty the Fill Tank and dry the wound umbilicals with a towel before storage NOTE It takes two to three minutes for this final flush Once a month it is advised to flush the system with a mix of 5096 distilled water and 5096 white vinegar to keep mineral and algae buildup to a minimum Always perform the steps for Flushing the Simulator afterward to remove vinegar 3 CAE Healthcare Care and Maintenance Cleaning the Trauma Fill Tank To prolong the life of the Trauma Fill Tank assembly and the fluid reservoirs wash and flush the tank and connections after each use with clean distilled water NOTE A small bucket is recommended to collect wastewater during cleaning and flushing operations Do NOT store liquids in the Trauma Fill Tank If simulated blood mixtures are stored in the tank they may clog the system when they dry and possibly damage the seals filter and other components 1 Remove and rinse the Overflow Bottle Remove and rinse the Pump Assembly Rinse the tank to remove all traces of the simulated blood JI W N Pour 480 mL 16 oz of distilled water into the tank and reinstall the Pump Assembly The Overflow Bottle holds 16 ounces VI Place the Overflow Bottle lid with umbilical attached
30. amount of fluid into the Chest Tube reservoir 1 Insert the METIman Priming Tube in the Chest Tube site 2 Using a 60 mL syringe filled with clinically appropriate fluids inject the contents into the CHEST TUBE port LEFT or RIGHT until fluid is seen in the METIman Priming Tube Use distilled water only with food coloring if desired 3 Remove the METIman Priming Tube 4 Inject the remaining contents of the syringe into the CHEST TUBE port 5 Remove the syringe Chest Tube and Needle Decompression The Chest Tube and Needle Decompression features can be enabled at the same time on the METIman Prehospital system Intrapleural volume will decrease when both are in use 170 CAE Healthcare Using METIman Chest Tube METIman Nursing METIman Nursing has the ability to simulate chest tube drainage The Chest Tube sites are located bilaterally in the fifth intercostal space For supported chest tube size see Recommended Clinical Supply Sizes on page 221 Ensure all fluids have been removed from previous uses before each new use to prevent overfilling Please refer to the Care and Maintenance section for directions on fluid removal To simulate continuous chest tube drainage 1 Insert the METIman Priming Tube in the Chest Tube site 2 Set up the IV pole near the simulator 3 Fill an IV bag with the clinically appropriate fluid Use distilled water only with food coloring if desired 4 Hang the IV bag on the IV pole 5 En
31. and attach a cand amp oac memor IF mone than 120 secondes ebwprees wielhout adgmrustratun ol epiwephriwe the mrstruxt os shaouki manually advance the SCE to State 2 Mild Anaphylaxis if spmnephriwe is administered the SOF i advanced to State Epinephrine Administered n State 2 Mild Anaphylasis the patient sepernences incrageed rarpiratar busco The Home Page NOTE To activate a fullscreen view in Internet Explorer press F11 to toggle Internet Explorer s fullscreen mode 44 CAE Healthcare Using Muse The SCE Selection Panel SCEs are process tools that enable the facilitator to execute a learning strategy using simulation Preconfigured CAE Healthcare SCEs provide an extensive overview and outline of the learning exercise and require minimal additional faculty development time for use Each SCE is comprised of a patient and up to four scenarios Available SCEs appear in the SCE Selection panel on the Home page The Search button The Clear button The Search field Running Now Recent Favorites Tabs Asthma Attack Norma L Female Food Poisoning Stan D Ardman II C Healthy Adult Female Norma L Female The selected SCE a h Healthy Adult Male Eten R Ardmoan 77 f9n74 AALT Ao SeA eran L D FC PLE W all LHus E US zO L tan D Araman 11 2U11 U3 12 U3 28 14 Base SCEs E Healthy Soldier GI Stan a Hypertensive Patient
32. can be launched To launch the software 1 Using the Laptop or Tablet Instructor Workstation launch the web browser e g Safari Internet Explorer The M se Start Screen appears The M se muse ali TouchPro Patient Monitor Icon The M se Start Screen 2 Select M se 41 Using M se METIman The Login screen appears User Guide Support The Muse Login Screen The links in the bottom left corner of the screen provide access to additional information about the software e Click the About link to access information about the Muse software version the type of simulator and the serial number e Click the User Guide link to download the user guide English version To access the User Guide in other languages please visit www caehealthcare com and click the Support link e Click the Support link for CAE Healthcare Support contact information e Click the globe shaped Language icon in the bottom left corner to change the language of the M se software 42 CAE Healthcare Using Muse 3 On the Login screen enter the Username admin and the Password admin in the appropriate fields to access Muse The Muse Login Fields Muse opens to the Home page by default 43 Using M se METIman Navigating the Home Page From the Home page users can run create edit search for and print SCEs The Home page can be accessed by clicking the Home button in the upper right corner of t
33. from regulator assembly Bleeding and Secretion System DO NOT modify the tank or any assembly component ALWAYS protect eyes skin and clothing against accidental exposure NEVER exceed 35 strokes while pressurizing the tank ALWAYS read and follow instructions for creating trauma fluids e g blood NEVER fill the tank with more than 6 liters 1 6 gallons of fluid After use ALWAYS release pressure and clean the tank DO NOT store liquids in the tank ALWAYS release tank pressure before servicing NEVER transport or ship in a pressurized and or full state or leave a pressurized tank unattended Cautions and Warnings METIman Mannequin e Do not disassemble factory assembled parts of the mannequin Do not clean the mannequin with chemical solvents Use water and a light soap solution only e Make sure that mannequin is set up on a stable sturdy work surface to avoid collapsing and causing injury to users e METIman should be operated in ambient temperatures below 104 F 40 C e Do not introduce foreign substances into the airway with the exception of small amounts of approved lubricant Only perform invasive procedures supported by the system as described in the applicable sections of the User Guide e Do not pick the mannequin up by the limbs support head and leverage weight with torso It may be necessary to have the help of a second person to lift and move METIman Latex Warning CAE Healthcare simulators
34. handling METIman s batteries be sure to adhere to all the cautions and warnings 212 CAE Healthcare Care and Maintenance Recharging should take approximately four hours IMPORTANT Never recharge the battery while it is connected to METIman Draining Condensation from the Simulator As part of a regular preventive maintenance schedule condensation should be drained from the simulator Depending on environmental conditions moisture may condense inside the compressed air lines and tanks within the simulator It is recommended that this fluid be drained every 40 hours of operation In outside high humidity conditions the system should be drained more frequently To drain condensation ie 10 oo OX Se eS e p Locate the Condensation Drain Hose included with the Inventory Kit Condensation Drain Hose Bring the hose and a small bucket to the simulator location Locate the EXTERNAL AIR port on METIman s left shoulder With assistance place METIman into a supine position Power on METIman Do NOT launch the Muse software Allow 60 seconds for the internal compressor to pressurize the system Power down METIman With assistance raise the left leg 45 degrees Place the tubing end of the Condensation Drain Hose into the small bucket and then connect the fitting onto the simulator s drain connector There will be a sudden release of pressure into the bucket Any condensation within the system drains w
35. have the CO canister pointed down toward the rear of the simulator Place the canister regulator and hoses inside the simulator Placing the Canister Regulator and Hoses f Attach the blue CO hose to the connection on the regulator g Carefully reposition the abdominal insert and pull the skin back over the simulator to its original location Once the canister and regulator assembly are in place CO is measurable with a disposable ETCO detector during positive pressure ventilation Based on the training environment a CO canister may last from 10 minutes rapid ventilation to 25 minutes See important Cautions and Instructions for removing transporting and disposing of the CO canisters in the Care and Maintenance section 27 Setup METIman Optional Detach the Arms METIman s arms may be removed for use with trauma scenarios To detach METIman s arms 1 Unscrew and remove the locking pin at the elbow Removing the Locking Pin 2 Carefully separate the lower arm from the upper arm 3 Twist to disconnect the four tubing connectors white Disconnecting the Tubing 28 CAE Healthcare Setup 4 Squeeze to disconnect the three electrical connectors black Disconnecting the Electrical Connectors 5 Place the loose connectors carefully within the upper arm NOTE When replacing arms ensure tubing and electrical connectors are matched using the color coding 29 Setup 30
36. infusion continues To stop the infusion you must select the medication from the medication library and set the infusion rate to zero 79 Using M se METIman Returning to the Home Page To exit the SCE and return to the Home page click the Return button gt Return The Return Button The SCE continues running and the Home page appears To return to the SCE from the Home page click the Continue button in the SCE summary panel of the running SCE a Anaphylaxis mm Print SCE Holly Monroe Wm Print B Age 21 years old dM Add To Favorites Gender Female Weight 70 0 kg Base Norma L Female Overview Your rescue squad responds to a report of a 21 year old female complaining of trouble breathing She was eating dinner at a cookout when she noticed some tightness in her chest The cook came by asking if anyone wanted another shrimp burger She then told him she was allergic to shellfish She was proceeding to her car to retrieve an epinephrine auto injector when a wasp stung her This SCE consists of six states five that manually transition and one State 5 that transitions automatically During the initial assessment in State 1 Beginning Anaphylaxis the patient presents with early signs of anaphylaxis HR in the 90s BP in the 100s 50s RR in the 20s and SpO2 in the low 90s on room air She remains conscious The learner is expected to assess and manage the patient s airway breathing and circulatory status A
37. into the wastewater bucket 6 Attach the fill blue labeled and vent yellow labeled fittings together at the other end of the umbilical 7 Pump the tank 25 times while making sure the wastewater is going into the bucket 8 Allow the tank to empty completely the remaining air pressure will purge the fluid from the lines 9 Reinstall the lid onto the Overflow Bottle and place the bottle back onto the tank assembly 10 Remove the Pump Assembly and pour any remaining fluid out of the tank Then reinstall the pump 11 Disconnect the fill and vent fittings from each other and wrap the Trauma Tank Umbilical around the neck of the tank Always depressurize the tank remove trauma fluid and clean the tank before performing maintenance The pump assembly may need periodic lubrication Call CAE Healthcare Customer Service for details if the pump loses the ability to create pressure squeaks loudly or is difficult to move 215 Care and Maintenance METIman Cleaning the In Line Filter To clean the in line filter 1 Grasp both ends of the in line filter and twist counterclockwise 2 Pull apart both ends of the filter to separate 3 Remove the blue filter cone from the encasement Do NOT remove the black rubber seal 4 Using a 60 mL syringe with distilled water push fluid from the outside of the blue filter cone to the inside removing all debris 5 Repeat process until all debris is removed 6 Re assemble the in l
38. is displayed NOTE Manual NIBP can be used at any time during cycling However this turns off auto cycling 149 Using TouchPro METIman Patients To view the available Patients click the Settings button in the lower right corner of the TouchPro screen The Settings menu appears From the Settings menu click Patients to view the current Patient 1 Patients Stan D Ardman II The Available Patients NOTE When connected to the simulator the TouchPro only displays the active Patient 150 Using TouchPro Configuring the TouchPro Software The background color and alarm suspension time can be set from the TouchPro Configure panel To access the Configure panel 1 Click the Settings button in the bottom right corner of the TouchPro screen The Settings menu appears 2 From the Settings menu click the Configure button The Configure panel appears 3 From the Configure panel set the background color and alarm suspension time Background Color Alarm Suspension Time 20 secs 1 min 5 mins Indefinite The Configure Panel 4 Click the Exit button to exit the Configure panel when finished 151 Using TouchPro METIman Changing the TouchPro Language To change the language of the TouchPro software 1 Click the Settings button in the bottom right corner of the TouchPro screen The Settings menu appears 2 From the Settings menu click the Language Selection button The Lan
39. is enabled unilateral chest excursion is observed during spontaneous breathing or positive pressure ventilation To stop airflow to the bronchi creating a bronchial occlusion the switch for the appropriate side s must be activated From the Respiratory view turn the desired Bronchial Occlusion switch to On Off Bronchial Occlusion Bronchial Occlusion Switch Respiratory Rate To adjust the respiratory rate manually from the Respiratory view click Respiratory Rate The Respiratory Rate slider appears Set the rate by dragging the arrow up or down Click Accept to exit and save the changes The switch is now orange indicating a change has been made To return to the programmed physiologic model click the switch and turn the Override switch to Modeled Respiratory Rate Parameter Pulse Oximetry To adjust the SpO percentage manually from the Respiratory view click SpO The SpO slider appears Set the rate by dragging the arrow up or down Click Accept to exit and save the changes The switch is now orange indicating a change has been made To return to the programmed physiologic model click the switch and turn the Override switch to Modeled SPO2 Modeled SPO2 Parameter The SpO probe is integrated with the TouchPro optional and the physiological model The connection for the SpO probe is located on the left side of the simulator The SpO probe must be connected for pulse oximetry data to be displayed CO
40. lungs and the intrapulmonary shunt fraction Arterial Blood PaO PaCO and pH are continuously calculated None required but None required Gases and the Patient Status Display can be configured adjustable to show them Venous Blood PvO and PvCO are continuously calculated and None required but None required Gases the Patient Status Display can be configured to adjustable show them o CAE Healthcare Using METIman Pulmonary System See Needle Decompression setup Needle Decompression Prehospital Only Needle decompression can be performed bilaterally into a small hole located in the midclavicular line of the second intercostal space For supported needle size see Recommended Clinical Supply Sizes on page 221 To enable the Needle Decompression feature activate the switch for the appropriate side s From the Respiratory view turn the desired Needle Decompression switch to On Needle Decompression Switch Needle Decompression When a needle is inserted in the second intercostal space along the midclavicular line air is released while intrapleural volume is present Needle Decompression and Chest Tube When using the METIman Prehospital system the Needle Decompression and Chest Tube features can be enabled simultaneously Intrapleural volume will decrease when both are in use 167 168 Using METIman METIman Bronchial Occlusion Prehospital Only When bronchial occlusion
41. one of the Quick Links The condition is applied and affects the patient s physiology The Conditions button Conditions Apnea BP Hypertension Quick Links BP Hypotension Heart Rate Bradycardia Heart Rate Tachycardia Patient Stability The Conditions Palette NOTE Quick Links can only be added while creating or editing an SCE 62 CAE Healthcare Using Muse Or to apply a condition that is not set up as a Quick Link in the Conditions palette 1 Click the Conditions button The Conditions menu appears Conditions are organized by system or all available conditions are listed under ALL CONDITIONS Close ALL CONDITIONS Cardiovascular Hemorrhage Neurologic Respiratory The Conditions Menu 2 Navigate the menus to find the desired condition Once the desired condition has been located click the condition s name from the list The condition is applied and affects the patient s physiology Using the Medications Palette There are two ways to administer medications using the Medications palette using a Quick Link or using the Medications menu Quick Links are preconfigured medications that are made accessible in the Medications palette for quick application Quick Links can also be created for the Conditions and Interventions palettes To set parameters using the Quick Links in the Medications palette click a Quick Link The medication is applied and appears in the pa
42. option using a drop down menu or toggle switch In the image below the Needle Decompression parameter is shown The Needle Decompression parameter is set using a discrete parameter switch that toggles between Off and On The Needle Decompression Switch Once the parameter has been set it is reflected in the patient s physiology NOTE Not all changes to parameters affect the patient s physiology but all are logged 61 Using M se METIman Using the Conditions Medications and Interventions Palettes The Conditions Medications and Interventions palettes on the Run screen enable the application of conditions medications and interventions during simulation Once applied conditions are reflected in the patient s physiology and logged All medications and interventions are also logged and most affect the patient s physiology Using the Conditions Palette Conditions are preprogrammed pathophysiological states that use one or more physiological parameters and are designed to enable you to create physiological changes on the fly There are two ways to apply conditions using the Conditions palette using a Quick Link or using the complete Conditions menu Quick Links are preconfigured conditions that are made accessible in the Conditions palette for quick application Quick Links can also be created for the Medications and Interventions palettes To set parameters using the Quick Links in the Conditions palette click
43. over a distance of approximately 4 cm distal to the bifurcation NOTE Use only distilled water with food coloring if desired NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal 163 164 Using METIman METIman Cricothyrotomy Cricothyrotomy can be simulated on METIman Before performing a needle cricothyrotomy the Cricothyrotomy plug must be removed and a 2 25 inch 6 cm length of red tape from the roll provided must be placed over the hole To replicate a needle cricothyrotomy 1 Spray the silicone lubricant onto the airway adjunct prior to the simulation session To prevent damage to the simulator always spray silicone lubricant into the airway 2 Locate the simulated cricothyroid membrane sealed with tape underneath the neck skin 3 Follow standard clinical techniques and palpate to find the cricothyroid space 4 Puncture the space through the neck skin of the patient simulator and into the tape membrane This puncture goes all the way through to the trachea simulating the clinical procedure 5 Users must replace the tape that simulates the cricothyroid membrane after each cricothyrotomy NOTE Replacement components are available in the Inventory Kit NOTE When ventilating through a surgical airway the Laryngospasm feature must be deactivated or the chest rise is not observed NOTE When finished using the C
44. page 112 Displaying Patient Records Patient records can be uploaded to M se and displayed in the TouchPro software while an SCE is running To display an uploaded patient record 1 From the M se Run screen click the Patient Records button The Patient Records Button 54 CAE Healthcare Using M se The Patient Records list appears displaying all available patient records Patient Records Normal Abdominal Ultrasound Patient records The Start Displaying button Start Displaying The Patient Records List 2 Select a patient record from the list 3 Click Start Displaying The patient record is shown in a new TouchPro web browser window IMPORTANT Ensure pop up blocking is turned OFF in the web browser of the Instructor Workstation and any TouchPro workstations Consult the web browser s help menu for assistance NOTE The web browser window containing the patient record may be minimized initially If the window is not readily visible click the web browser icon on the Dock Macintosh Instructor Workstation or Taskbar Windows Instructor Workstation to locate the new window The Patient Records button turns red indicating that a patient record is being displayed The Patient Records Button 55 Using M se METIman The Start Displaying button at the bottom of the Patient Records list changes to a red Stop Displaying button Patient Records Normal Abdominal Ultrasound T
45. record to delete 2 Click Delete The patient record is deleted and is no longer available to display in the TouchPro software Individual patient records can also be previewed renamed or exported by selecting the record and clicking Rename Export or Preview For information about displaying patient records in TouchPro see Displaying Patient Records on page 54 120 CAE Healthcare Using Muse User Accounts To access the User Accounts panel from the System Administration screen click the User Accounts button The User Accounts panel appears From the User Accounts panel users can create edit and delete users Content Management User Accounts The User Accounts button Ax Full Name Student ID First Name 1D meti admin Last Name Email admin admin meti com The user list Password Confirm Password Group Administrators Privileges System Management User Management Content Management The user fields The Edit button The New button The Delete button The User Accounts Panel NOTE User Accounts functions are available only to users with the User Management or System Management privilege 121 Using M se METIman Creating a User To create a new user 1 From the User Accounts panel click New The New Account Creation panel appears 2 In the New Account Creation panel enter the user s personal data and choose a password
46. simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal NOTE Ice the nasogastric tube if extra rigidity is needed for insertion 189 Using METIman 190 METIman Gastric Suction Nursing Only To perform gastric suction the reservoir must be primed prior to use To prime the gastrointestinal reservoir attach a syringe with a luer lock extension set provided and inject 60 mL of distilled water into the GASTRIC FILL port on the simulator s left shoulder The GASTRIC FILL port o Q i d METIman Nursing s Left Shoulder Fluids can then be removed according to procedure using a standard nasogastric tube For supported nasogastric tube size see Recommended Clinical Supply Sizes on page 221 NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal CAE Healthcare Using METIman Genitourinary System METIman may be configured with either male or female genitalia either of which allows for the insertion of a urinary catheter The genitourinary system also provides for the excretion of urine Urinary Catheterization Catheterize the simulator using a standard urinary catheter lubricated with silicone spray For supported catheter size see Recommended Clinical Supply Sizes on page 221 Urinary Catheterization The bladder for the simulated urine is accessed directly via the urethra 1
47. system or the chest tube feature e To prevent pitting of the chest skin electrode do NOT apply conductive gel or conductive defibrillation pads intended for patient use e Do NOT use cables or connectors having visible damage e Do NOT spill fluids over any component inside the simulator torso This could damage the system and may also present a possible hazard for the operator e When using a manual defibrillator the ECG can be monitored via the defibrillator paddles Coarse ventricular fibrillation and high rate ventricular tachycardia cardiac rhythms are automatically recognized as shockable rhythms e With each defibrillation the METIman automatically records the amount of energy discharged and the time defibrillation was performed The simulated patient response to defibrillation is determined by the scenario script or instructor intervention Thus cardioversion is not automatically determined by the physiological models e The minimum electrical charge recognized by the circuitry within the simulator is 20 joules For paddle placement on the chest the simulator has two anterior defibrillation disks which can be unscrewed leaving threaded connections if required e Biphasic defibrillators can be used with either paddles or hands free connectors Pacing Pacing can be achieved virtually by selecting the appropriate intervention in the Interventions palette A standard transthoracic cardiac pacemaker can be connected to the
48. the computer to the METIman network Up to two additional computers may be used to run the TouchPro software The additional computers must meet the TouchPro Software Specifications mapped out in the Muse and TouchPro Specifications section of this User Guide on page xii Follow the steps below to use the TouchPro software on a TouchPro computer Step 1 Set Up METIman The METIman simulator must be set up and powered on and the Instructor Workstation must be powered on and connected to the METIman network If you have followed the complete setup procedure you may proceed to Step 2 Step 2 Obtain METIman s IP Address METIman s IP address is the same as the IP address used to access the Muse software on the Instructor Workstation It can be found in the Address field of the web browser on the M se Start screen METIman s IP address The M se Start Screen IMPORTANT The IP address is different for each simulator NOTE If the Address field does not appear check the view settings of your browser In Safari access the View menu and select Show Toolbar 34 CAE Healthcare Setup Step 3 Configure the TouchPro Computer s Network Settings Access the Networking screens the TCP IP settings screens for your operating system If you are unfamiliar with these screens contact your Network Administrator or CAE Healthcare Customer Service 1 866 462 7920 for help with this step AirPort AirPort TCP IP DNS WINS AppleT
49. transition variable types Close Assessment Intervention Medications Physiology Scenario Vitals The Transitions Menu 2 Select the desired variable type For example if a transition based on the administration of medication is desired select Medications and then select the desired medication from the list 102 CAE Healthcare Using Muse Once a medication is selected The Medication Transition menu appears asking for the comparison type and transition value Dopamine Dopamine Greater than or Equal Com pa rison type Transition value The Accept button The Medication Transition Menu Follow the same steps to make selections from similar menus for the Assessment Intervention Physiology Scenario and Vitals variable types 3 Once the variable values e g comparison type and transition value have been selected click Accept The selected transition variable is listed beneath the original state on the Scenario Designer 103 Using M se METIman 4 From the Scenario Designer click the GOTO arrow beneath the new transition variable The GOTO LINE r Equal Smeg kg 8 arrow J GOTO aS Begins ese The Available States menu Hypotension Worsens ieai a None The Scenario Designer The Available States menu appears listing all the available states 5 Select a state from the menu An orange connector line appears indica
50. 20 Related CAUTIONS WARNINGS esessssecsssessssessssessssessssessssessssessssesssssesssesssseessseessseessseessseessseeesaee 220 Recommended Clinical Supply Sizes 4 eee eere eere eere eene enn nte 221 Condition Guidelines for Programming METIman eere eere eee ne 223 Appendix A M se Parameters Descriptions e eere eee eere enne enne een nues M1 Appendix B Wireless Voice Link 4 eere eere ee eee eere ee eee enne eee ee enooueee B 1 xxii p CAE Healthcare Introduction Introduction METIman Nursing and Prehospital simulators give you all the power of CAE Healthcare s cutting edge simulation technology with more of what you want METIman Nursing was created by nurses to teach the fundamentals of nursing practice and METIman Prehospital was built for medics by medics Both simulators are less expensive than other simulators are easy to use and have everything you need with nothing you don t METIman METIman is fully wireless with on board fluid pneumatic and electrical systems and is built tough to withstand a wide variety of real life indoor and outdoor learning environments METiman comes with extensive clinical features and capabilities designed specifically for emergency medical personnel and nurses The simulator can be placed on standard operating room tables on an ICU bed on the ground or even in
51. 9 35 10 Elevated Heart Rate 2011 09 12 09 41 01 Scenarios Heroin Overdose 2011 09 12 09 39 41 Inferior Myocardlal Infarction 2011 09 12 09 40 13 Organophosphate Exposure 2011 09 12 09 40 39 The Add button The Choose Scenario Dialog Box 2 Select a saved scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 3 Click Add The scenario is added to the SCE and is listed on the SCE Editor beneath the Pre Loaded Scenarios heading 4 Click the scenario s name under the Pre Loaded Scenarios heading 94 CAE Healthcare Using Muse The Scenario Designer appears displaying the selected scenario Anaphylaxis i Soanana 1S ap hea cate Collapse AE Expand Ali The Scenario Designer The Scenario Designer The Scenario Designer is accessed by creating or editing a scenario from the SCE Editor From the Scenario Designer scenario states can be added modified and deleted Anaphylaxis The Scenario button i Sranane ia ge New State jy Collapse AE wp Expand Ali The View buttons Canvas The New State button The Scenario Designer The Scenario button is used to manage states and save the scenario The View buttons toggle between Scenario Designer views The New State button is used to add new states Once created states are displayed on the Scenario Designer canvas 95 Using M se METIman Scenario Desi
52. 91 Using METIman METIman Simulating Urine Output METIman allows urinary catheterization and simulation of urinary output Ensure all fluids have been removed from previous uses before each new use to prevent overfilling Please refer to the Care and Maintenance section for directions on fluid removal To simulate continuous urinary output 1 Set up the IV pole near the simulator 2 Fill an IV bag with the clinically appropriate fluid Use distilled water only with food coloring if desired 3 Hang the IV bag on the IV pole 4 Ensure the roller clamp is closed and insert the IV spike into the IV bag 5 Connect to the simulator by attaching the end of the IV spike set tubing to the GU port on the simulator s left shoulder METIman Prehosptial s Left Shoulder METIman Nursing s Left Shoulder 192 CAE Healthcare Using METIman 6 Open the clamp and allow fluid to flow into the simulator There is a reservoir inside the simulator that fills up with the fluid 7 Keep the IV bag attached Adjust the flow rate manually using the roller clamp 8 Catheterize the simulator using a urinary catheter lubricated with silicone spray For supported catheter size see Recommended Clinical Supply Sizes on page 221 The urinary catheter must be fully inserted for the fluid to flow NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal I
53. BCs identify early signs of allergic reaction consider use of oxygen call for help with interventions consider early use of epinephrine and attach a cardiac monitor If more than 120 seconds elapses without administration of epinephrine the instructor should manually advance the SCE to State 2 Mild Anaphylaxis If epinephrine is administered the SCE is advanced to State 5 Epinephrine Administered In State 2 Mild Anaphylaxis the patient experiences increased respiratory distress The patient s HR is in the 110s BP is 100s 50s and SpO2 is in the 80s on room air The learner is expected to continue to assess patient s The Continue L dj eir button The SCE Summary Panel Stopping the SCE Running SCEs can be stopped from the Run screen or the Home page To stop an SCE from the Run screen 1 Click Stop in the upper right corner of the screen The Stop Button 80 CAE Healthcare Using Muse The Stop the Simulation dialog box appears Stop the Simulation Do you want to stop the simulation The Stop Simulation button The Stop The Simulation Dialog Box 2 Click Stop Simulation The SCE stops running and the Muse Home page is shown To stop an SCE from the Home page 1 Click the Stop button in the bottom left corner of the SCE Summary Panel The Stop Button The Stop the Simulation dialog box appears Stop the Simulation Do you want to stop the simulation The Stop Simulation button The Stop The
54. Both ventricular Failure Left Vantricular Failure Right Parameters Bi Fere tus ne Variable Tranaiticns Creane The Scenario Designer To add parameters to a state click the Parameters button within the state The Parameters button A State 100 CAE Healthcare Using Muse The State Parameters screen appears Hypotension Begins Fypotbensian Eyes Blink Speed Fact The State BP Systolic 45 mem E Parameters Temperature body 18 0 C pa n el Respiratory Rabe The Complete button The State Parameters Screen Click the various organs to change the views and then select the desired parameter Once a parameter has been selected it appears in the State Parameters panel on the right side of the screen Add as many parameters as needed Added parameters appear consecutively within the state Drag and drop to reorder as needed Click Complete to save and exit the State Parameters screen or click Back to exit without saving NOTE If the physiology of any of the parameters conflicts the M se software reflects the physiology of the last parameter entered 101 Using M se METIman Adding Transitions To add a transition the scenario must have both an original state and a state that results from the transition To add a transition 1 Click the Create button in the original state The Create button A State The Transitions Menu appears listing all available
55. Default 50 mA Range 0 mA 119 mA Cold Fluid Inject The Cold Fluid Inject parameter is used to simulate the injection of 10 mL iced saline into the pulmonary artery catheter The appropriate Thermodilution waveform and cardiac output measurement are then displayed on the Patient Status Display or TouchPro software CAE Healthcare Appendix A Parameter Descriptions Pulses The tables below show the defaults and ranges for the pulses and pulse deficits for METIman Prehospital and METIman Nursing METIman Prehospital Default A 15 Appendix A Parameter Descriptions METIman METIman Nursing Default All pulses unless altered by an SCE are enabled by default To disable a pulse click the pulse location on the human form To enable a pulse click the pulse location again Click and hold a pulse location to adjust the pulse deficit o CAE Healthcare Appendix A Parameter Descriptions Fluids The blood droplet provides a means of controlling the amount of fluid lost by or infused into the patient The amount of fluid to be lost or infused and the time frame during which the fluid loss or infusion takes place can be entered Fluid Parameters Fluid Loss Blood When used the Fluid Loss Blood parameter reflects a decrease in total blood volume Blood loss proportionally decreases both the red blood cell volume and the plasma volume according to the current hematocrit Range 0 mL 4000 mL Fluid Loss Pla
56. EVAIS xii rive tei seose E EE E E 1 A a T E 1 Eguipment OVEN VICW esesececssicscacosssdvocsaccsntesiesssveccicecesesecusensvataccencusucasnetecesacasanetassicgusneascestaaussess 2 Standard Components AV CHIUONY castri b PREUTEDRTDHREPANSERETEERHTUPONTUIRMOR EETAS SEER ESSENSEN 2 Optional Components Inventory esssesssssessssseessseesssssreossecrssseceossscesssecsosssreosseersssecossssersssecessssreosseeres 3 METiman Standard Equipment savecesessveccacecescctesaucbecssazauccecssecosedernsctvevqvacessavnevenceosausieoseveceasveas 4 F N Body Wireless SIDES COT sssssissessesinisiisrisnsrivarrasnneroseresinarresnssinapsairinia ierann nae erroia REO E aSa 4 Battery Charger and External Power Supply eterne eee tete testen tosten eaten tons 4 Instructor Workstation Laptop or Tablet ccccssssscssssssesssssssssscessssscsssssssessssssesssessesscesessssessssesesssees 4 UREE E ILON Pals 4 JI i cc 5 Wireless UCONN Sages scat ottime nin Dn tutem dendi onn nh Diete n i DEED E 6 IGISSATUICIE e T T 6 MANA AINA dem 7 xiv CAE Healthcare Table of Contents Optional Equipment for MET man eene ee eee eene eee eene eee eene etna aee eee en aee een a aee e enaee 7 METIman Replacement Lithium Battery csccsccssscssssssscssssssscesssssscecssssecsssssssssscsscastsssscasesssecn
57. I T 150 Configuring the TouchPro Software 4 cene eere eene eere eee en eee eroe eee eo esee tne eee eaae etta 151 Changing the TouchPro Language 4 eere eene e eee eene eee ee en o eee etna oeste tena se tetas see eas 152 Exiting the TouchPro SOL CWA O waceserteccsccasecsavenccsssesanasusspsceanspcaustsrsvexetuavucenensectsaeeiecaaveueanseaess 152 xviii CAE Healthcare Table of Contents AGIR SETTE 153 NEHFOlodICal tivi vai EAE A O O T E A O OE O A 154 FY OS A N E E EEA E N A A E E crea 155 SUI n 155 Neuromuscular BIOCKAQE cosas tere Peppe mp et utt Uds impete iesedvterqutta uS 155 Body MIS RT M 155 Blood ESL SAMNIO 155 Head Secretions Prehospital OD osos ton THEOO ERR eire LO HIBSRUED EN UEREOVERIEHHR UD URS 156 ESD IPAUON V e EROR N A A A A ORATOR KU ERU PESE CONTE FIXE ETIN INR US 157 PAM WAY P T 158 PUTO Rd Co HERR RTEEEAEEHURAELNORRGUEEREDILUTO RUE RUNDEN REO A 166 CAN GIOVASCUNAN e 172 Pulses METIman PRONOS Da legctserecacctszcvteczctes sete esp odei olet Che rt DUE RE CIUS LER UI ERES GI ene IS 174 Pulses METiman NUTSIMO RETRO 175 DIDOU PEeSSUIB EE EE E acesceecesentecteaseseseatcostiavasche dnedsas4ctvsdocelczssistresuctessceccestcccucecateach nagnatesne 176 EIEE I ER EE E E TENT OAA A E UNES 180
58. ILICONE SPRAY to lubricate the adjunct NEVER use a water based lubricant because of resulting residue damage 161 162 Using METIman METIman Laryngospasm Prehospital Only A laryngospasm actuator closes the patient s vocal cords and prevents both ventilation and intubation Click the Laryngospasm switch to activate the feature Teeth with Breakaway Incisors Prehospital Only METIman Prehospital is equipped with Breakaway Teeth whose front incisors become dislodged with improper handling of a laryngoscope The teeth are tied to the upper denture with a lanyard which prevents losing the teeth down the airway or misplacing them during storage CAE Healthcare Using METIman Airway Secretions Nursing Only METIman Nursing allows for suctioning of fluids from the airway using a manual feed Ensure all fluids have been removed from previous uses before each new use to prevent overfilling Tracheostomy Suction To use the airway secretion feature inject up to 40 mL of clinically appropriate colored fluid into the AIRWAY FILL port on METIman Nursing left shoulder The AIRWAY i FILL port METIman Nursing s Left Shoulder The trachea is now ready to be suctioned Using the proper clinical technique insert the suction catheter until resistance is encountered at the bifurcation For supported catheter size see Recommended Clinical Supply Sizes on page 221 Withdraw and apply suction Fluid can be suctioned
59. METIman User Guide m 2n MER S Technology CAE Healthcare CAE Healthcare License Copyright CAE Healthcare METIman Simulator Software and Users Guide THIS IS A LEGAL AGREEMENT PLEASE READ THIS DOCUMENT CAREFULLY The software you are about to access is provided to you pursuant to the purchase of the Product by the legal entity which employs you or which you represent the Licensee or You from CAE Healthcare This purchase of the Product is subject to CAE Healthcare s Healthcare Education Products General Terms and Conditions the HEPGTC and this End User License agreement License This License governs the grant of licenses for the software in object code only embedded in or bundled with the Product or required to operate the Product as the case may be Software as well as all related Product documentation and information Data supplied by CAE Healthcare either with or separately from the Product which items as indicated in the HEPGTC are not sold but licensed Acceptance of these terms and conditions must be without modification of any of the terms conditions and notices contained herein Consequently please be sure to read the terms of this License carefully If You agree to these terms conditions and other provisions in their entirety then click the ACCEPT button below If You do not accept these terms conditions and other provisions in their entirety without modification of any sort
60. Management pop up menu select Play The scenario is resumed 77 Using M se METIman The Medication Monitor The Medication Monitor tracks the infusion of medication administered To activate the Medication Monitor from the Run screen click the Medication Monitor button in the bottom right portion of the screen The Medication Monitor Button The Medication Monitor appears as a movable box on the Run screen E Medication Monitor The Close Medication rocuronium j button name The Reset button 0 0001 mg kg Normalized effector site concentration The Medication Monitor The normalized effector site concentration is shown next to each medication listing The Reset button is used to clear a medication from the physiological model and the Medication Monitor To close the Medication Monitor press the Close button in the upper right corner of the medication Monitor window 78 CAE Healthcare Using Muse Resetting a Medication To reset a medication from the Medication Monitor click the Reset button on the Medication Monitor The Reset Medication dialog box appears asking you to confirm that you wish to reset the medication Reset Medication Reset the medication rocuronium re ae ES The Reset button The Reset Medication Dialog Box The medication is cleared from the model and from the Medication Monitor With continuous infusions the amount infused goes back to zero but the
61. Run Time 4 hours Typical Communications Simulator Network Wired 10 100 Ethernet or Wireless IEEE 802 11g Wireless Voice 537 MHz to 819MHz Country Specific vi CAE Healthcare METIman Specifications Electrotherapy Defibrillation 20 to 360 joules Monophasic Biphasic Pacing 20mA to 180mA Air Supply When using the optional external compressed air kit in conjunction with the facility supply source and facility wall adapter Supported source pressure 50 psi to 120 psi CO Supply When using the optional external CO kit in conjunction with the facility CO source and facility wall adapter Supported source pressure 30 psi to 120 psi vii viii Cautions and Warnings METIman Cautions Warnings Please read and understand these cautions and warnings before you begin using the METIman system USE OF THIS EQUIPMENT IN AN UNSPECIFIED MANNER MAY IMPAIR DESIGNED PROTECTION Your safety is in your hands Be sure to follow the instructions on the proper setup breakdown and use of the METIman system SHOCK HAZARD Electrical Safety This product must be connected to an electrical outlet that is properly grounded Precautions should be taken so that grounding or polarization is not defeated e Do not place defibrillator paddles on or adjacent to the ECG patient electrodes Contact between defibrillator paddles and the electrodes may cause injury to the user and damage to the equipment e Always use th
62. Simulation Dialog Box 2 Click Stop Simulation The SCE stops running IMPORTANT Always stop all running SCEs before logging out of M se 81 Using M se METIman Developing SCEs Creating and editing SCEs are similar processes Once an SCE is created the steps for modifying the SCE are the same as those for editing a previously created SCE The processes of creating and editing SCEs each begin with a unique button on the Home screen Use the New SCE button to create a new SCE The New SCE Button The minimal requirements for creating a new SCE include selecting a Patient naming the SCE and saving the SCE Once the new SCE is created you can continue with the SCE development or edit it later Use the Review button to edit an existing SCE The Review Button Creating a New SCE Creating an SCE requires naming the SCE and selecting a Base Patient To create a new SCE 1 From the Home screen click New SCE The New SCE Button 82 CAE Healthcare Using Muse The Patients Palette appears Name Stan D Ardman II Age 33 years old Gender Male Weight 70 0 kg fa Create The Create S button The Patients Palette 2 Select a patient from the palette and click Create The SCE Editor appears showing the Enter a name for the SCE dialog box Untitled SCE The SCE Name field The Save button The SCE Editor Screen 3 Enter the name for the SCE NOTE The name of the SCE may
63. Sounds Gasping Groaning Long Loud Cough Long Soft Cough Wheezing Mumbling Vocal Sounds Menu Click Vocal Sounds and select the type of sound desired from the Vocal Sounds drop down menu Vocal Sounds play continuously when selected and are emitted immediately when selected from the Vocal Sounds drop down menu To stop playing one of the vocal sounds select None from the list 195 Using METIman METIman Speech Sounds Speech Sounds include a male or female voice that can utter pain rating indicators from 0 to 10 various phrases and a series of other utterances Unlike Vocal Sounds Speech Sounds only play once Speech Sounds 196 CAE Healthcare Using METIman To play a Speech Sound click the Speech balloon A list of Speech Sounds appears oud cough Soft cough Short Loud Cough Short Soft Cough X Scream d j E Grunt Yes No Sometimes i Tir Ouch l 10 9 8 7 6 a The Speech SAPE ar Sounds menu ble My chest is tight can t breathe y terra Ow that hurts Zero a Ts i ccm The Speech Sounds Menu Select the desired sound The sound plays and the list disappears To replay the last sound click the Play button in the Speech balloon 197 Using METIman METIman Wireless Voice Capability In addition to the pre programmed speech any response can be transmitted through the speakers using the w
64. Stanley A Wreck Page arrows lt Page 17 2 gt The Open Library button jy Open Library mm fiw mew sce The New SCE button The SCE Selection Panel The SCE Selection panel has four tabs that access SCEs Running Now Recent Favorites and All e Running Now tab Lists the SCEs that are currently running and is only available when at least one SCE is running e Recent tab Lists all the recently run or edited SCEs e Favorites tab Lists all SCEs that have been selected as favorites and is only displayed after favorites have been selected To add a favorite SCE to your profile click the Add to Favorites button at the top of any SCE on the Home page Managing favorites is achieved in the Account Profile portion of the software All tab Lists all SCEs including user created SCEs and all SCEs from available learning modules To search for an installed SCE enter part of the name of an SCE in the Search field and click the Search button 45 Using M se METIman Click any SCE to select it Once an SCE is selected it appears in the SCE Summary panel To run an SCE click Run in the SCE Summary panel to execute the SCE A running SCE appears in orange with an X icon Base SCEs are created by CAE Healthcare and represent base patient physiology Base SCEs have no associated scenarios and no physiological progressions The Lock icon indicates a locked SCE The Lock it ealthy Adult Male icon St
65. TO IRREVOCABLY WAIVES TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATING TO THIS AGREEMENT 8 3 Notwithstanding the foregoing if a party seeks injunctive proceedings to preserve confidentiality obligations or intellectual property rights then it is entitled to seek relief before the competent court body of any jurisdiction 9 MISCELLANEOUS 9 1 United States Government Customer If Licensee is the United States Government U S Government or a unit or agency of the U S Government the Software and Data are deemed to be commercial computer software and commercial computer software documentation respectively pursuant to DFAR Section 227 7202 and FAR Section 12 212 b as applicable Any use modification reproduction release performance display or disclosure of the Software and or Data by the U S Government or any of its units or agencies shall be governed solely by the terms of this License and the HEPGTC Any technical data provided by CAE Healthcare with the Product that is not covered by the above provisions is deemed to be technical data commercial items pursuant to DFAR Section 252 227 7015 a 9 2 Amendment This License may only be amended by the duly authorized representatives of CAE Healthcare 9 3 No Waiver The failure of CAE Healthcare to enforce at any time any of the provisions of this License or to require at any
66. a vehicle in the case of a simulated accident METIman can also be seated in an upright position In addition METIman has the assessment cardiovascular genitourinary and trauma features familiar to CAE Healthcare customers plus an SpO finger probe fluids on board bilateral noninvasive blood pressure and IV access Wireless and tetherless METIman takes simulation education to a new and exciting level of realism Introduction METIman Equipment Overview METIman has been designed to be used in any learning environment METIman s standard features are easily integrated into a laboratory setting or remote locations Standard Components Inventory METIman comes with all the necessary equipment for establishing an educational simulation center Standard Equipment NOTE As you would with any shipment cross check this inventory with your CAE Healthcare packing invoice to verify that all components have been received CAE Healthcare Introduction Optional Components Inventory Optional equipment is available to accommodate special customer requirements For example options like an air compressor METIVision and METI FX enable instructors to create real life scenarios at authentic locations Optional Equipment Contact CAE Healthcare Customer Service at 866 462 7920 if there are any questions or if optional equipment is needed Introduction METIman METIman Standard Equipment METIman comes with stan
67. ae RUPER TUAE REP REPOSEETHISUEHEYE RUD E EHRERE LER NEDENE TRES 109 EWIBEXDG BD Ui SU ieszcsse ean WR PESOEUR DATUR EEE tetas ERE VU EAE E E RERO OUR BPO ROA 110 Cuir m M 112 alis P ears 112 SVS CCM OOE EO DOTT E CUI E PO dure v IE E RFRKOR E EPER E 113 AECODTIEPEOTIB ceat EA A eIO OUR UNE A 129 Using TOUCTI T FU E ES P PLE NEU Pe A E AVESSE EVE EE VETERES SER i tUe tS I EU 135 Accessing tne TouchPro SOTUWATO iier oe sis a era Year e eV envEF EYE eO YN UPa Yen TUE F v E EFE EN X PY YN PI FEY SUPER ES 135 Modifying the TouchPro Display 4 ees eere eene e eene e eene eroe eterne ee rn oe eene ee eno senos 137 Selecting a Preconfigured Layout s sscsssssssssssesssssssssessssssessesssseessesssassessessscsecseesssassaesscsscsecseenes 137 Changing a Waveform or Numeric Display eese rnntnntnntnnnnnnnns 139 Adding a Waveform DR 140 Agang a Nomeri DIS Didier IE eraan aessa REES EARE S TAT ES 142 Moving a Waveform or Numeric Display s ssccssssssssssscsssessesssssssssssssossessesssssecsseassassassacsscsecseaes 143 SCENE E 144 II 145 ipie 146 NIBP Cycling and Manual NIBP sie eii D PONERET NEPRO EUR FREU UC Aen DDR OD FERNER COE ER RE ELE EA 148 AC ISTITUT
68. agement privilege From the Groups panel users can create new groups delete groups and assign privileges to groups In the Groups panel three groups appear by default e Administrators e Educators e Deactivated Users Each default group has privileges assigned 123 Using M se METIman Privilege System The M se software has three different privileges e System Management User Management e Content Management User Management and Content Management can be assigned independently or combined The System Management privilege contains all privileges System Management Users with the System Management privilege have access to all features of the Muse software including the benefits of the User Management and Content Management privileges listed below Users with the System Management privilege can also view system settings back up and restore data and apply software updates User Management Users with the User Management privilege can manage all users and groups Content Management Users with the Content Management privilege can create and manage all SCEs Creating a New Group To create a new Group 1 From the Groups panel click New The Group Name field appears 2 Enter the name of the Group in the Group Name field 3 Click Create Group The group appears in the Groups panel Privileges can now be selected 4 Select the privilege s to be assigned to the Group 5 Click Save 124 CAE Health
69. ainage 1 Insert the METIman Priming Tube in the Chest Tube site 2 Set up the IV pole near the simulator 3 Fill an IV bag with the clinically appropriate fluid Use distilled water only with food coloring if desired 4 Hang the IV bag on the IV pole 5 Ensure the roller clamp is closed and insert the IV spike into the IV bag 6 Connect to the simulator by attaching the end of the IV spike set tubing to the corresponding CHEST TUBE port LEFT or RIGHT on the simulator s right shoulder Chest Tube ports g 2 METIman s Right Shoulder 7 Open the clamp and allow fluid to flow into the simulator until fluid is seen in the METIman Priming Tube 169 Using METIman METIman 8 Once fluid appears in the METIman Priming Tube remove the METIman Priming Tube The simulator is ready for chest tube insertion 9 Keep the IV bag attached and adjust the flow rate manually using the roller clamp The chest tube must be fully inserted for the fluid to flow Chest Tube Insertion NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal When the Chest Tube feature is used on METIman Prehospital the simulator automatically detects the tube insertion and creates a log entry On METIman Prehospital if a small volume of fluid is needed to simulate proper chest tube insertion the internal reservoir may be filled To insert a small
70. alk B02 1X Configure IPv4 Manually IPv4 Address 192 168 XXX XXX Subnet Mask 255 255 255 0 Router Configure IPv amp Automatically You can get IP settings assigned automatically if your network supports this capability Otherwise you need to ask your network administrator for the appropriate IP settings 5 Obtain an IP address automatically IP address 192 168 XXX XXX Subnet mask 439 252 285 10 Default gateway Internet Protocol Version 4 TCP IPv4 Properties Screen Windows Enter a unique IP address in the IP address or IPv4 Address field and a subnet mask in the Subnet Mask field The unique IP address must match the IP address obtained in Step 2 except for the number after the third and final period This number can be any number between 2 and 254 BUT must be different from the final number of the IP address obtained in Step 2 METIman s IP address and the IP address of the Instructor Workstation and any other computers on the network No two IP addresses can be the same including the Instructor Workstation s IP address Unique IP Address 192 168 XXX XXX Subnet Mask 255 255 255 0 Router Gateway Leave Blank Example If the IP address of your METIman is 192 168 206 5 and the IP address of your Instructor Workstation for your METIman is 192 168 206 10 you could assign the TouchPro computer the IP address 192 168 206 20 35 Setup METIman Step 4 Option 1 Join the METIman Network Usin
71. an D Ardman II A Locked SCE Locked SCEs are installed by CAE Healthcare and cannot be deleted Base and preconfigured SCEs are locked Click the page arrows to view additional pages of installed SCEs To open the SCE Library click the Open Library button To create a new SCE click the New SCE button 46 CAE Healthcare Using Muse The SCE Library Access SCEs from your library by clicking the Open Library button at the bottom of the SCE Selection panel The SCE Library appears The Learning K Learning Modules v 1m Modules icon Preconfigured SCEs 1 0 The Learning Modules menu E SCEs The SCEs icon The Close Library button s Cose Library fig New sce The SCE Library The Learning Modules menu is open by default The Learning Modules menu lists Base SCEs Preconfigured SCEs and all installed learning applications Click the desired learning application name to access its SCEs or click Base SCEs or Preconfigured SCEs The selected SCEs appear Clicking the SCEs icon reveals the SCEs menu which lists all user created SCEs Clicking the Learning Modules icon again reveals the Learning Modules menu To open an SCE click the name of the SCE Click Close Library to exit the SCE Library 47 Using M se METIman Base SCEs Base SCEs are fundamental SCEs with no scenarios and no progression of events Each base SCE is designed to provide facilitators with a baseline to run simulat
72. an Start Up Kit Quick Start Chart and Setup Map istan Logo Accessories Priming syringe Roll 4 ft of VHB tape and roll of 2 inch wide red tape for cricothyrotomy Cricothyrotomy skin BP adapter kit Silicone lubricant Chest tube priming tube ECG posts Pacing Defibrillation disks Condensation drain Wound umbilicals SpO probe Female genitalia VGA mini adapter Introduction Introduction METIman Wireless Microphone The wireless receiver enables the user to communicate through the simulator using a microphone The clip on microphone is attached to a transmitter that may be attached to a belt or waistband Wireless Microphone The microphone is battery operated and has a power switch on the top to turn it on and off Wireless Voice Link The wireless voice link replaces the wireless microphone feature in some METIman simulators and comes packaged separately For more information about this feature see Appendix B Wireless Voice Link on page B 1 CAE Healthcare Introduction Trauma Fill Tank Fluids are supplied to the simulator using a trauma fill tank One tank is supplied and can be used for distilled water mixed with red food coloring to create simulated blood Disassembled Trauma Fill Tank Trauma Fill Tank Disassembled and Assembled This tank should be cleaned after each use Optional Equipment for METIman Additional components enable the METIman system to be customized to fit the
73. and hold the power switch for two seconds The light on the button begins to blink indicating shutdown is in progress After approximately 30 seconds the light is off and shutdown is complete If the simulator fails to shut down when the above steps are performed correctly hold the power button for five seconds to force the system to power off 2 Carefully put the skin back into place for storage Maintenance Advice Simple care and maintenance helps to ensure that METIman stays in good working condition Many problems are caused by inadequate or improper maintenance Perform a thorough check of the various components each time the simulator is used Failure to follow these guidelines can lead to damage not covered by warranty General Simulator Care Avoid the use of writing instruments and sharp objects near the patient simulator to prevent unattractive markings on or tears in the skin Lubricate airway adjuncts urinary catheters and chest tubes with silicone spray NOT a water based lubricant prior to insertion A mild detergent and warm water will remove most marks and stains Gently rub the soiled area with a soft cloth Do NOT use ABRASIVE soaps or pads Prior to using moulage of any kind CAE Healthcare suggests the application of a very light coating of petroleum jelly followed by a light dusting of baby powder to the simulator s skin This application makes cleaning the skin easier If any of METIman s fluid systems have
74. ate through the menus to find the desired intervention 3 Once the desired intervention has been located click the intervention s name from the list ALL INTERVENTIONS Bag Valve Mask Cardioversion Biphasic Cardioversion Monophasic Chest Tube Flow Rate Colloids Crystalloids Defibrillation Biphasic Defibrillation Monophasic Fraction of Inspired Oxygen FiO2 Intubated Nasal Cannula The All Interventions Menu The Intervention Options menu appears showing the available options for the selected intervention 68 CAE Healthcare Using Muse 4 Click the desired option Face Mask Room Air 5096 FiO 60 FiO The Intervention Options The intervention is applied and appears in the patient s physiology 69 METIman Using M se Transitioning Scenario States from the Run Screen To move between scenario states from the Run screen 1 Click the desired scenario Anaphylaxis Beginning Anaphylaxis 00 00 11 A Scenario The Scenario Management pop up menu appears and all available states are listed Scenarios E Add Scenario Anaphylaxis em Show Scenario Begining amp naphylaxis Pham wu T Beginning Anaphylaxis DO D0 04 E Mild Anaphylaxis Moderate Anaphylaxis oo 00 00 was Severe Anaphylaxis Epinephrine Administered Condition Improves Pla y The Scenario Management Pop Up Menu 2 Select the desired state The scenario proceeds to the selected stat
75. been used flush out the simulator as described in the following pages Failure to flush the systems may cause damage to the simulator Storage When in regular use METIman s breakdown procedure and general cleanup should be sufficient to prepare the simulator for storage In addition be certain to follow these instructions e Storage temperature should not exceed 122 F 50 C or fall below 41 F 5 C e If a soft sided simulator case is being used the simulator should lie flat e The simulator should NEVER be stored or shipped with fluids in the system 209 Care and Maintenance METIman Care of Electronic Equipment Install any CAE Healthcare software updates as soon as they become available Airway Inspection METIman is equipped with an anatomically accurate airway that supports the practice of difficult airway management techniques In the process of performing these techniques improperly or aggressively the upper airway can be damaged Because damage can occur occasional visual inspection of the airway is recommended Using the light of a laryngoscope blade or a flashlight visually examine the airway While tears in the upper airway resulting from intubation may be obvious needle holes in the lower trachea resulting from techniques such as transtracheal jet ventilation may not be readily apparent If damage to the airway is found small cuts or tears may be reparable with silicone adhesive However for permane
76. bookmark on the timeline The Return to Bookmark message appears Return to Bookmark Return the patient to Bookmark 3 at time 00 01 27 The Return button The Return to Bookmark Message 2 Click Return The SCE returns the selected point in the timeline NOTE The SCE time continues moving forward and does not reset to the bookmarked time Using the Event Recorder to Save States The Event Recorder can be used to save conditions interventions and parameter changes as states To save a state using the Event Recorder 1 Apply the desired conditions interventions and parameters 2 Click the Event Recorder button at the bottom of the M se screen HM Event Recorder The Event Recorder Button 73 Using M se METIman The Event Recorder appears displaying all events that have occurred since the start of the SCE T Event Recorder Whole Blood Infusion 17 mL hr Events z Bag Valve Mask 73 FiO2 The Edit button The Save State o ds Save State Edit Clear 7 L The Clear button The Event Recorder WARNING The Clear button deletes all recorded events This action cannot be undone 3 Review the list of events If you wish to remove any events from the state to be saved a Click Edit A Delete button appears next to each recorded event ex Event Recorder Whole Blood d 17 Events A Delete buttons Bag Valve Mask 73 FiO2 The Save State button
77. box appears stating that restoring data erases all current data and asks if you want to continue m System Restore Warning Restoring data will permanently delete all current data Do you want to continue The System Restore Warning Box IMPORTANT Restoring data ERASES all current data and replaces it with the backed up data 2 Click Yes A select file dialog box appears 3 Locate the appropriate bak backup file to restore 4 Click Select The data is restored Product Licensing To view product licensing information for your simulator or to enter a license key to activate your software click License Manager Error Log The Error Log is available for technicians and is used when diagnosing the Muse software IMPORTANT Do not clear the Error Log Localization To change the language of the Muse software 1 From the System Settings panel under the Localization heading Click Change Language The Change Language dialog box appears 2 Select a language from the dialog box 3 Click Accept The Muse user interface changes to the selected language NOTE Only the English version of the User Guide is available via the software regardless of the Muse language selection To access the User Guide in other languages please visit www caehealthcare com and click the Support link 128 J CAE Healthcare Using Muse Account Profile From the Account Profile screen users can view update and reset p
78. caracazcosecn seacssivaacosg cntesancsciaaeesststaassarsaasee SU ES En ERES URS REESE OEUES 34 Step 3 Configure the TouchPro Computer s Network Settings eee 35 Step 4 Option 1 Join the METIman Network Using a Macintosh Operating System 36 Step 4 Option 2 Join the METIman Network Using a Windows Operating System 38 Step 5 Access the Software from the TouchPro Computer een 40 Using MUSB cimi ore E T E E EE E E 41 Star THE APPICAON Petr innin rien oent NoE eNEAN Ri E aA aUas 41 Navigating the Home Page eeesssoeesssocessosoeessoocessoccessococesscocessooocessoocessooccessoocesssoceessooeesssoses 44 MIN SUE aE N a T E AEA EE A A A E DEEE 45 E EEE AA E E O AE ETE EAEE 47 E A E E E PE ETE O E E 49 a E a E E I E E E E 50 CAE Healthcare Table of Contents AU E Elder 51 Using the Patient Status Display osse mike neri EPRR vH BEER bi Drree HURRY HO FW FP vod ftre rere 52 AEE NR M 54 DISD IAW ING Patient BOCORUS ssim RETOUR PURPOSE DNI om HRS Een DER 54 Adding a Scenario to a Running S UE ascen OUI EEUU SIE Fen UOS IEEE IEEE UIS 57 KA INGUIN PANY STO TOO A E E EE E A PRODR waapnanetn 58 S Ere e 72 Using the Event Recorder to Save States cccssccsssssssssssssssssssessssessssessssessssessscessscessscessssessscessscesescess 73 Creating a N
79. cardia and bradycardia ventricular fibrillation and asystole The hemodynamic response to the arrhythmias is physiologically correct Myocardial oxygen balance and cardiac ischemia automatically influence the cardiac rhythm resulting in a realistic and automatic response of the rhythm to hypoxemia The degree of influence can be controlled or completely overridden by the instructor p CAE Healthcare Using METIman Cardiovascular Interventions Therapy METIman can simulate chest compressions and three types of electrical therapy defibrillation cardioversion and pacing Realistic Cardiovascular Interventions Manual Control None required None required See Defibrillation below for defibrillation disk locations and instructions See Pacing below for cardiac pacing disk locations and instructions 181 182 Using METIman METIman Chest Compressions METIman supports normal hand placement and standard compression techniques and chest compressions can be performed METIman can detect the compressions and the physiology responds accordingly Defibrillation and Cardioversion Manual defibrillation and cardioversion can be performed on METIman Additionally defibrillation and cardioversion are available virtually through the software METIman is designed to safely absorb the energy discharged from manual and automatic defibrillators Standard defibrillation energy levels should be used for positive learning re
80. care Using Muse Deleting a Group Groups can be deleted when they are no longer needed Once a Group is deleted all users who were affiliated with the Group are moved to the Deactivated Users Group To permanently delete a Group select the group to be deleted from the Groups panel and click Delete When the Group Deletion warning box appears click Yes Providing Access to Content Only To provide users with the ability to create and manage SCEs but not the ability to manage users or groups 1 Create a new group called Content Only 2 Assign the group the Content Management privilege Do NOT assign any other privileges to the group 3 On the User Accounts tab create or edit the desired users placing each user in the Content Only group Maintenance The Maintenance panel is used to flush fluids from the simulator To access the Maintenance panel from the System Administration screen click Maintenance The Maintenance panel appears The Maintenance button Bleeding System Flush The Flush The Maintenance Stem button panel The Maintenance Panel 125 Using M se METIman System Settings From the System Settings panel users can manage the System Configuration Data Management and Product Licensing of the M se software To access the System Settings panel from the System Administration screen click System Settings The System Settings panel appears Content Management User Accounts Maintenance Sy
81. dard equipment that allows students and instructors the ability to create an endless number of possible clinical situations The following equipment is provided with your METIman simulator Full Body Wireless Simulator All patient assessments and clinical interventions are played out on the METIman mannequin which represents a human patient At six feet two inches 188 cm in height and weighing 100 pounds 45 36 kg METIman is fully operational in the supine lateral prone and seated positions The simulator offers features like arm pronation and supination breath heart and bowel sounds palpable pulses patient voice and genitourinary features Battery Charger and External Power Supply The simulator is rechargeable using the Battery Charger provided Instructor Workstation Laptop or Tablet The Instructor Workstation is a computer that utilizes M se Software to operate as the main simulation control center Instructors control the simulation session from the Workstation by using SCEs that meet their learning objectives The standard METIman configuration includes a choice of Laptop Instructor Workstation or a ruggedized Tablet Instructor Workstation CO Canisters Prehospital Only Four CO canisters are included with METIman to supply the on board CO exhalation feature o CAE Healthcare Inventory Kit iStan comes with a number of accessories and replacement components Included in the Inventory Kit are iSt
82. ded for use with the simulator Other sizes may cause damage and should not be used Clinical Supply Recommended Size Recommended Size METIman Prehospital METIman Nursing With fluid return Insertion only 221 Recommended Clinical Supply Sizes METIman 222 CAE Healthcare Condition Guidelines for Programming METIman Condition Guidelines for Programming METIman This card is intended to help you select M se conditions to achieve desired vital signs within each programmed state All four conditions should be programmed into each state in the order presented below Respiratory Desaturation e Cardiovascular Blood Pressure e Cardiovascular Heart Rate e Respiratory Respiratory Rate The Muse software is physiologically driven When using multiple conditions e g Desaturation Hypertension Tachycardia Tachypnea physiological regulatory mechanisms such as the baroreceptor reflex and ventilatory control cause compensatory changes within parameters To achieve the desired vital sign select one condition level above greater or below less to achieve the desired physiological effect Respiratory Desaturation Desaturation SpO Value 223 Condition Guidelines for Programming METIman METIman Cardiovascular Blood Pressure Hypertension Hypotension 224 CAE Healthcare Condition Guidelines for Programming METIman Cardiovascular Heart Rate Tachycardia Bradycardia Mid 60s Hig
83. e The scenario can also be paused or continued by selecting the Pause and Play options from the Scenario Management Pop Up menu 70 CAE Healthcare Using Muse Transitioning Scenario States from the Scenario Screen To move between scenario states from the Scenario Screen 1 From the Run screen click the desired loaded scenario The Scenario Management pop up menu appears Scenarios fe Add Scenario Anaphylaxis Begining Anaphylaxis show Scenario The Show Scenario option Pg ee 4 Beginning Anaphylaxis 00 00 04 Scenari MM T Anaphylaxis started Moderate Anaphylaxis 0 DO Od SCE was 3 Severe Anaphylaxis Epinephrine Administered Condition Improves Pla Pause Close The Scenario Management Pop Up Menu 2 From the menu select Show Scenario The Scenario screen appears displaying the scenario The Jump to EEE Collapse AW cw expand an The Close State button Window Beginning Anaphylaxis B Button i Selected state States The Scenario Screen At the top of this screen the Scenario Time and State Time are visible Additionally users can pause and continue playing the scenario by clicking the Pause and Play buttons on the Scenario Management pop up menu which is still visible on the left side of the screen 71 Using M se METIman 3 Click the Jump to State button The Jump to State menu appears displaying the available states P Beginning
84. e 49 0 6131 4950354 Fax 49 0 6131 4950351 Email Address international service caehealthcare com CAE Healthcare Customer Service UK and Ireland Monday Friday from 9 00 a m to 5 00 p m GMT Phone 44 0 800 917 1851 Email Address uk service caehealthcare com Principal hours of operation exclude holiday and non business days 205 206 Care and Maintenance METIman Contract Period Warranty contracts are not ordinarily offered for periods of less than one year However multiple year warranty contracts may be arranged for up to an additional three years Discounts are available for purchase of multiple year contracts Limitations of Agreement Your exclusive remedy for any defective patient simulator is limited to the repair or replacement of the defective patient simulator CAE Healthcare may elect which remedy or combination of remedies to provide at its sole discretion CAE Healthcare shall have a reasonable time after determining that a defective material exists to repair or replace defective material CAE Healthcare s replacement material will be manufactured from new and or serviceable parts CAE Healthcare s agreement applies to repaired or replaced materials for the balance of the applicable period of the original warranty or ninety days from the date of shipment of a repaired or replaced material whichever is longer CAE Healthcare warrants its LABOR for 30 days or the balance at the applicable period of the orig
85. e using a Quick Link or using the complete Interventions menu Quick Links are preconfigured interventions that are made accessible in the Interventions palette for quick application Quick Links can also be created for the Conditions and Medications palettes To apply an intervention using the Quick Links in the Intervention palette click an Intervention Quick Link NOTE Not all interventions affect the patient s physiology but all are logged The E Interventions Interventions Ba Valve Mask button zh Rate dy Crystallolds intubated Quick Links Nasal Cannula Non Rebreather Mask The Interventions Palette Once an Intervention is selected a menu appears with available options for the selected Intervention Click the desired option to select it The intervention is applied and appears in the patient s physiology The Bag Valve Mask Interventions tastes options Intubated ooo A selected Non Rebreather Mask intervention The Selected Intervention Options NOTE Quick Links can only be added while creating or editing the SCE 67 Using M se METIman Or to apply an intervention that is not set up as a Quick Link in the Interventions palette 1 Click the Interventions button The Interventions menu appears Interventions are organized by type or all available interventions are listed under ALL INTERVENTIONS Electrical Therapy Fluids Invasive Procedures The All Interventions Menu 2 Navig
86. e Mute All button to mute all Patient Status Display alarms To adjust the widget layout click the Setup button 52 CAE Healthcare Using Muse The Widget Setup menu opens displaying available widget types Waveform Numeric and Volume Widget Setup Waveform Numeric Lung Volume R L 1322 0 1322 0 The Widget Setup Menu Adjust the Patient Status Display layout by dragging a widget type from the Widget Setup Menu and dropping it over the Patient Status Display The new widget type replaces the old To change a Patient Status Display widget click the widget to be changed A list of available parameters appears Choose the desired option from the list and the widget changes to reflect the new selection From the numeric widget menu you can also use the Set Color button to change the display color of the widget and the Set Alarm button to change the alarm settings for the selected widget 53 Using M se METIman The Event Logs During an SCE all software operations sensed by the simulator or entered manually e g virtual defibrillation are recorded by an event entry that appears on the screen The event entry notes what occurred and the time it happened Event Logs 00 01 27 Applied condition Bag Valve Mask 73 FiOZ2 00 01 18 Epinephrine 1 1 000 0 3 mecg kg min IM Administered 00 00 00 SCE was started The Event Logs Event Logs can also be exported For more information see History on
87. e Vocal Sounds are available Vocal Sounds are male or female based on the gender of the active patient Vocal Sounds To select a sound from the Vocal Sounds drop down menu click the Sounds button on the Run screen The Sounds panel appears Click Vocal Sounds and select the type of sound desired from the Vocal Sounds drop down menu Default None NOTE The volume control slider may be used to adjust the amplitude of the sound A 24 p CAE Healthcare Appendix B Wireless Voice Link Appendix B Wireless Voice Link This information is intended to assist in preparing Wireless Voice Link WVL devices for use in conjunction with METIman Cautions and Warnings This device complies with part 15 of the FCC Rules and with Industry Canada licence exempt RSS standard s Operation is subject to the following two conditions 1 This device may not cause interference 2 This device must accept any interference including interference that may cause undesired operation of the device Cet appareil est conforme aux normes d Industrie Canada exempts de licence RSS s Son fonctionnement est soumis aux deux conditions suivantes 1 Cetappareil ne doit pas provoquer d interf rences 2 Cet appareil doit accepter toute interf rence y compris les interf rences pouvant provoquer un fonctionnement ind sirable de l appareil Any modifications made to this device without the express approval of CAE could void the user s auth
88. e can then be displayed on the Patient Status Display and TouchPro software Note that changes in arterial temperature may alter the shape of the standard oxyhemoglobin dissociation curve As temperature increases or pH decreases more oxygen is released from hemoglobin and thus the patient s saturation decreases The inverse is also true Default 37 C Range 32 0 C 42 0 C Respiratory Parameters Respiratory Parameters CAE Healthcare Appendix A Parameter Descriptions Respiratory Parameters Swollen Tongue This parameter is used to create tongue swelling The tongue is either Swollen or Not Swollen The Not Swollen setting returns the tongue to its normal anatomic state Default Not Swollen Options Not Swollen Swollen A 5 Appendix A Parameter Descriptions METIman A 6 Airway Occluder Prehospital Only Using the Airway Occluder parameter swelling of the posterior oropharynx can be activated to obstruct the view of the larynx and prevent intubation but allow mask ventilation of the patient s lungs thereby creating a cannot intubate can ventilate scenario Default Off Laryngospasm Prehospital Only Use the Laryngospasm parameter to simulate a laryngospasm A laryngospasm actuator closes the patient s vocal cords and prevents both ventilation and intubation When activated with the Airway Occluder parameter a cannot ventilate cannot intubate crisis scenario is achieved Default Of
89. e minus sign decreases the volume and setting On the handset pressing straight down on B 4 C AR Haslthoare Appendix B Wireless Voice Link Preparing the Base Station in the Simulator When using the base station in the simulator ensure the batteries are removed and the following items are attached Power cable Line out cable Serial Connector The DIP switch is located in the battery compartment of the base station Figure 5 DIP Switch Settings DIP Switch Settings Figure 5 Dip Switch Settings The serial connector is located on the side of the base station Figure 6 Serial Connector Serial Connector Figure 6 Serial Connector on base station B 5 Appendix B Wireless Voice Link METIman The base station should come already connected and installed inside the METIman Base Station Connected and Installed in METIman Figure 7 Base Station in METIman To prepare the base station 3 Setthe base station DIP switch positions 6 and 7 to OFF and 8 to ON 4 Turn the power off and on using the power switch on the outside of the base station to ensure the DIP switch changes take effect 5 Leave the power switch on the outside of the base station in the on position Figure 8 DIP Switch Settings for the Base Station NOTE Since the base station receives power from the simulator the power switch on the outside of the base station must remain in the ON position Use this power switch t
90. e new password in the New Password field and re enter the new password in the Confirm Password field Click Change Password when finished IMPORTANT If you change your username or password you MUST use the new username and or password upon your next login You cannot access the system with the old username or password once it has been changed 131 Using M se METIman Favorite SCEs To access the Favorite SCEs panel click Favorite SCEs from the Account Profile screen All of the logged in user s favorite SCEs appear in the Favorite SCEs panel meti admin Email admin meti com Favorite SCEs ID admin Angina with Cardiac Arrest Food Polsoning Profile Information The Favorite SCEs link Medication Preferences Profile Preferences The Favorite SCEs panel The Add Favorites button The Account Profile Screen To add SCEs to the Favorite SCEs panel click Add Favorites The SCE Library appears Select the desired SCE and it automatically appears in the Favorite SCEs panel 132 CAE Healthcare Using Muse Medication Preferences From the Medication Preferences panel users can import customized medication response files created in the Pharmacology Editor software To access Medication Preferences click Medication Preferences on the Account Profile screen The Medication Preferences panel appears meti admin Email admin meti com Medication Responses ID admin Patient Group Medicati
91. e supplied power cords Do not substitute e Always use the supplied power adapter to run the simulator from AC Operate the system from a power source with the following rating 115VAC 50 60 hertz cycles per second e 9 North America Japan 230VAC 50 60 hertz cycles per second e 9 Europe e Do not allow excess fluids to flow on or into electronic parts e Do not attempt to disassemble the simulator or service any of the electrical components other than the resetting of circuit breakers CAE Healthcare Cautions and Warnings General Use Warnings Electrical System Operate the system from a power source with the following rating 115VAC 50 60 hertz cycles per second e g North America Japan and 230VAC 50 60 hertz cycles per second e g Europe Do not operate the METIman system in rain Apply water to the mannequin only in accordance with the supported clinical procedures identified in this User Guide Do not allow excess fluids to flow on or into electronic parts CO Production System Care must always be taken when using high pressure equipment Do not disassemble or alter regulator Store CO canisters in dry location between 32 and 104 F 0 to 40 C Do not expose CO canister to heat above 140 F as rupture may occur Never point CO canister towards your face or someone nearby Use only CAE Healthcare specified CO canisters Wear protective gloves and eye protection when removing canister
92. ed hand pump is used to create the pressure for the Trauma Fill Tank WARNING To prevent ejected pump assembly and or solution from striking and injuring you NEVER stand with your face or body directly over the top of the tank when pumping or loosening the pump To operate the pump and fill the reservoir a Unlock the pump handle by turning counter clockwise Be careful not to loosen the pump from the tank b Stroke the pump handle up and down from 25 to 35 times to transport 2 liters of simulated blood to the on board blood reservoir NEVER exceed 35 strokes while pressurizing the tank C Lockthe pump handle back into the pump assembly by turning clockwise d Watch the Overflow Bottle located on the tank assembly When liquid begins to appear in this bottle the on board blood reservoir is full Filling the on board blood reservoir takes approximately 3 to 5 minutes 32 CAE Healthcare Setup Step 4 Release Pressure from the Trauma Fill Tank Immediately release pressure from the tank by turning and holding the yellow pressure relief knob clockwise until all air pressure is gone If pressure will not release using the relief knob a Place a rag over the top of the tank and pump handle b While firmly pushing down on the pump handle slowly turn the handle counter clockwise NEVER leave a pressurized tank unattended Step 5 Disconnect the Trauma Fill Tank Umbilical from the Simulator Disconnect the T
93. een 153 METIman Using METIman Neurological The clinical features that can be controlled from the Neurological Assessment view are Blinking Eyes Reactive Pupils Convulsions Neuromuscular Block Body and Blood Temperature and Speech To access the Neurological view from the Run screen click the brain on the human form Click the brain P Reactive P Reactive 4 to access the Auto Auto Blinking Blinking Closed Closed 8 Neurological Modeled parameters TUN Temperature Blood a amp f LLLA f CL M Sounds The Neurological View 154 o CAE Healthcare Using METIman Eyes The pupil diameter pupil reactivity blinking and blink speed of the simulator s eyes can be controlled from the software Click the Reactive drop down menus of each eye to determine reactivity Reactive Non Reactive Pinpoint or Blown Click Auto to have the eyes blink while the patient is conscious Click Closed to close the eyes Click Blinking to force the eyes to be open and blinking regardless of patient consciousness These features can be controlled on both eyes Click Slow Normal or Fast to control the blink speed Convulsions METIman simulates convulsions when the feature is activated on the software To activate the Convulsions feature click the Convulsions switch The Convulsions feature is activated when On appears To deactivate the convulsions feat
94. eled Intrapleural Vol Left Intrapleural Vol Right Chest Tube Flow Left Chest Tube Flow Right 50 y CI M Sounds The Respiratory View 157 158 Using METIman METIman Airway Various clinical signs such as breath sounds chest excursion and airway patency can be physically demonstrated A series of speakers inside the simulator can generate a range of breath and throat sounds used in diagnosing conditions METIman Prehospital s anatomically realistic upper airway provides for the opportunity to intubate the patient as well as apply other airway interventions In addition the METIman Prehospital airway was designed to be a difficult airway that teaches learners to use the best technique when encountering clinical situations with real patients The airway is best visualized when using the Sellick maneuver which is performed when a patient is undergoing the intubation procedure The METIman Nursing airway has the ability to produce secretions to allow for suctioning CAE Healthcare Airway Features Anatomy Physiology Clinical Interventions Patient Software Control Manual and Clinical Signs Monitoring and Scenarios Control Realistic Upper Allows direct laryngoscopy oral and None required None required Airway Oropharynx nasal intubation and use of specialty N harynx and Larynx airway devices Simulator detects opnan ana Eayn and responds appropriately to right mainstem int
95. ement marketing and commercialization of its products and services without any restrictions based on confidentiality or intellectual property rights CAE Healthcare License Copyright 4 TERM AND TERMINATION 4 1 This License shall become effective as of the date of Your execution of this License and shall remain in effect until terminated as provided hereafter 4 2 This License terminates immediately upon termination of the HEPGTC 4 3 CAE Healthcare may terminate this License immediately upon written notice should Licensee a fail to comply with any of the terms and conditions of this License b terminate or suspend its business make an assignment for the benefit of creditors or any proceedings are instituted by any party or against it seeking to declare it bankrupt or insolvent or seeking liquidation winding up reorganization arrangement adjustment protection relief or composition of its debts under any law relating to bankruptcy insolvency reorganization or relief of debtors or seeking the entry of an order for relief or the appointment of a receiver trustee or other similar official for it or for any substantial part of its property 4 4 Upon termination of this License Licensee agrees to immediately discontinue use of the Confidential Information and the Product and to return same to CAE Healthcare as well as any copies summaries or extracts thereof with any associated CD ROM s DVD keys dongles or other device
96. enamed 98 CAE Healthcare Using M se Modifying Scenario States Once a scenario state has been placed on the canvas it can be modified Additional parameters transitions and notes can be added Each state can contain multiple parameters and transitions Double click the state name to rename it The Collapse State button A State Click the Collapse State button to minimize the state Double click the collapsed state to expand it 99 Using M se METIman Adding Conditions Interventions and Parameters Conditions and interventions can be added to states by dragging and dropping them from the Conditions menu to the desired state Adding a condition or intervention to a state The Conditions menu m se ipetentien t Scena S pares I P Collapse Al Expand All o Cardiovascular Acute ventricular Failure Both oe uL Ere EWEed LN S IB onini Acute ventricular Failure Right 1 Anxiety er j 5tress BF Hypertension Acute ventricular Failure Laft py Me nto A PN BP Hypotensian Cardiac Tamponada Chronic Hypertension I Depamine Greater tan ar Equal menta Hart R tt Bradycardia p Hypetentign lS poe e n o Hran Rate Tachycardia IF Thee En State OGnrater than or Equal 3 amp 0 arcs A k Idiopathic Hypotension GOTO Hypaten ion Workers rg _ Patient Stability et ERR Ventricular Failure
97. enario to edit Creating a New Scenario To create a new scenario 1 From the SCE Editor under the Pre Loaded Scenarios heading click the Add Scenario button Pre Loaded Scenarios The Add Scenario button 4 Add Scenario The Pre Loaded Scenarios Heading The Choose Scenario dialog box appears Scenarios vas Name Last Modified Anterior Myocarclal Infarction 2011 09 12 09 38 35 COPD Exacerbation with Resplratory Fall re 2011 09 12 09 39 10 Elevated Heart Rate 2011 05 12 09 41 01 Heroin Overdose 2011 09 12 09 39 41 Inferior Myocardial Infarction 2011 09 12 09 40 13 Organophosphate Exposure 2011 09 12 09 40 39 The New button inne a et Gu ax The Choose Scenario Dialog Box 92 J CAE Healthcare Using Muse 2 Click New The Scenario Designer appears displaying the new untitled scenario Untitled Scenario C al J Mew State jy Collam AW Expand Al ALL CONDITIONS Cardiovasclar Hemorrhage M urvdnniz Respiratory ImMerverdions The Scenario Designer 93 Using M se METIman Editing a Scenario To edit a scenario 1 From the SCE Editor under the Pre Loaded Scenarios heading click the Add Scenario button Pre Loaded Scenarios Add Scenario The Add Scenario button The Pre Loaded Scenarios Heading The Choose Scenario dialog box appears Scenarios Anterior Myocardial Infarction 2011 09 12 09 38 35 COPD Exacerbation with Resplratory Fallure 2011 09 12 0
98. er Regulated Materials Domestic ORM D Ground shipping containers must be clearly marked with this label CO Canisters are considered hazardous material when offered for air transportation so different rules apply Contact carrier for details and instructions Related CAUTIONS WARNINGS CO Canister e Store the CO canisters in a dry location between 32 and 104 F 0 to 40 C e Do not expose the CO canister to heat above 140 F as rupture may occur e Never point the CO canister towards your face or someone nearby e Use only CAE Healthcare specified CO canisters CO Regulator Assembly e Care must always be taken when using high pressure equipment Do not disassemble or alter regulator e Dry completely if the regulator becomes wet e Discontinue use of this equipment if leakage or visible damage is evident Use of Equipment e Canister end becomes punctured when screwed into regulator base and therefore should not be removed until empty e Unscrewing canister before it is empty will result in sudden release of all high pressure gas with a possibility of liquid CO spray Unprotected skin could receive freezing burns Wear protective gloves and eye protection when removing canister from regulator assembly e Remove CO canister from regulator assembly when shipping simulator CAE Healthcare Recommended Clinical Supply Sizes Recommended Clinical Supply Sizes The following clinical supply sizes are recommen
99. er attached to the regulator assembly Assembly of the CO Regulator e Care must always be taken when using high pressure equipment e Do not disassemble or alter the regulator e Dry completely if the regulator becomes wet e Discontinue use of this equipment if leakage or visible damage is evident 25 Setup 26 METIman Insertion of the CO Canister Prehospital Only To insert the CO canister a Lift the chest skin at the waist and lift the abdominal insert b From the simulator s right midsection remove the pull pin and disconnect the blue CO hose Remove the Pull Pin c Remove the regulator from the simulator d While holding the regulator firmly carefully twist the CO canister into the regulator as far as it will go The final turns puncture the CO canister which is necessary for correct operation Insert the CO canister into the regulator Connecting the CO Canister CAUTION Do not loosen the canister once it has been inserted into the regulator assembly until the contents are exhausted and pressure relieved CAUTION Removing the canister before it is empty results in the sudden release of all high pressure gas with a possibility of liquid CO spray Unprotected skin could receive freezing burns 3 CAE Healthcare Setup e Place the CO canister regulator and hoses inside the simulator Use the pull pin to secure this assembly to the tray A properly installed assembly will
100. erial oxygen or carbon dioxide levels by adjusting the Tidal Volume parameter Default Modeled Range 4 breaths per minute 40 breaths per minute SpO The SpO parameter is used to override the normal pulmonary circulation and set the SpO at a fixed numeric value regardless of the oxygen applied Resetting to Modeled returns control of the underlying SpO to the physiological models 2 Default Modeled Range 096 10096 Neuromuscular Blockade NMB The degree of NMB is automatically determined by pharmacokinetic and pharmacodynamic models which are based on the neuromuscular blocking agents administered and the time course of their injection For some educational applications however the instructor may wish to set a fixed degree of neuromuscular blockade that remains stable for an indefinite period This can be accomplished using the NMB parameter The default value instructs the pharmacologic models to determine the degree of neuromuscular blockade based on the drugs injected and their pharmacologic properties When a positive numeric any other positive value is assigned to this parameter the degree of NMB is set to that level For example 8096 NMB causes the simulator to set the degree of NMB to 8096 regardless of the presence or absence of neuromuscular blocking drugs Clinically the spontaneous tidal volume is markedly reduced Default Modeled Range 096 10096 Tidal Volume The Tidal Volume parameter is used to se
101. ersonal profile information Users can also view and add favorite SCEs from this screen Click the Account Profile button to access the Account Profile features The Account Profile Button 129 Using M se METIman The Account Profile screen appears meti admin Email admin meti com Profile Information ID admin First Name meti Last Name admin Emall admin meti com Favorite SCEs 1D admin Medication Preferences Password Reset Profile Preferences New Password Confirm Password The Account Profile Screen 130 CAE Healthcare Using Muse Profile Information From the Account Profile screen the Profile Information panel appears by default If another panel has been selected click Profile Information to return to the Profile Information panel From the Profile Information panel users can change their profile information and reset their passwords meti admin Email admin meti com Profile Information ID admin First Name meti The Profile Information link Last Name admin Emall admin meti com Favorite SCEs 1D admin Medication Preferences The Profile Information panel Password Reset Profile Preferences New Password Confirm Password The Account Profile Screen To change profile information enter the new information in the appropriate fields and click Update Profile when finished To reset a password enter th
102. es m o 2 o rap mE eo gm emo eco cmm ez wi w uO wo wo wo E EEST T FEET EET EET EET EET EET EET ON 1 1234 mm i 12345 12345 Tm il j 12345 123as 12345 ON ON ON cus BR cuo gilt cu 15 gia 12345 1273454 12345 ON ON ON 12345 123a45 12345 ON ON ON 12345 12345 12345 Figure 10 RF Channel Selection Methods For a complete list of the initial frequencies associated with the RF Channels see RF Channel Initial Operating Frequencies on page B 13 B 8 p CAE Healthcare Appendix B Wireless Voice Link Powering Up the WVL Pair To power up the WVL pair Power on the base station by turning on the simulator The base station power switch is in the on position by default Power on the handset by setting the power switch to the on position The red power light on each unit blinks when the unit is on Once both units are powered on and communicating with each other the green connection light flashes once every second If the green connection light fails to blink ensure both units are set to the same RF channel See Selecting the Radio Frequency Channel on page B 7 If you make changes to the DIP switch settings toggle the power switches of the handset and base station off and back on to ensure the changes takes effect Using the iPhone Standalone Microphone DIP switch position 6 on the handset determines if the iPhone microphone input or the standa
103. es 7 External Compressed Air Kit lt sadescsscscesaseyesscssenseusstadevedsniedesesusedavesesinsentsidessteognoationiescdoonsdesseteanseutsanseatnaaecs 7 SUCCUM t E A T E E A A E R 8 PRE COMM ES PA EE AAT A EIEE A E AE ENEA AEE T T 8 Hands Free Training Cables eseessseessseessseeesseessseeessecsssecensecssseeeusecouseeonsecosseconsecosseconsecosseeonsseosseeosseess 9 METIman Learning Applications and Training Courses cssssessssesssecsssesssseesessessssessssesseesssessseesesee 10 TOORN e 10 MUSS m cae 11 i111 11 DICE S d RR E RTT 12 MEMAN SEUD er 13 Before Beginning lum M M 14 Step 1 Place METIman in the Work Area eene eee eere eere eee enero ooo eee eno 15 Step 2 Connect the Lower Legs to METIman eese eere eene eee eere e enero nonet eno eee ens 16 Step 3 Power ON ME TIM sco o visi reed vEEEER VERI SIN E EYE EYE PEE nnii niaan 18 Step 4 Power On the Instructor Workstation 444r eere eere eee eee enne eee ee etn ooo eee eno 19 Step 5 Connect to the METIman Network Laptop Instructor Workstation Macintosh Option 20 Step 5 Connect to the METIman Network Table
104. etary notices indicated on the Software and Data ghost export or produce any derivative works from the Product or any part thereof not network the Product without CAE Healthcare s prior written approval or make it available for concurrent use b not sell attempt to sell or transfer unless in compliance with the HEPGTC sublicense encumber the Software or Data c not modify the Product in any way combine with other programs or reverse engineer screen scratch decompile or disassemble any Software nor otherwise attempt to create or derive the source code related thereto d not deface or remove any copyright or proprietary notices e not use the Product without the Key if provided with the Product or attempt to develop or develop any means or technology which would enable Licensee to bypass the use of the Key to operate the Product f prevent anyone other than Authorized Users from accessing or using the Product g not incorporate the Product in whole or in part to any product or service that Licensee would make available to a third party on a commercial basis or not 2 4 Notwithstanding anything else contained in this License in no event shall Licensee use the Product and or Confidential Information to enable support or otherwise aid Licensee or a third party to develop any product software or service competitive with any of CAE Healthcare s products 23 Licensee agrees to grant CAE Healthcare its agents and repre
105. ew Patient esessssssssesssoessersseesssesssersssesssessscessersssrsssesssersssrossesssersseressrsssesssersssrossesssersseress 76 Resetting a Patient sssesssessssesssesssersseresecsssoessersssrossesssersssrosscosseesseressresseossersssresscossersseressresseesserssses 7 The Medication VOTING sczccseatexaceszesctactatescesacescasqantaatsetesetacasasorctacseceenseasessecaecseoencactvsceqnterseraccvatoceniasse 78 Returning to the Home PO Boe aen ebrei EE VIR t fete smit bonu cb 90 UOT PUIG ENS C canonem apoph DUERME MIU MI 80 pevelopInd SCES ausos Ven VHS DRAN EIS VICA CURA FIVC OON ERN EEEE EIE 82 eatin NW S CB nom RUPEM RU RUM NIRE aunts MEME NA 82 lie dais M 84 Developing SCCM AOS setesccsecxsaloscueensatecessencssace TRECE HEIN EU IURE ETHERNET IUE 92 Creating a New Scenario ecce eise castors ceveesaoaeaseubendestectieaiesni PERMOTI HIER TU HERE NNTIH 92 Editino A Ss NR 94 The SCO E a E IEN i nnd manete A tique N 95 PVCU Scenario E E dencoteet entem obti tu a pen IPRC IN IMIS 97 MOGI YING S CEMANO SER CS EEE EA ERN PLURI DRE ORDRE ANETTA 99 Deleting SGC TNO Ed 65 coconecdi marier nOWOda manae n DIA 106 xvii Table of Contents METIman Deleting Parameters and Transitions ccccssssssssssssssssssesessessssesessesessesessesessesessesessesessesesseseeseseeeeeees 107 Saving the Se LL UPON RRRRCRRE E 108 Saving States to the State WII AN Eas c
106. f Needle Decompression Left and Right Prehospital Only The Needle Decompression parameter is used to activate the Needle Decompression hardware in the simulator to relieve a pneumothorax in the simulator This causes a rush of air to be heard on successful decompression The amount of decompression is automatically subtracted from the Intrapleural Volume set Default Off Bronchial Occlusion Turning on the Bronchial Occlusion parameter completely obstructs the right or left bronchi simulating a lower airway obstruction e g mucus plug Improper intubation creates a main stem occlusion yielding an inability to ventilate the lungs However the right and left bronchi are not occluded individually Default Off Respiratory Rate The Respiratory Rate parameter is used to set the respiratory rate to a given number of breaths per minute Once set arterial oxygen and carbon dioxide values have no effect on the resulting respiratory rate but continue to influence other components of the physiological models The patient continues to breathe at the set number of breaths per minute regardless of the arterial oxygen or carbon dioxide levels 3 CAE Healthcare Appendix A Parameter Descriptions For example when the respiratory rate is set to 10 breaths per minute the respiratory rate remains at 10 breaths per minute regardless of arterial oxygen or carbon dioxide levels In such situations the patient can only respond to art
107. f a small volume of fluid is needed to simulate proper urinary catheterization in a field location the internal reservoir may be filled To fill the genitourinary reservoir attach a syringe with a Luer lock extension set provided and inject 60 mL of distilled water into the GU port on the simulator s left shoulder Changing the Simulator s Genitalia METIman comes with male and female genitalia To switch genitalia 1 Pull apart the Velcro holding the genitalia 2 Loosen and remove the urethra connector This connection may be tight when genitalia are removed the first time 3 Remove the genitalia 4 Attach urethra tube to the urethra connector 5 Attach the desired genitalia using the Velcro 193 194 Using METIman METIman Sounds A variety of simulated sounds are available to enhance realism A patient must be running on METIman for any sounds to be available Speech Speech can be added to simulations using the Vocal Sounds and Speech Sounds features on the software or by using an external microphone Vocal Sounds A variety of programmable vocal sounds are available Vocal sounds are male or female based on the gender of the active patient Vocal Sounds CAE Healthcare Using METIman To select a sound from the Vocal Sounds drop down menu click the Sounds button on the Run screen The Sounds panel appears Bowel Sounds Breath Sounds Vocal Sounds Heart Sounds ate Crying Gagging Throat
108. g Upper The Bleeding Upper parameter is used to activate the site of bleeding Default Off Bleeding Lower The Bleeding Lower parameter is used to activate the site of bleeding Default Off p CAE Healthcare Appendix A Parameter Descriptions Sounds A variety of simulated sounds are available to enhance realism Bowel Sounds Bowel Sounds Normal Hypoactive Hyperactive and absent bowel sounds None are selected using this parameter Independent control of the type and volume of bowel sounds may be selected in each anatomical region Bowel Sounds Locations To affect the bowel sounds simultaneously in all anatomical regions select All Bowel Sounds and the desired sound Default Normal NOTE The volume control slider underneath each area may be used to adjust the amplitude of the sound Appendix A Parameter Descriptions METIman Breath Sounds Normal and abnormal breath sounds are selected using this parameter Breath sounds are independently synchronized with ventilation of the left and right lungs Independent control of the type and volume of breath sounds may be selected in each anatomical region Breath Sounds Locations Breath Sounds To affect the breath sounds simultaneously in all anatomical regions select All Breath Sounds and the desired sound Default Normal NOTE The volume control slider underneath each area may be used to adjust the amplitude of the sound A 20
109. g METIman Gastrointestinal METIman produces realistic bowel sounds In addition on METIman Nursing gastric lavage gavage and suction can be administered Gastrointestinal Gavage Lavage and Suction Nursing Only METIman Nursing has a gastric reservoir that allows for simulated gavage lavage and gastric suction Before each use ensure the reservoir has been drained completely The reservoir should be primed with 60 mL of fluid before performing gastric suction see Gastric Suction on page 190 for more information A maximum of 100 mL of fluid may be added to the gastric reservoir once the reservoir is primed Gavage Nursing Only To perform gastrointestinal gavage ensure the reservoir is empty and infuse fluid according to procedure using a standard nasogastric tube For supported nasogastric tube size see Recommended Clinical Supply Sizes on page 221 NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal NOTE Ice the nasogastric tube if extra rigidity is needed for insertion Lavage Nursing Only To perform gastrointestinal lavage ensure the reservoir is empty and infuse fluid normally using a standard nasogastric tube Fluids can then be removed according to proper clinical procedure For supported nasogastric tube size see Recommended Clinical Supply Sizes on page 221 Gastric Lavage NOTE Cleanup is very important when using
110. g a Macintosh Operating System a Click the AirPort icon located in the top right hand corner of the screen Clicking the AirPort Icon b If the AirPort is not on select Turn AirPort On Turn AirPort On M Open Network Preferences Selecting Turn AirPort On 36 p CAE Healthcare Setup C Select the network e g for METIman Prehospital MMPXXX where XXX is the simulator s unit number Fri 12 39 PM E wear Un Turn AirPort Off MMNXXX D yites Select a hpsetup network j Jain Other Metwork Create Network Open Network Preferences Selecting METIman s Network The AirPort dialog box appears The network MMPXXX requires a WPA password Password Show password Remember this network Cancel OK J The AirPort Dialog Box d Enter the password metiadmin into the Password field e Click OK The network MMPXXX requires a WPA password Password Gem 00000 g Show password Ivi Remember this network Cancel Click OK i Connecting to METIman s Network The computer has joined the METIman network You can now proceed to Step 5 37 Setup METIman Step 4 Option 2 Join the METIman Network Using a Windows Operating System a Click the Wireless Network icon located in the bottom right hand corner of the screen Clicking the Wireless Network Icon b Click Connect to a Network Not Connected A Wi
111. ge ports located on METIman s right shoulder UPPER MOULAGE or right hip LOWER MOULAGE METIman s Right Hip 3 Enable Bleeding Upper or Bleeding Lower on the Fluids view of the M se software as desired Hemorrhage Control When bleeding is controlled e g hemostat tourniquet the action is detected and logged and the physiology responds accordingly 187 188 Using METIman METIman Tourniquet Application A tourniquet may be applied to stop the flow of blood The wound umbilical contains an 18 inch section of soft tubing that allows the use of a tourniquet to stop the flow of blood For added realism the simulator should be dressed in clothing that can be torn to conform with the type of injury being demonstrated Bleeding moulages and the wound umbilical should be concealed under the victim s clothing with only the wound showing Tourniquet Application Fluid Loss Blood To manually control a patient s blood loss from the Fluids view click the Fluid Loss Blood parameter The Fluid Loss Blood slider appears Set the amount of blood loss by dragging the arrow up or down Click Accept to exit and save the changes Fluid Loss Plasma To manually control a patient s plasma loss from the Fluids view click the Fluid Loss Plasma parameter The Fluid Loss Plasma slider appears Set the amount of Plasma loss by dragging the arrow up or down Click Accept to exit and save the changes CAE Healthcare Usin
112. gner Views The Scenario Designer has two views the Graphical view and the Line Item view The Graphical view allows users to map out scenario states The Line Item view places the states and transitions into a linear format The The Line Graphical Y Scenario Em EZ New State b Collapse All Expand All Item View View button button The Scenario Designer View Buttons Click the Graphical view button to utilize the Graphical View Anaphylaxis CETS Qe Mew State jy Collapse A Expand AB n nmm The Collapse m State button An expanded state v TL The Graphical View From the Graphical View double click on any state to expand it and view all its components Click the Collapse State button to collapse an expanded state 96 CAE Healthcare Using Muse Click the Line Item view button to utilize the Line Item view Anaphylaxis xal ae New State je Collapse all ALL CONDITIONS The Expand Ses Reha crores Collapse arrow An expanded state The Line Item View From the Line Item View click the Expand Contract arrow to the left of any state to expand it and view all its components Click the arrow again to collapse the state Adding Scenario States When beginning to create a new scenario the canvas is blank Scenario states can be created by dragging and dropping conditions medications and interventions from their respective
113. greement cx ctostanctesvencecsonedscasnarsiessGscaesstveronteresantessuocnsesvavestevstestrsetasaesGtecbensnseustoueascoeusae 204 sanior eu e nsi i cC inae 205 ROA AT PEO m 206 L rttauons ar AGEEBITODIE eese citis EE EAE A AT AE A E A E 206 Return Materials Authorization RIVA sssssssssssssssssssssseeesssssseeesnssseeeessssssseeeessssseeeeesssssreeeessssereeeesss 206 System Software Upgrade Support ssessocessoessocesocssocesooeesosesocesooesoosesocesosesooessosesocssssessosssses 207 EI ani y E A A E I N A E E E AS 207 E AND VV ACCT AIS E E E A A A A E TE T 207 XX CAE Healthcare Table of Contents illo e 208 Step 1 Stop All Running SCES ee ncsscekceneecsasaestektevicrtiehenires sevce ehe tin he ettet cepere nth teen eedrnieus toes 208 Step 2 Clean the Simulator and the Fluid System reete 208 Step 3 Shut Down the Software averenecti cui dumm evi n EN UR FUEL UNIS PUE EPI SVA ErURR SUCH IEEE ences 208 Step 4 Power off the Simulator Potusisssestunserei cavaccscoxes oars deuscesasesroncsosstocosesnacessiavensarseuoiesnutossorestheasstinesnaccs 209 Maintenance puri m 209 Greta SI ato E 6 oer en E eran T ERE perma amm 209 SUN c 209 Care of Electronic EGUIDITIGTIE co scsacsctecamsestencosecessorestazestencsctacscasso
114. guage Selection panel appears 3 From the Language Selection panel select a language 4 Click Accept Language Selection English US French France Spanish Spain Chinese Traditional Chinese Simplified Polish Russian Korean Cancel Accept The Language Selection Panel The TouchPro software changes to the selected language Exiting the TouchPro Software To exit TouchPro 1 Click the Settings button from the bottom right corner of the TouchPro screen The Settings menu appears 2 From the Settings menu click Shutdown A warning box appears asking if you want to exit 3 Click Shutdown TouchPro shuts down and the Muse Start Screen appears 152 S CAE Healthcare Using METIman Using METIman Once METIman has been set up see the Setup section and the software has been launched see the Using the Software section the simulator is ready for learner interventions The features of METIman are broken down by Neurological Respiratory Cardiovascular Gastrointestinal and Genitourinary systems Healthy Adult Male i 00 00 04 i Gy D 2 og b Stan D Ardman 11 W serkmark Slog mm Aprea BP Hypertenascon HP petani Heart Fate Erad ycxradia Heart Hab Farfiycarcion Patient Stabiliby Aceta mira nhan winds keg Vahe Mari Hon egbneather Mask Airut User Guede Tn Event Recorder Patient gd Medication Monitor Y meti adrnin The Run Scr
115. h 70s High 170s 225 Condition Guidelines for Programming METIman METIman Respiratory Respiratory Rate Tachypnea Bradypnea VI W w Ww Ov WwW O31 33 00 36 00 226 p CAE Healthcare Appendix A Parameter Descriptions Appendix A M se Parameter Descriptions The M se software has a number of parameters that control the physiological features of METIman The parameters are grouped by category Neurological Respiratory Cardiovascular Fluids and Sounds The following is a brief description of each parameter Each parameter description lists the default settings for the Stan D Ardman Il and Norma L Female patients as well as the ranges if available for all patients Neurological METIman can simulate a variety of neurological clinical indicators such reactive eyes and convulsions Neurological Parameters Eyes Each eye has reactive pupils and eyelids that blink and close A 1 Appendix A Parameter Descriptions METIman A 2 Eyes Pupil Diameter These parameters are used to control the diameter of the pupils in the eyes Each eye has reactive pupils and functional eyelids that blink Currently there are four pupil options that are used to control the diameter of the pupils in both eyes Reactive Non Reactive Pinpoint or Blown When the Eyes are set to Reactive the pupils re size in response to changes in lighting condition If both pupils are set to Reac
116. harmacokinetic and pharmacodynamic models based on the neuromuscular blocking agents administered and the time course of their injection automatically determines the degree of NMB For some educational applications however the instructor may wish to set a fixed degree of neuromuscular blockade that remains stable for an indefinite period This can be accomplished using the NMB parameter The default setting instructs the pharmacologic models to determine the degree of neuromuscular blockade based upon the drugs injected and their pharmacologic properties When a positive numeric value is assigned to this parameter the degree of NMB is set to that level For example 8096 NMB causes the simulator to set the degree of NMB to 8096 regardless of the presence or absence of neuromuscular blocking drugs Clinically the spontaneous tidal volume is markedly reduced Default Modeled Range 096 10096 Temperature Body The temperature measured at the body surface can be set using this parameter and can be displayed on the Patient Status Display and TouchPro software The body temperature is not linked to the physiologic models However changes can be made on the fly or scripted using the Scenario Designer Default 36 5 C Range 32 0 C 42 0 C A 3 Appendix A Parameter Descriptions METIman A 4 Temperature Blood The arterial blood temperature can be set using the Temperature Blood parameter The arterial blood temperatur
117. has the ability to change channels automatically to avoid interruption This process occurs simultaneously in both the handset and the base station without the need for user intervention The units revert back to the original frequency set on the DIP switches when both devices are restarted using the power switch Recommendations for Use To receive the best sound quality from the WVL please note the following recommendations Do not separate the WVL pair with more than two walls Use channels 0 through 11 for the best sound quality Use channels 12 through 31 if more than 12 simulators are present in one area CAE Healthcare Appendix B Wireless Voice Link Wireless Voice Link Devices There are two unique devices that make up a WVL pair the handset device and the base station device The base station device is located inside the simulator while the handset device is battery powered and carried by the user The handset transmits voice input through a microphone to the base station receiver where it is transmitted to the speakers in the simulator s head The two different devices can be identified by their cases The handset device has a cover that extends over the length of the antenna Figure 1 WVL Handset The base station device antenna is almost fully exposed Figure 2 WVL Base Station B 3 Appendix B Wireless Voice Link METIman Physical Features The following features are located on the top of the WVL devices
118. hcare iii is independently developed by Licensee provided it is not in whole or in part related to the Product and iv is obtained by Licensee in good faith and on a non confidential basis and without a use restriction from a third party who lawfully obtained and disclosed such information However Confidential Information does not come within the foregoing exceptions merely because features of it may be found separately or within a general disclosure in the public domain 5 3 Licensee agrees to be responsible for enforcing the terms of this Section 5 and to take such action legal or otherwise to the extent necessary to cause anyone having access to the Confidential Information to comply with the terms and conditions set forth herein including all actions that Licensee would take to protect its own trade secrets and confidential information but with not less than reasonable care Licensee shall be responsible and indemnify defend and hold harmless CAE Healthcare for any default caused by any such persons License Copyright METIman 6 IRREPARABLE HARM 6 1 Licensee acknowledges that the Software and Data constitute a special irreplaceable asset of great value to CAE Healthcare and that a breach in any way of any of Licensee s obligations under Sections 2 License and 5 Non Disclosure hereof would cause serious and irreparable harm to CAE Healthcare which may not be adequately compensated for in damages If the Licensee breaches a
119. he M se software or on any screen without a Home button by clicking the Return button in the upper left or right corner of the screen Joly Monroa L E Angina will Cardiac Arrest Broce Seveni Y Anlerir Hyocardial Infarction Steve Johneen Asthmatic with Poeun thorax Tecan Eae 1 COPD Feacerbalion will Borxpsbralary Fail Bau Cont it EOPD Pali ni m Eran dma rok x Page iy d zh Ji Open canas I fnm n Anaphylaxis Holly Manes 21 years old Female kg Noman L Ferale Gverview Your rescue squad responds to a report of a 21 year old female complaining of rouble breathing She was eating dinner at a cookout when she peticead some tightness in her chest The cook came by asking if anyone wanted another shrimp burger She then told hem she was alagi to shelhsh She was proceedms Lo Fes car to retreve an epmiephnra a3ubo anpector when wasp hung her This SCE consists of six states that manoay ansta Ewing the sw al assessment in State 1 Beginning Anaphylaxis the patent presents with early signs of anaphylaxis HR in the 90s DP im tha 100s 50s RR in the 20s and pOz m the low 408 on room air She remains ronsosus The learmer is expected to assess and manage the pabents airway breathing and orculatory status ABCs dently early eons of allergic reactor consider use ol oxygen call tor help with inbervenbons consider early use n epuwephezmws
120. he Stop Displaying button The Patient Records List To stop displaying a patient record click Stop Displaying at the bottom of the Patient Records list To close the Patient Records list click the Patient Records button The list closes If a patient record is being displayed the Patient Record button remains red until the list is re opened and Stop Displaying is chosen NOTE Only one patient record can be displayed at a time For information about uploading patient records to M se for selection from the Run screen see Patient Records on page 119 56 CAE Healthcare Using Muse Adding a Scenario to a Running SCE SCEs incorporate scenarios that contain pre programmed physiology Scenarios can be added to SCEs to enhance patient physiology To add a scenario to an SCE that is running 1 Click the Add Scenario button on the Run screen The Add Scenario Button The Choose Scenario dialog box appears 2 Select a scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 3 Click Add The scenario is added to the SCE and appears under the Scenarios heading on the Run screen Scenarios ge Add Scenario Anaphylaxis Beginning Anaphylaxis 00 00 03 An Added Scenario 57 Using M se METIman Changing Physiology The patient physiology can be adjusted while an SCE is running in two ways by using one of the physiological views on the Run screen to
121. hen the METIman on board tank is filled To attach the Overflow Bottle to the Trauma Fill Tank 1 Connect the clear trauma fill tank hose to the bottle lid fitting Connect the clear hose to the bottle lid fitting Connecting the Trauma Fill Tank Umbilical to the Overflow Bottle 2 Clip the bottle to the tank using the attached carabiner mechanism WA The carabiner The Carabiner Operating the Trauma Fill Tank Be careful to complete the following steps correctly to ensure proper use and maintenance of the METIman and its peripherals Step 1 Pour the Fluid into the Trauma Fill Tank Pour the desired amount of fluid into the Trauma Fill Tank being careful to NOT to exceed 6 liters 1 6 gallons of fluid NOTE The right thigh tank holds 1 5 liters and is used for blood Three 3 liters of simulated blood provides enough fluid to fill the right thigh reservoir twice The amount of blood used in a training session varies with the patient the wounds simulated and the learner s experience 31 Setup METIman Step 2 Connect the Trauma Fill Tank Connector to the Simulator a Locate the tan FILL port and white VENT port b Connect the FILL with the tan label and VENT with the white label hoses of the Trauma Fill Tank to the corresponding ports on the simulator Both connections must be made for correct operation Step 3 Pressurize the Trauma Fill Tank and Fill the On Board Blood Reservoir An integrat
122. ield where the beats per minute value can be keyed in Weided Poire Modeind etme Oda Masc Mate Porter i Heart Rate The Override Certa keym a Pete es Arara Lares a Modeled Contras Yr Cater er A airaa switch F Catheter yim dy FA Babes er ee ad Deli Biete naet o Firag mars ao The value setting slider The Heart Rate Parameter Once the parameter has been set it is reflected in the patient s physiology 60 CAE Healthcare Using Muse Types of Parameters There are two types of parameters numeric and discrete Once a parameter is selected and set the patient s physiology changes according to the model for that parameter Numeric Parameters Numeric parameters set either a measured value e g 20 mL or a multiplied value called a factor e g Heart Rate Factor 2 0 is two times the baseline Heart Rate Numeric parameters are changed by clicking in the relevant field and entering a new value in place of the existing one or using a slider to move through the range of parameter values until the desired numeric value is established Once a measured value is set that value overrides the physiologically modeled parameter value To return to a physiologically modeled value switch the slider in the parameter dialog from Override to Modeled Discrete Parameters Discrete parameters enable users to select one of two or more options Discrete parameters are changed by choosing the appropriate
123. ight and Lower Left The sounds can be independently set in each anatomical region to Normal Hypoactive Hyperactive or None bowel sounds are absent All Bowel Sounds Ei LUQ Bowel Sounds L j LLQ Bowel Sounds Normal 1 i I I lt Breath Sounds RUQ Bowel gt Normal Heart Sounds Throat Sounds Vocal Sounds The Bowel Sounds Menu Norma Hypoactive Hyperactive None RLO Bowel Sounds I I i j Bowel sounds can be adjusted by clicking the Sounds button on the Run screen When the Sounds panel appears select Bowel Sounds Click any one of the Bowel Sounds drop down menus that each control one of four quadrants to change the type of sound Click and drag the slider for each location to adjust the volume Normal bowel sounds are present by default 9 CAE Healthcare Care and Maintenance Care and Maintenance Maintaining METIman requires careful treatment of the electronic and mechanical components Each time METIman is assembled or disassembled make sure all components are properly handled and either removed from or placed into storage correctly 203 204 Care and Maintenance METIman METIman Warranty Programs General Information CAE Healthcare patient simulator products come with a one year Manufacturer s Warranty excluding batteries and consumables All warranties begin at date of shipment or CAE Healthcare installation You may upgrade your first year Warranty to a
124. in this License CAE Healthcare grants to Licensee and Licensee accepts a personal non exclusive non transferable license to use the Software and Data exclusively with the Product and with the computer on which this License appears 2 2 Except for the License granted herein CAE Healthcare grants no express or implied right under any patent copyright mask work right trademark know how or other intellectual property rights Without limiting the foregoing the Licensee shall not obtain any rights to CAE Healthcare s property or any part thereof by implication estoppel or otherwise Title to and full ownership of any trade secrets and other intellectual property rights related to the Product and components thereof shall remain with CAE Healthcare and if applicable its suppliers For clarification Licensee agrees that the source code for the Software is a trade secret of CAE Healthcare and only CAE Healthcare shall have the right to alter maintain enhance or otherwise modify the Software License Copyright METIman 2 3 Without limiting the foregoing or any other terms in this License Licensee shall and shall ensure that any person authorized to access the Product which are limited to Licensee s employees agents representatives medical staff and students Authorized Users a not copy save and except for normal back up and disaster recovery purposes provided such copy shall include CAE Healthcare s copyright and any other propri
125. inal warranty whichever is greater CAE Healthcare shall not be liable under this warranty for incidental or consequential damages or in the event of any unauthorized repairs or modifications have been made or attempted or when the product or any part thereof has been damaged by accident misuse or abuse This warranty does not cover normal wear and tear staining discoloration or other cosmetic irregularities that do not impede or degrade product performance Any damage or malfunction as a result of the installation of software or hardware not authorized by CAE Healthcare will be repaired under the Time and Materials service plan see Time and Materials section CAE Healthcare s warranty does not cover products that have been received improperly packaged altered or physically damaged Products will be inspected upon receipt Some states in the USA do not allow the exclusion or limitations of incidental or consequential damages so the limitations above may not apply to you This warranty gives you specific legal rights and you may also have other rights which vary from state to state Return Materials Authorization RMA No product may be returned directly to CAE Healthcare without first contacting CAE Healthcare for an RMA number If it is determined that the product may be defective you will be given an RMA number and instructions for product return An unauthorized return e g one for which an RMA number has not been issued wil
126. incorporate latex into their design When performing certain maintenance procedures the latex can become exposed Users with latex sensitivity should take necessary precautions when handling the simulator while performing those procedures CAE Healthcare Cautions and Warnings Battery General Warnings METIman uses Li ion batteries Li ion batteries have special requirements during handling to avoid hazardous situations The Polymer Li ion Battery pack should be stored indoors and be kept far from fire and high temperatures Do not store batteries with hairpins coins screws or other similar objects e Do not heat the battery e Do not throw the battery into a fire Do not use or leave the battery close to heat or flame e Do not use the battery inside of a car where temperature may exceed 80 C 176 F Also do not charge discharge the battery in such conditions e Do not short circuit the positive and negative terminals with other metals e Do not place the battery in a device with the positive and negative terminals in the incorrect positions e Do not strike the battery with force Do not step on throw or drop or drop the battery to cause strong shock Do not disassemble or modify the battery Do not solder a battery directly Do not use a battery that has been damaged or deformed xi M se Software Specifications METIman Additional Warnings Stop charging the battery if the batte
127. ine filter ensuring the black rubber seal is in place at the base of the blue filter cone The In Line Filter 216 CAE Healthcare Troubleshooting the Trauma Fill Tank Care and Maintenance Before making any repairs ALWAYS depressurize the tank remove all trauma solution and clean the tank Problem Solution Remove hose from tank and reinsert siphon tube 1 Thoroughly clean pump cylinder gasket or o ring and surrounding area and apply a light coating of silicone to pump gasket or o ring 2 Contact CAE Healthcare for service 3 Turn valve until it returns toa sealed position 1 Pump 25 to 35 times for best performance 2 Clean filter 3 Reconnect the overflow fitting 4 The Trauma Fill Tank works best with 1 gallon 3 6 liters of fluid inside If greater amounts of fluid are used tank may require additional pumps as fluid is transported to simulator 217 218 Care and Maintenance METIman Emptying and Flushing the Chest Tube Reservoir Removing fluids from the Chest Tube reservoir and the Chest Tube system requires the same steps To empty the Chest Tube reservoir or flush the Chest Tube system have a chest tube and a basin to catch fluid in place Use a syringe to slowly push air through the appropriate CHEST TUBE port until only air flows through the chest tube Flushing the IV Lines To flush the IV lines 1 Connect an empty IV bag to the IV DRAIN po
128. inforcement and to avoid negative training transfer Defibrillation sites Defibrillation Sites However use of a defibrillator for training purposes represents an operational hazard equivalent to use of a defibrillator on a real patient Consequently ALL SAFETY PRECAUTIONS for the use of defibrillators MUST BE FOLLOWED as if the simulator were a patient Consult the specific defibrillator s user manual for further information CAE Healthcare Using METIman The following cautions should be observed e Defibrillation should be performed on the defibrillation electrodes only If defibrillation is performed over any ECG electrode high voltage may be present on the remaining connectors during the shock This may also damage ECG circuitry To prevent overheating do NOT provide more than three 3 defibrillator discharges maximum 200 joules with a biphasic defibrillator in a sequence Do NOT exceed an average of two 2 defibrillator discharges per minute during the training session Avoid a large number of consecutive discharges For example 20 or 25 discharges without any recovery interval may damage the system e Do NOT let the simulator come in contact with electrically conductive surfaces or objects during defibrillation A flame supporting atmosphere for example with a high content of oxygen should be avoided during defibrillation Keep the simulator s chest dry Special attention should be taken when using the urinary
129. ion retrograde Cricothyrotomy wire techniques and cricothyrotomy 159 Using METIman METIman Swollen Tongue The swollen tongue feature is activated on the Respiratory view by setting the Swollen Tongue switch to Swollen Posterior Pharynx Swelling Prehospital Only Swelling of the posterior oropharynx posterior airway occlusion can be activated to obstruct the view of the larynx and prevent intubation but allow mask ventilation of the patient s lungs thereby creating a cannot intubate can ventilate scenario Click the Airway Occluder switch to activate the feature 160 o CAE Healthcare Using METIman Realistic Upper Airway Prehospital Only The upper airway of METIman Prehospital is designed to allow for intubation and laryngoscopy Oral and nasal intubation can be performed using a variety of airway devices including LMAs endotracheal tubes nasal pharyngeal airways and oropharyngeal airways For supported sizes see Recommended Clinical Supply Sizes on page 221 Intubation The simulator detects and responds appropriately to right mainstem intubation and an event is recorded in the Event Log Intubation incorrectly applied into the esophagus causes abdominal distension IMPORTANT Airways can be damaged by improper insertion of an airway adjunct e g endotracheal tube To protect the airway lubricate the adjunct prior to insertion using the silicone spray provided Use ONLY the provided S
130. ion session is listed with the Start Time the title of the SCE and the Patient s name In addition the Physiological Data and Simulation Events are available for review and export Start Time 2011 11 16 14 21 57 2011 11 16 13 06 27 2011 11 15 10 51 44 2011 11 15 10 38 23 Healthy Adult Male Healthy Adult Male Healthy Adult Male Anaphylaxis Patient Stan D Ardman 11 Stan D Ardman Il Stan D Ardman 11 Holly Monroe Simulation Events Simulation Events Simulation Events Simulation Events Simulation Events Physiological Data Physiological Data Physiological Data Physiological Data Physiological Data The History Screen By clicking the Simulation Events link of a Simulation Session users can view the entire log of the simulation and all the events that occurred during the SCE When the Physiological Data link of a Simulation Session is clicked users can view all the physiological data that occurred during the SCE On both the Simulation Events and Physiological Data screens there is an Export button that when clicked exports the data to a CSV file that can be stored on an external device 112 J CAE Healthcare Using Muse System Administration From the System Administration screen users can control and access Content Management User Accounts Groups Maintenance and System Settings To access the System Administration screen click the System Administration butt
131. ions on the fly or as a physiological baseline from which to design their own SCEs To access a base SCE from the SCE Library choose Learning Modules then click Base SCEs The base SCEs are displayed and available for selection Preconfigured SCEs Preconfigured SCEs are training tools with scenarios and multiple states They are intended to be used for learner education and training To access a preconfigured SCE from the SCE Library choose Learning Modules then click the name of the SCE category The SCEs in the chosen category are displayed and available for selection 48 J CAE Healthcare Using Muse The SCE Summary Panel The SCE Summary Panel provides information about the selected SCE Anaphylaxis The Print button Holly Monroe mv Print SCE The Add to Age 21 years old s Add To Favorites Gender Female Favorites Weight 70 0 kg T n Base Norma L Female butto Overview Your rescue squad responds to a report of a 21 year old female complaining of trouble breathing She was eating dinner at a cookout when she noticed some tightness in her chest The cook came by asking if anyone wanted another shrimp burger She then told him she was allergic to shellfish She was proceeding to her car to retrieve an epinephrine auto injector when a wasp stung her The SCE This SCE consists of six states that manually transition During the initial assessment in State 1 Beginning Anaphylaxis the patient p
132. ir Compressor product AIR 004 is also available CAE Healthcare Introduction Hands Free Training Cables Hands Free Training Cables connect to most popular defibrillators and cardiac pacing units and take the place of non reusable electrode pads Three different cable designs are available to support the most popular defibrillation and pacing equipment Each cable kit includes posts that attach to the defibrillator or pace locations on METIman Physio Control Medtronic Inc product 4ACC 005 Zoll Zoll Medical Corporation product ACC 006 Philips Koninklijke Philips Electronics N V product ACC 007 10 Introduction METIman METIman Learning Applications and Training Courses METIman Learning Applications CAE Healthcare Learning Applications enhance the use of the simulator by providing preprogrammed scenarios and corresponding support documentation i e course objectives instructor s notes that can be readily integrated into a lesson plan a specific curriculum or an educational program EMS Learning Application 1 EDU 047 Adult Nursing Learning Apllication EDU 071 METIman Training Courses METIman Basic and Advanced courses offer learners at all levels in depth instruction in the setup operation development of scenarios and maintenance related to the use of METIman The METIman Basic course provides learners with an overview of the system and its components as well as a
133. ireless microphone Wireless Microphone The microphone volume can be adjusted on the microphone itself using the volume control Wireless Voice Link If a wireless voice link package was included with the METIman simulator see Appendix B Wireless Voice Link on page B 1 for additional instructions 198 CAE Healthcare Using METIman Throat Sounds Stridor throat sounds can be enabled using the software Throat sounds can be adjusted by Clicking the Sounds button on the Run screen When the Sounds panel appears select Throat Sounds Bowel Sounds Breath Sounds Throat Sounds Heart Sounds None None i I i i Stridor Vocal Sounds The Throat Sounds Menu Click the Throat Sounds drop down menu to change the type of sound Click and drag the Slider to adjust the volume 199 Using METIman METIman Breath Sounds Breath sounds are independently synchronized with ventilation of the left and right lungs Fourteen speakers eight anterior and six posterior provide breath sounds that can be auscultated Each of the four quadrants of the torso can be set independently to produce a particular breath sound Breath Sounds Click any one of the Breath Sounds drop down menus that each control one of four quadrants to change the type of sound Click and drag the slider for each location to adjust the volume A patient must be running on a METIman simulator for any sounds to be available By default Normal breath s
134. is automatically subtracted from the set amount of Intrapleural Volume Default 50 mL per minute Range 0 mL per minute 50 mL per minute Cardiovascular Parameters Cardiovascular Parameters CAE Healthcare Appendix A Parameter Descriptions Cardiovascular Parameters Blood Pressure The Blood Pressure parameter is used to override the physiological modeling for blood pres sure The systolic and diastolic blood pressures can both be set to fixed numeric values regard less of interventions performed Resetting the parameter to Modeled returns control of the underlying Blood Pressure to the physiological models Default Modeled Range Systolic 20 mmHg 200 mmHg Diastolic 10 mmHg 200 mmHg Heart Rate The Heart Rate parameter is used to set the heart rate to a given fixed number of beats per minute Once the heart rate is set to a numeric value administered drugs or intravascular volume changes have no effect on the heart rate but continue to influence other components of the physiological models Use this parameter to fix or set the heart rate to a specific number Default Modeled Range 30 beats per minute 220 beats per minute A 9 Appendix A Parameter Descriptions METIman Cardiac Rhythm The Cardiac Rhythm parameter is used to change the patient s underlying cardiac rhythm displayed on the Patient Status Display TouchPro software or physiological monitor To change the cardiac rhythm clic
135. isters from the Regulator The following instructions describe how to safely remove the CO canister from the regulator assembly for replacement or shipping CAUTION If unsure that CO canister is empty eye and hand protection must be worn to protect from release of freezing gas or liquid 1 Remove the CO regulator assembly from the simulator 2 While holding the regulator assembly firmly slowly unscrew the CO canister from the regulator There is a small relief hole in the side of the regulator from which any remaining CO will bleed If this should happen no harm will be done to system but it is rather noisy and the rapid release of CO gas can freeze the canister s surface and cause frostbite to unprotected skin 3 Continue unscrewing the canister until it is free from the assembly 219 220 Care and Maintenance METIman Important Canister Information The 16 Gram CO Canister with threaded neck is available at most sports equipment retailers most often used for bicycle tire inflators We recommend purchasing Leland brand canisters P N 821222 which are also available from CAE Healthcare Punctured canisters are considered to be empty No residue remains in the canister after use The steel used is a low carbon type which rusts if disposed in a landfill If your community requires recycling then place with normal household recycling CO Canisters are considered by the U S Department of Transportation to be Oth
136. isy when the speaker is not speaking You can use the noise reduction feature by setting the handset DIP switch position 8 to ON The simulator voice output is cut off when the speaker is speaking quietly In this case there are three possible options Attempt to talk louder Increase the microphone gain Disable the noise reduction feature by setting the handset DIP switch 8 to OFF p CAF Baalticare Appendix B Wireless Voice Link RF Channel Initial Operating Frequencies o 240 2480 Appendix B Wireless Voice Link METIman Specifications Frequency of operation 2 400 2 4835 GHz Wireless range 100 ft clear line of sight RF power output OdBm Batteries 2 AAA Alkaline NiCd NiMH Lithium Handset battery life with base station on 25 hours with alkaline batteries Handset battery life with base station off 100 hours with alkaline batteries DC voltage input 5 VDC 0 2A Line out jack 3 5 mm Headphone iPhone jack 3 5 mm Standalone microphone jack 3 5 mm Mechanical dimensions with antenna 6 17 x 2 52 x 0 65 Mechanical dimensions without antenna 4 2 x 2 52 x 0 65 MAHI Ape RI LIS KYS Technology 02 2911 5233 F 02 2911 6855 E info kyst com tw www kyst com tw CAE Healthcare caehealthcare com For more information about CAE Healthcare products contact your regional sales manager or the CAE Healthcare distributor in your country or visit caehealthcare com Tel 1 941 377
137. ith this exhaust Disconnect the Condensation Drain Hose from the simulator 213 214 Care and Maintenance METIman Cleaning the Simulator and the On Board Bleeding System NOTE A small bucket is recommended to collect wastewater during cleaning and flushing operations To clean and maintain the simulator and On Board Bleeding system 1 2 10 11 12 13 14 15 16 Remove and clean the wound haptics Connect the beige colored fill connector from the Trauma Fill Tank to the hip but do not connect the white vent connection Open the yellow Pressure Relief knob clockwise on the Trauma Fill Tank or loosen its Fill Lid so the tank is able to vent during this draining process With the wound umbilicals in place put the ends of both wound umbilicals into a wastewater bucket From the M se home screen click the System Administration button in the top right of the screen From the Maintenance screen click Flush System The fluid begins to drain Verify both channels produce a high steady flow When fluid stops flowing from either wound umbilical detach the Fill Tank from the simulator When fluid stops flowing from the lower wound umbilical detach from the simulator When fluid stops flowing from the upper wound umbilical detach from the simulator Click Done on the Maintenance screen The fluids are now drained Empty the wastewater bucket Rinse out the
138. itor Click Save when all data for the field has been entered 87 Using M se METIman SCE Configuration Setting up the Conditions the TouchPro software and the Patient Status Display is achieved by clicking the buttons under the SCE Configuration heading in the SCE Editor SCE Configuration Condition Setup TouchPro Setup Patient Status Display The SCE Configuration Buttons Condition Setup Screen and Creating Quick Links Click Condition Setup to access the Condition Setup screen From the Condition Setup screen conditions medications and interventions can be preconfigured for the SCE creating Quick Links On the Condition Setup screen Conditions Medications and Interventions buttons are available To navigate through available conditions and interventions click the Conditions Medications and Interventions buttons The Conditions Setup screen appears Q Medications Interventions Select a Catego Quick Links ALL CONDITIONS Apnea Cardiovascular Hemorrhage BP Hypertension Neurologic BP Hypotension Respiratory Desaturation Heart Rate Bradycardia Heart Rate Tachycardia Patient Stability The Condition Setup Screen To create a Quick Link drag and drop the desired choice s from the Conditions Medications or Interventions palette to the list of Quick Links Click the minus sign to remove a Quick Link from the SCE 88 CAE Healthcare Using Muse Modifying the TouchPro Setup
139. k succession every second This indicates the batteries need to be replaced To get the most battery life out of the handset the handset should be powered down when it is not in use p CAE iealthcare Appendix B Wireless Voice Link Troubleshooting CAE Healthcare Customer Service is available to help with iStan problems should they arise However sometimes you can speed up the customer service process by performing diagnostics before calling and eliminating some problems on your own with the help of the following instructions Power Problems The red power light on the handset does not flash when power switch is turned on Check that the batteries are inserted correctly Install a fresh set of batteries if needed The red power light on my base station is not flashing when the simulator is powered on Check that the cables from the simulator are installed in the base station correctly Communication Problems The simulator and handset are turned on but the green connection light is not blinking Verify that DIP switch positions 1 through 5 are all set to OFF which is the default position set in the simulator base station and handset at the factory If you have modified this setting verify positions 1 through 5 on the handset and the simulator base station are the same Be sure to turn the power off and back on for the changes to take effect on both the handset and the base station Check if the green connection light is fla
140. k the Cardiac Rhythm parameter and select the desired rhythm from the available list If a number appears following the cardiac rhythm on the list this overrides the heart rate to the rate indicated Default Modeled Options Modeled Asystole Atrial Enlargement Left Atrial Enlargement Right Atrial Fibrillation Atrial Fibrillation HR 120 Atrial Fibrillation HR 80 Atrial Flutter with 2 1 AV Conduction Atrial Flutter HR 150 Atrial Tachycardia AV Block First Degree AV Block Second Degree Mobitz I AV Block Second Degree Mobitz II AV Block Third Degree Bundle Branch Block Incomplete Right Bundle Branch Block Left Bundle Branch Block Left with PVC 2596 Bundle Branch Block Right Hypercalcemia Hyperkalemia Hypertrophy Biventricular Hypertrophy Left Ventricular Hypertrophy Right Ventricular Hypocalcemia Hypokalemia Hypothermia Junctional Junctional HR 50 Long QT Syndrome Myocardial Infarction with LBBB Myocardial Infarction Anterior o CAE Healthcare Appendix A Parameter Descriptions Myocardial Infarction Anterolateral Myocardial Infarction Inferior Myocardial Infarction Lateral Myocardial Infarction Posterior Myocardial Infarction Septal Myocardial Ischemia Mild Myocardial Ischemia Moderate Myocardial Ischemia Moderate with PVC 10 Myocardial Ischemia Severe Paroxysmal Junctional Tachycardia Paroxysmal Junctional Tachycardia HR 130 Pericarditis Premature Atrial Contraction Premature Ventric
141. kstation and a surge protected power outlet C Power on the Instructor Workstation 19 Setup METIman Step 5 Connect to the METIman Network Laptop Instructor Workstation Macintosh Option a Click the AirPort icon located in the top right hand corner of the screen Clicking the AirPort Icon b If the AirPort is not on select Turn AirPort On Activating the AirPort Card C Select the network e g MMPXXX or MMNXXX where XXX is the simulator s unit number Turn AirPort Off MIM NOOK ETET ie hpsetup Join Other Network Create Network Open Network Preferences Selecting the Network 20 ZW CAE Healthcare Setup The AirPort dialog box appears The network MMPXXX requires a WPA password i Password Show password Vi Remember this network Cancel OK jJ The AirPort Dialog Box d Enter the password metiadmin into the Password field e Click OK The network MMPXXX requires a WPA password Password l ma d RAARGERE T Show password ivi Remember this network Cancel 4 Connecting to the METIman Network The M se software can now be launched 21 Setup 22 METIman Step 5 Connect to the METIman Network Tablet Instructor Workstation Microsoft Windows Option Once METIman and the Instructor Workstation are both powered on they automatically establish a wireless connection and when the I
142. l be returned at your expense Authorized shipments are to be shipped prepaid to the address on the RMA Your original box and packaging materials should be kept for storing or shipping your product To request an RMA please contact Customer Service CAE Healthcare Care and Maintenance System Software Upgrade Support Customers with current warranty contracts are entitled to receive upgrades to applications software previously purchased Installation of the system software is the user s responsibility The System Software Upgrades Support includes software upgrades for base software and purchased optional software modules This does not apply for major upgrades or technological enhancements Pricing Structure Time and Materials For those systems not under agreement service will be provided as required on a Time and Material basis Description In House On Site CAE Healthcare s prevailing Technical Support labor rate with a minimum of four hours labor Material As quoted at time of repair Travel Priced at CAE Healthcare s fully burdened cost plus fee Principal period of on site support customer s local time is e Monday through Friday 8 00 AM to 5 00 PM customer s time zone e Holiday and non business days excluded e Support outside the principle period is billed at the premium rate hourly rate x 1 5 A minimum of 48 hours notice is required for scheduling an on site support call Urgent on site support with le
143. lone microphone input is enabled When DIP switch position 6 is set to the OFF position the standalone microphone jack is enabled for the standalone microphone provided by CAE Healthcare Figure 11 Handset and CAE Healthcare provided Microphone To use a microphone compatible with an iPhone three pole jack set DIP switch position 6 to ON Please note that an iPhone compatible microphone is not provided as part of the product package Any microphone with a common 3 5 mm input jack can be used with the handset when DIP switch position 6 is set to ON B 9 Appendix B Wireless Voice Link METIman Special Handset Settings Advanced settings for the handset DIP switch are available iPhone microphone enable Base station volume control enable Noise reduction enable default Noise reduction disable Microphone gain control enable default Standalone microphone enable default Figure 12 Advanced DIP Switch Settings DIP switch settings are only refreshed when the handset is powered on To ensure the DIP switch changes take effect turn the power off and back on after making changes To enable noise reduction and minimize background noise in high ambient noise environments place the position 8 DIP switch in the ON position Battery Capacity Indicator The red power light flashes one time every second when the battery capacity is good When the battery capacity is nearly depleted the red power LED flashes twice in quic
144. male Overview Your rescue squad responds to a report of a 21 year old female complaining of trouble breathing She was eating dinner at a cookout when she noticed some tightness in her chest The cook came by asking if anyone wanted another shrimp burger She then told him she was allergic to shellfish She was proceeding to her car to retrieve an epinephrine auto injector when a wasp stung her This SCE consists of six states that manually transition During the initial assessment in State 1 Beginning Anaphylaxis the patient presents with early signs of anaphylaxis HR in the 90s BP in the 100s 50s RR in the 20s and SpO2 in the low 90s on room air She remains conscious The learner is expected to assess and manage the patient s airway breathing and circulatory status ABCs identify early signs of allergic reaction consider use of oxygen call for help with interventions consider early use of epinephrine and attach a cardiac monitor If more than 120 seconds elapses without administration of epinephrine the instructor should manually advance the SCE to State 2 Mild Anaphylaxis If epinephrine is administered the SCE is advanced to State 5 Epinephrine Administered Al Review k Run The SCE Summary Panel 2 From the SCE summary panel click the Print SCE button A PDF of the selected SCE appears in a new browser window The Print SCE button 3 Save the PDF to an external storage device to print from another computer OR
145. menus on the right side of the Scenario Designer to the canvas Drag and drop a condition onto the canvas to create a state CU Cardiovascu te 3j BP Hypertension M BP Hypotension Cardiac Rhythm Set Cardiac Tamponade Heart Rate Bradycardia Heart Rate Tachycardia Patient Stability Pulses Ventricular Failure Both Ventricular Failure Left Ventricular Failure Right The Scenario Designer Canvas Or a new empty state can be added using the New State button 97 Using M se METIman To add a new state using the New State button 1 Click the New State button on the upper left side of the Scenario Designer abe New State The New State Button A new state appears A New State 2 From the Graphical View double click the new state or from the Line Item View click the Expand Collapse arrow to the left of the state to expand it The state expands and additional options appear The state name The Expanded State 3 Double click the state name By default new states are named State The Rename state window appears and contains a field for entering a new state name Ns oy The Save ae button The Rename State Window 4 Enter a new state name NOTE When naming a Scenario State the state name may NOT exceed 127 characters Additionally scenario file and state names CANNOT contain any special characters such as lt gt 5 Click Save The state is r
146. modify parameters or by using the Conditions Interventions and Medications palettes Using the Physiological Views From the Run screen users can select from five different views representative of various body systems and features Neurological Respiratory Cardiovascular Fluids Sounds To access each view click the appropriate organ icon or button e For Neurological click the brain For Respiratory click the lung For Cardiovascular click the heart e For Fluids click the droplet of blood e For Sounds click the Sounds button 58 CAE Healthcare Using M se From each view various parameters can be viewed and adjusted Blood droplet Sounds button The Physiological Views 59 Using M se METIman To change a patient s physiology using the physiological view 1 Click the appropriate organ icon or button from the homunculus to select the appropriate physiological view The associated parameters The homunculus The Run Screen The associated parameters appear to the left of the homunculus 2 Locate the desired parameter 3 Select the parameter and set the new value Parameters have varying controls such as sliders switches and menus In the image below the Heart Rate parameter is shown Within the Heart Rate parameter there are switches that toggle between Modeled and Override and Seconds and Minutes a slider that sets the beats per minute and it s an available f
147. mpty the Trash click the Trash icon in the lower left corner of the Scenario Designer Anaphylaxis sonar ral i ahs Mew State jy Collapse AB Expand all The Trash eine icon The Scenario Designer 110 CAE Healthcare Using Muse The Trash List appears Cardiac Rhythm Set Heart Rate Tachycardia The Empty B m Trash button The Trash List Click Empty Trash to empty the Trash If you do not wish to delete the items listed they can be dragged back into the scenario at which time they are removed from the Trash Logging out of the software automatically empties the Trash IMPORTANT Items emptied from the Trash cannot be retrieved 111 METIman Using M se Administrative Tools The M se software has administrative tools that allow users to manage logs stored content users and system settings The administrative tools are accessed via the Administrative Tools buttons located on the Home page The History button s system The Account Administration Profile button button The Administrative Tools Buttons Click the History button to view and manage simulation session logs Click the System Administration button to manage stored content user accounts groups and system settings Click the Account Profile button to manage and determine preferences for the active account History From the History screen users can view and export simulation session logs Each simulat
148. n Enhanced Warranty and receive remedial and planned maintenance To prevent equipment downtime and delays after your warranty expires we encourage you to contract for extended maintenance services for all subsequent years Units Out of Agreement For units no longer under warranty requiring repairs the Time and Materials service plan will apply see Time and Materials section To place an out of warranty unit under a warranty contract CAE Healthcare reserves the right to have the patient simulator inspected by a CAE Healthcare approved technician at the customer s expense If necessary the unit would have to be repaired at the customer s expense prior to issuance of a warranty contract The repairs required as the result of the examination will be quoted on a time and material basis 9 CAE Healthcare Care and Maintenance How to Contact Customer Service CAE Healthcare Customer Service Headquarters United States and Latin America Monday Friday from 7 00 a m to 6 00 p m ET Toll Free 1 866 462 7920 24 hour Hotline 1 941 342 5605 Fax 1 941 342 5600 Email Address customerservice caehealthcare com Web URL www caehealthcare com CAE Healthcare Customer Service Canada Monday Friday from 8 00 a m to 5 00 p m ET Toll Free 1 877 223 6273 Email Address can service caehealthcare com CAE Healthcare Customer Service Europe Middle East and Africa EMEA Monday Friday from 8 00 a m to 5 00 p m CET Phon
149. n introduction to patient creation and scenario design METIman Basic two days at CAE Healthcare facility TRN 018 METIman Basic On Site two days at learner defined facility TRN 020 The METIman Advanced course builds upon the concepts introduced in the prerequisite Basic course After a quick review of the Basic course Advanced instruction spends the majority of the two days providing learners with the ability to design patients and scenarios that can be used immediately upon completion of the course METIman Advanced two days at CAE Healthcare facility TRN 019 METIman Advanced On Site two days at learner defined facility TRN 021 Tool Kit To simplify common adjustments and periodic repairs CAE Healthcare has put together a kit containing tools selected for use with the simulator product TOL 001 Tool Kit CAE Healthcare Introduction METIVision METIVision is a fully integrated digital audio visual management system that is data synchronized in real time for use with CAE Healthcare simulators METIVision is the only solution available with the capability not only to capture and store simulation data but to broadcast and review any medical simulation exercise using CAE Healthcare simulators Complete with physiologic data logs event logs pharmacology logs and patient monitoring data METIVision offers the capability to provide a complete record of your simulation exercise for debriefing assessment and evalua
150. ndows operating system may be used To run the TouchPro software the computer used must meet the following minimum requirements Macintosh Operating System e Mac OS X 10 5 8 minimum e Safari 5 x x or Firefox 10 ESR minimum e Adobe Flash Player 10 1 x x minimum e Adobe Reader 9 x or higher Windows Operating System e XP Service Pack 2 Vista Windows 7 or Windows 8 e Firefox 10 ESR Internet Explorer 8 or Safari 5 x x minimum e Adobe Flash Player 10 1 x x minimum e Adobe Reader 9 x or higher Hardware Windows and Macintosh Intel Core Duo 2 0 GHz minimum e 2 GB DDR3 RAM minimum e 8 GB Hard Drive space available e 1024x768 screen resolution minimum e USB 2 0 e Wireless 802 11b g n Ethernet card e 100BASE T Ethernet Adapter Macintosh Quicktime and Safari are registered trademarks of Apple Inc Windows Media and Internet Explorer are registered trademarks of the Microsoft Corporation in the United States and or other countries Firefox is a registered trademark of the Mozilla Foundation Adobe Flash Player is a trademark of Adobe Systems Inc xiii Table of Contents METIman Table of Contents Hicense CoDVEIdBE A E E E i METiman Specifications eeseessoooceeccsoocccccsooocececsoooceeccsocccccccooocececsooccecesoooceceesoosoceessoo vi EA e R A E E A E vii System ReduiremeniS ses ssinisssirarriresrres rh rs HA FYPRE SERRE rran EiT ea R ESASI RETES D
151. needs To change a waveform or numeric display 1 Click the waveform or numeric to be changed The Wave Vital Selection menu or the Numeric Vital Selection menu appears displaying all the available waveforms or numerics Wave Vital Selection ECG I ECG II ECG III ECG V1 ECG V2 ECG V3 ECG V4 ECG V5 ECG V6 ECG aVL ECG aVR ECG aVF ABP PAP CVP Pleth Capnogram Blank Set Alarm Set Color Set Scale L J The Wave Vital Selection Menu 2 Select the desired waveform or numeric The new waveform or numeric is reflected on the screen From the Wave Vital Selection menu the alarm color and scale can be set for the waveform using the Set Alarm Set Color and Set Scale buttons From the Numeric Vital Selection menu the color and alarm for the numeric can also be established using the Set Color and Set Alarm buttons 139 Using TouchPro METIman Adding a Waveform The TouchPro software supports up to six waveforms To add a waveform 1 Click the Settings button in the bottom right corner of the TouchPro display The Settings Button The Settings menu opens and the Add Waveform and Remove Waveform buttons appear 2 Click the plus button in the location above which you want the empty waveform to appear An empty waveform field appears Sa Ol NN The Add Waveform An empty and Remove waveform Waveform field buttons e tune pem oem e e rU erst The TouchPro Display Settings
152. ng the original scenario intact a Click Save As When Save As is clicked the Save Scenario dialog box appears Enter scenario name The Enter Scenario name The Save field button The Save Scenario Dialog Box b Enter the name for the scenario in the Enter scenario name field c Click Save NOTE When naming a scenario the scenario name CANNOT exceed 128 characters Additionally scenario file names CANNOT contain any special characters such as V lt gt 96 M 108 CAE Healthcare Using Muse Saving States to the State Library Users can save states to the State Library for later use To save a State drag and drop the state to the States button ALL CONDITIONS kapid 1 m nce ni Carafavascular ee Cortsm rura ILLE memes Heart Bale Tackyrentis p Moderete tan Here Bodens lind Batis b fel BOB fens P im Aree ise b oe veuve 0 DUAE A dragged P n atm Tem state Bis PrpLRe RS i i oa oO cere e The States Am 2m gram button The Scenario Designer The state is stored in the library To access the State Library click the States button in the bottom right corner of the Scenario Designer The States Button 109 Using M se METIman The State Library appears listing all saved states Hpertension Begins The State Library Click Conditions to exit the State Library Emptying the Trash To e
153. nly All pulses unless altered by an SCE are enabled by default To disable a pulse click the pulse location on the human form To enable a pulse click the pulse location again Pulses METIman Nursing Active and Inactive 175 Using METIman 176 METIman Blood Pressure METIman supports non invasive blood pressure measurements and systolic and diastolic readings can be obtained and manipulated through the software Systolic and Diastolic Blood Pressure To manually adjust the systolic and or diastolic blood pressure 1 From the Cardiovascular view click the parameter of desired blood pressure 2 Set the pressure by dragging the arrow up or down 3 Click Accept to exit and save the changes The switch is now orange indicating a change has been made 4 Toreturn to the programmed physiologic model click the switch and turn the Override switch to Modeled Non Invasive Blood Pressure Measurement Blood pressure can be taken manually on either arm Non invasive blood pressure NIBP monitoring techniques can be used by attaching the standard cuff modified with a T fitting and adapters To modify a standard blood pressure cuff 1 Cut the blood pressure cuff tube approximately 9 cm from the cuff 2 Insert the barbed end tubing connectors into the cut ends of the blood pressure cuff tubes o CAE Healthcare Using METIman 3 Secure the tubing connectors with cable ties An Attached Tubing Connector
154. nsstesiasaseints rrieditemdet eset irdonei tei donde 210 Airway Inspection REIR 210 EETA a E E E N E E EEE T E E E 210 e NA ES a A EE EEEE EE E E CORP RRRUN RUD FEA 212 Draining Condensation from the SIMA CRON sasacasescezecacancaeedcpasstdssereaccspavassseseyescessestaatesaussisssonsnesnseiacnse 213 Cleaning the Simulator and the On Board Bleeding System 214 Cleaning the Trauma Fill Tank oe 215 SISTI the In Line Fill RE EOM 216 Troubleshooting the Trauma Fill Tank esee 217 Emptying and Flushing the Chest Tube Reservoir sess nnne 218 FUG FANT CMV DB TOS NU 218 Emptying the Genitourinary Reservoir erre eene tenerent tonta toast tontos tos tonc 218 Emptying the Head Secretions Lines Prehospital Only eere 218 Emptying the Airway Secretions Reservoir Nursing Only essere 218 Flushing the Subclavian Catheter Nursing Only eere 218 METIman Table of Contents Handling CO Canisters eee erer eee ee rere e eere eere tete ta tata tatnen ones enses teta tata ta tuts 219 Removing CO Canisters fron the RE QUIRON sirnaan 219 Important Canister Information ccccecssessssesssesssesssssssssessssessssessssesssssssssssssssssssssesseessseessseeeesee 2
155. nt repair of damaged simulators contact CAE Healthcare Customer Service Replacing the Battery After approximately four hours of use the simulator s battery must be removed to be recharged or replaced with a charged battery WARNING When handling METIman s batteries be sure to adhere to all the cautions and warnings To replace the battery 1 Unzip the chest skin 370 Unzipping the Chest Skin 210 o CAE Healthcare Care and Maintenance 2 Lift the abdominal insert Lifting the Abdominal Insert 3 Remove the abdominal support a r O Remove the abdominal support Removing the Abdominal Support 4 Release the Velcro battery tie down Comum dun as Releasing the Battery Tie Down 211 METIman Care and Maintenance 5 Disconnect the battery leads Disconnect the battery leads Disconnecting the Battery Leads 6 Remove the uncharged battery Remove the uncharged battery bam Removing the Battery 7 Insert a charged battery and affix the battery tie down 8 Connect the battery leads and replace the abdominal support ensuring both ends are secure in the slits 9 Replace the abdominal insert and chest skin Recharging the Battery The battery should be recharged after approximately four hours of use To recharge the battery disconnect and remove the battery from the simulator and connect to the external charger provided WARNING When
156. nternet Explorer browser is opened the M se software launches If the auto connect does not occur perform the following steps 1 Tapon the Wireless Network icon in the task bar 2 Select the METIman wireless network e g MMPXXX or MMNXXX where XXXX is the serial number for the unit The network password is metiadmin and the password is case sensitive 3 Click the Connect button The wireless connection is established The M se software can now be launched using Internet Explorer p CAE Healthcare Setup Optional Connect the SpO Probe Connect and attach the SpO probe to METIman a Locate the SPO port on METImans left hip b Connect the SpO probe to the SPO port c Place the SpO probe on METIman Attached SpO probe Attached SpO Probe The probe must be connected to view pulse oximetry data on the TouchPro software 23 Setup METIman Optional Connect External Air Using the External Air kit allows METIman to be run by an external air source rather than the internal compressor The air hose can be connected to or disconnected from METIman at any time When the external air pressure is sensed the pump internal to METIman turns off automatically When you want to make METIman mobile again simply disconnect the hose The optional External Compressed Air Kit consists of a flexible 30 ft 9 m hose attached to a preset air regulator and a fitting for air compressors and adapters for wall or tank air
157. ny of such provisions Licensee consents to an injunction being issued against it restraining it from any further breach of such provision without derogation from any other remedy which CAE Healthcare may have in the event of such a breach 7 WARRANTY LIMITATION OF LIABILITY 7 1 THE SOLE WARRANTIES PROVIDED BY CAE HEALTHCARE ARE LIMITED TO THE WARRANTIES PROVIDED IN THE HEPGTC ANY WARRANTIES PROVIDED ARE PERSONAL AND NOT TRANSFERABLE 7 2 CAE HEALTHCARE S LIABILITY SHALL IN NO CIRCUMSTANCES EXCEED THE LIMITATION OF LIABILITY INDICATED IN THE HEPGTC LIABILITY IF ANY SHALL BE SOLELY FOR DIRECT DAMAGES NOT TO EXCEED ON A CUMULATIVE BASIS THE AMOUNT PAID BY LICENSEE FOR THE PRODUCT 8 GOVERNING LAW 8 1 This Agreement shall be governed by subject to and interpreted according to the laws of the State of Florida U S A without regard to its conflict of law rules In all cases the Parties expressly exclude and waive the application of the United Nations Convention on Commercial Agreements for the International Sale of Goods 1980 Vienna Sales Convention as amended 8 2 The exclusive forum for the resolution of any and all disputes arising out of or in connection with this Agreement shall be a court of appropriate jurisdiction located in the State of Florida U S A Each Party hereby waives any right that it might otherwise have to object to such venue or seek dismissal of the action on the basis of forum non conveniens EACH PARTY HERE
158. o access the Cardiovascular view Heart Rate Modeled 2 Cardiac Rhythm A Modeled Arterial Catheter gt Peripheral b intrathorac Central Venous Catheter r gt Pulmonary Cardiovascular parameters Pacing Current Pacing Rate Pacing Capture Threshold Cold Fluid Inject The Cardiovascular View Prehospital 173 Using METIman METIman Pulses METIman Prehospital METIman Prehospital has 14 pulse sites that are activated by touch e Carotid 2 e Brachial 2 e Radial 2 e Femoral 2 e Popliteal 2 Posterior Tibial 2 e Dorsalis Pedis 2 NOTE The Dorsalis Pedis and Posterior Tibial pulses are controlled together The left and right Carotid pulses are also controlled together Pulses are visible and can be controlled from any physiological view To disable a pulse click the pulse location on the human form To enable a pulse click the pulse location again F j l0 Oi r 4 LLL m ien LE Sounds Pulses METIman Prehospital Active and Inactive 174 CAE Healthcare Using METIman Pulses METIman Nursing METIman Nursing has 14 pulse sites that are activated by touch e Carotid 2 e Brachial 2 e Radial 2 e Femoral 2 e Popliteal 2 Posterior Tibial 2 e Dorsalis Pedis 2 NOTE The left and right Carotid pulses are controlled together Pulses are controlled from the Cardiovascular view o
159. o refresh DIP switch settings Do not turn the simulator off and on to refresh the DIP switch settings B 6 p CAF Bacca Appendix B Wireless Voice Link Preparing the Handset for Use To prepare the handset for use 1 Insert two AAA batteries into the battery compartment 2 Set the handset DIP switch positions 6 and 7 to OFF and position 8 to ON 3 Turn the power switch off and back on to ensure the DIP switch changes take effect Figure 9 DIP Switch Settings for the Handset While DIP switch positions 6 through 8 affect the handset and base station settings DIP switch positions 1 through 5 are used to set the radio frequency channel used for communication between the handset and the base station Selecting the Radio Frequency Channel There are two ways to configure the radio frequency RF channel spacing The first method reduces channel to channel interference but allows only 12 channels to operate simultaneously in the same vicinity The second method increases the number of channels that can be used simultaneously to 20 channels However this method diminishes the channel to channel noise immunity All of the WVL pairs in the same vicinity must use channels from RF Channel Group 1 or RF Channel Group 2 and channels must belong to the same group The DIP switch determines the initial communication frequencies that the WVL pair use to communicate when the power of the base station and handset is first turned on If
160. omatically closes Clicking the Mute button from the Audio Setup window mutes all alarms Click the Mute button again to return the alarms to their original state 145 Using TouchPro METIman 12 Lead ECG To view a 12 lead ECG report click the 12 Lead ECG button at the bottom of the TouchPro screen The 12 Lead ECG Button The report appears The Close button nek YI Ly ju ci Ri PSEA TEES ee SSEFSHSEPESE E S Ad ent TR oe Eu EE ue erst d Jie s AA Wt Rola IL Ld hcl GL The Print button A 12 Lead ECG Report The report can be printed or saved by clicking the Print button in the bottom right corner of the 12 lead ECG report To close the report click the Close button IMPORTANT Prior to saving the report as a PDF or printing to a network printer the print presets must be adjusted The page orientation must be set to Landscape and the margins must be set to 25 inches on all sides These settings vary in location depending on the operating system i e Macintosh or Windows To save the report to a PDF file on a Macintosh Instructor Workstation 1 From the 12 lead ECG report screen click the Print button located in the bottom right corner of the 12 lead ECG report 2 Select the Save As PDF option 3 The report saves as a PDF on the Macintosh Instructor Workstation 146 Using TouchPro To save the report to a PDF file on a Windows Instructor Workstation 1 From the 12 lead ECG repo
161. on Responses Profile Information Favorite SCEs The Medication Preferences The link Medication Preferences panel The Account Profile Screen To import medication response files click the Set button The select file dialog box appears Select the medication response file to be added and click Open or OK 133 Using M se METIman Profile Preferences From the Profile Preferences panel users can change the font size used in the software To access Profile Preferences click Profile Preferences on the Account Profile screen The Profile Preferences panel appears meti admin Email admin meti com Profile Preferences ID admin Font Size Normal The Font size Profile Information menu Favorite SCEs Medication Preferences The Profil The Profile P E TOLES Preferences re Pee panel link The Account Profile Screen To change the font size click on the Font size selection The Font size drop down menu appears From the Font size drop down menu select Normal Small or Large 134 Using TouchPro UsiNG TOUCHPRO The TouchPro software enables users to view patient physiology The software can be used from the Instructor Workstation or on another computer provided the computer has joined the simulator s wireless network IMPORTANT Only two TouchPro software screens can be open at a time Accessing the TouchPro Software Like the M se software the TouchPro software is compatible with com
162. on from the Home page The System Administration Button The System Administration screen is displayed The System Administration Screen 113 Using M se METIman Content Management From the Content Management options users can manage learning applications SCEs Base Patients and Scenarios To access the Content Management options from the System Administration screen click Content Management The Content Management options appear The Content Management button The Content Management options The System Administration Screen Learning Modules From the Learning Modules panel learning applications can be installed or deleted When the Content Management button is selected the Learning Modules panel appears by default If another panel has been selected return to the Learning Modules panel by clicking the Learning Modules link The Learning Modules link Base datis The Lea rning Sornarios Applications Patient Records panel The Install Learning The Remove Module button T button The Learning Modules Panel 114 CAE Healthcare Using Muse To install a learning application 1 Click Install Learning Module The Select file to upload dialog box appears 2 Locate the correct learning application file on the external storage device or the hard drive location where the SCE file is saved The file extension is mim 3 Select the file and click Select or Open
163. onnect to the simulator by attaching the end of the IV spike set tubing to the NOSE MOUTH or EYES port on the simulator s left shoulder Repeat for each site necessary The NOSE MOUTH and EYES ports METIman Prehospital s Left Shoulder 7 Open the clamp and allow fluid to flow into the simulator 8 Keep the IV bag attached Adjust the flow rate manually using the roller clamp NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal 156 CAE Healthcare Using METIman Respiratory METIman Prehospital s Respiratory system is comprised of the airway management spontaneous breathing and ventilation features On METIman Nursing various clinical signs such as breath sounds chest excursion and airway patency can be physically demonstrated A series of speakers inside each simulator can generate a range of breath and throat sounds used in diagnosing conditions To access the Respiratory parameters of METIman on the Run screen click the lung on the human form The respiratory parameters appear on the Run screen Swollen Tongue Not Swollen Click the lung to access the Respiratory view Alrway Occluder Off Laryngospasm Off Needle Decompression Off Bronchial Occlusion off Y Respiratory Rate Modeled f Respiratory Modeled f l parameters Modeled Tidal Volume Mod
164. ority to operate this equipment B 1 Appendix B Wireless Voice Link METIman What s Included The WVL package includes the following items Wireless Voice Link Handset 1 Olympus ME52W Standalone Microphone 1 AAA Alkaline Batteries 2 Quick Start Guide 1 How It Works The WVL is a radio pair that operates in the 2 4 GHz unlicensed radio band The handset communicates wirelessly with the base station located inside the simulator The base station converts the digitized microphone stream from the handset and outputs it via the base station to the headphone and line out jacks The output projects through the head speakers inside the simulator To accommodate multiple WVL pairs in close proximity each WVL is assigned two RF channels on which to operate The RF channels divide up the 2 400 2 4835 GHz spectrum in 80 single frequencies to prevent the WVLs from interfering with each other Due to the nature of the unlicensed 2 4 GHz band there may be other devices such as Wi Fi microwave ovens or Bluetooth radios operating in the 2 4 GHz band as well Therefore two channels are used to transmit the audio stream redundantly to avoid interference In case there is an interference in one channel the other can be used to extract the audio stream To operate correctly both the handset and base station should be set to the same frequency using the DIP switches located in the devices If the interference is too high the WVL firmware
165. ort a scenario file to an external device The scenario file extension is mss NOTE Preconfigured CAE Healthcare scenarios CANNOT be exported 118 CAE Healthcare Using Muse Patient Records Patient records can be uploaded to Muse for display in the TouchPro software Once uploaded a patient record is available for use with any SCE Patient Records are managed from the Patient Records panel on the Content Management tab of the System Administration screen Costert Kanagemest Learning Modules CEs Normal Abdominal Ultrasound Base Patients Patient records Scenarios Preview Upload Patient Rename Records Delete Export The Patient Records Panel The following patient record file types can be uploaded to Muse e JPG or JPEG images e GIF images e PNG images e XPS images e PDF documents e MPEG videos e MOV videos e MP3 audio files A single patient record file cannot exceed 20MB 119 Using M se METIman To upload a patient record 1 From Patient Records panel click Upload Patient Records A file selection window appears 2 Select the desired file and click Open or OK The file is uploaded and is now available to display in the TouchPro software M se can store up to 2GB of patient record files To ensure adequate space please delete patient records when they are no longer needed To delete a patient record 1 From the Patient Records panel select the patient
166. osition is selected and can be used to simulate zeroing a pressure transducer This may also be used to remove the central venous pressure waveform if desired i e beginning of an SCE with an unmonitored patient Default Intrathoracic Vein Options Atmosphere Extrathoracic Vein Intrathoracic Vein Pulmonary Artery PA Catheter The pulmonary artery pressure displayed on the Patient Status Display or TouchPro software is set using this parameter A non pulsatile zero pressure signal is emitted when the Atmosphere position is selected and can be used to simulate zeroing a pressure transducer This may also be used to remove the pulmonary artery pressure waveform if desired i e beginning of an SCE with an unmonitored patient The pulmonary artery catheter can be floated into position by sequencing through the right heart positions This may also be scripted into a scenario using the Scenario Designer Default Pulmonary Artery Options Atmosphere Intrathoracic Vein Right Atrium Right Ventricle Pulmonary Artery 3 CAE Healthcare Appendix A Parameter Descriptions PA Balloon Inflation of the pulmonary artery catheter balloon is simulated by switching to the Inflated option of the PA Balloon parameter The appropriate pulmonary artery occlusion or wedge waveform is then displayed on the Patient Status Display or TouchPro software Default Deflated Options Deflated Inflated Defibrillation Defib
167. ounds are heard Breath sounds can be adjusted by clicking the Sounds button on the Run screen When the Sounds panel appears select Breath Sounds Bowel Sounds All Breath Sounds I LU L Crackles E Diminished Breath Left Upper Sounds Breath Righ Gurgling Pleural Rub Rhonchi m Wbec ig Breath Left Lower Sounds Breath Right Lower Sounds i 1 1 i 1 L Voca Sounds Teme m Throat Sounds The Breath Sounds Menu 200 CAE Healthcare Using METIman Heart Sounds Heart sounds emanate from four speakers and are synchronized with the cardiac cycle Heart sounds can be auscultated over the left and right sternal border right lower sternal boarder and apex By default heart sounds are set to the Normal sound The following sounds are available Heart Sounds Heart sounds can be adjusted by clicking the Sounds button on the Run screen When the Sounds panel appears select Heart Sounds Bowel Sounds Breath Sounds Normal Normal S3 S4 Throat Sounds S3 and S4 Early Systolic Murmur Mid Systolic Murmur Vocal Sounds Late Systolic Murmur Pan Systolic Murmur Late Diastolic Murmur The Heart Sounds Menu Click the Heart Sounds drop down menu to change the type of sound Click and drag the slider to adjust the volume 201 Using METIman 202 Bowel Sounds METIman Learners can auscultate bowel sounds over each of four intestinal quadrants the Upper Right Upper Left Lower R
168. physiology Scenarios can be added to SCEs to enhance patient physiology When a scenario is added to an SCE from the SCE Editor the scenario becomes associated with the SCE and begins automatically when the SCE is run Click the Add Scenario button on the Run screen to add a scenario to an SCE that is running To add a scenario to an SCE from the SCE Editor 1 Click the Add Scenario button under the Preloaded Scenarios heading Pre Loaded Scenarios The Add Scenario Button The Choose Scenario dialog box appears scenarios Name Last Modified Anterior Myocardlal Infarction 2011 09 12 09 38 35 COPD Exacerbation with Resplratary Fallure 2011 09 12 09 39 10 Elevated Heart Rate 2011 09 12 09 41 01 S nari Heroin Overdose 2011 09 12 09 39 41 Sones Inferior Myocardial Infarction 2011 09 12 09 40 13 Organophosphate Exposure 2011 09 12 09 40 39 e Add The Search button field The Choose Scenario Dialog Box 2 Select a saved scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 3 Click Add The scenario is added to the SCE and is listed on the SCE Editor beneath the Pre Loaded Scenarios heading For information about editing scenarios see Editing a Scenario on page 94 91 Using M se METIman Developing Scenarios The Scenario Designer allows users to create and edit scenarios To access the Scenario Designer create a new scenario or choose an existing sc
169. puters that have touch screen capabilities To run the TouchPro software the Instructor Workstation must be connected to the simulator s network IMPORTANT An SCE must be running on the M se software for any physiological data to be displayed on the TouchPro software The TouchPro software can only show one Patient at a time To launch TouchPro from the Instructor Workstation 1 With the M se software running open a new tab in the web browser and go to the Home page of the web browser The M se Start Screen appears la ToucliPro The TouchPro Patient Monitor Icon The M se Start Screen 2 Select the TouchPro icon 135 Using TouchPro METIman When TouchPro opens the simulated patient monitor appears bri min The TouchPro Display NOTE The capnogram waveform is not displayed on the TouchPro software from the Instructor Workstation Capnogram information can be found on the clinical patient monitor if one is connected to the simulator 136 Using TouchPro Modifying the TouchPro Display The layout of the waveforms and numeric data shown on the TouchPro software can be customized The TouchPro software can show up to six waveforms plus an additional four numeric readouts Selecting a Preconfigured Layout There are five preconfigured CAE Healthcare Layouts ICU Arterial Line Only preconfigured with waveform and numeric readouts for ECG Lead II ECG Lead V ABP Pleth and a numeric readout for
170. rauma Fill Tank Umbilical from the simulator and store the assembly out of the way for later use After use ALWAYS release pressure and clean the tank Preparing for Storage After filling and using the Trauma Fill Tank and the simulator s blood reservoir both must be cleaned for storage Step 1 Clean the Simulator and Fluid System When the simulation is completed and the Trauma Fill Tank has been disconnected remove the fluids and clean the simulator see Cleaning the Simulator and the On Board Bleeding System in the Care and Maintenance section of this User Guide Step 2 Clean the Trauma Fill Tank Before storing the Trauma Fill Tank make sure the equipment is clean see Cleaning the Trauma Fill Tank in the Care and Maintenance section of this User Guide Step 3 Store the Trauma Fill Tank After cleaning the Trauma Fill Tank assembly should be stored securely for future use a Allow the interior of the tank to dry by loosening the pump assembly Do NOT leave the pump assembly out of bottle however because dust contaminates the system b Loosely wrap the Trauma Tank Umbilical around the neck of the tank to protect it C Store all components in a clean dry area 33 Setup METIman Optional Connecting a TouchPro Computer to the Wireless Network The CAE Healthcare TouchPro computer is pre configured for use with METIman If you wish to supply your own TouchPro computer use the following instructions to connect
171. reless networks are available Connect taa network Network and Sdaring Center Clicking Connect to a Network The Connect to a network dialog box appears 38 CAE Healthcare Setup C Select the network i e METIman Prehospital MMPXXX XXX is the simulator s unit number Connect to a network Select a network to connect to Select a s n f network EIE EE EE EE Unsecured network Hi Set up a connection or network Open Network and Sharing Center Cancel Selecting METIman s Network d If prompted for a password enter metiadmin into the available field e Click Connect Connect to a network Select a network to connect to Show All v EE EE EE E EE EE EE E EE E EE EE EE EE EE EE EE E EE EE EET Click Connect Unsecured network Set up a connection or network Open Network and Sharing Center Cancel Connecting to METIman s Network The computer has joined the METIman network You can now proceed to Step 5 39 Setup METIman
172. resents with early signs of Content anaphylaxis HR in the 90s BP in the 100s 50s RR in the 20s and SpO2 in the low 90s on room air She remains S conscious The learner is expected to assess and manage the patient s airway breathing and circulatory status umma ry ABCs identify early signs of allergic reaction consider use of oxygen call for help with interventions consider early use of epinephrine and attach a cardiac monitor If more than 120 seconds elapses without administration of epinephrine the instructor should manually advance the SCE to State 2 Mild Anaphylaxis If epinephrine is administered the SCE is advanced to State 5 Epinephrine Administered e The Review In State Mild Anaphylaxis the patient experiences increased respiratory distress The patient s HR is in the 110s The Run button 4 f review _ e i button The SCE Summary Panel The Print SCE button can be used to generate a printable PDF of the selected SCE The Add to Favorites button adds the SCE to your Favorites list Clicking the Review button accesses the SCE Editor which can be used to review and edit SCEs Select the Run button to run the SCE 49 Using M se METIman Printing SCEs To print an SCE 50 1 From the Home page select the SCE to print The SCE summary panel appears n Anaphylaxis i Print SCE Holly Monroe Age 21 years old s Add To Favorites Gendet Female Weight 70 0 kg 5 Base Norma L Fe
173. ricothyrotomy feature replace the Crichothyrotomy plug Replacing the Cricothyrotomy Tape Remove the old punctured tape completely from the cricoid feature and use alcohol to clean the glue residue from the surface An alcohol prep pad works well Allow to dry Cut an approximately 2 25 inch 6 cm length of the double sided tape from the roll provided Carefully remove the paper backing and lightly stretch the newly revealed adhesive side of the tape over the cricoid hole and down the far side of the cricoid feature Use the non stick paper backing to press the tape against the cricoid feature Cut a 2 5 inch to 3 inch 7 cm to 8 cm length of red tape and apply it over the cricoid feature and the tape CAE Healthcare Using METIman Resealing the Membrane After a Puncture To reseal the cricoid feature apply a small piece of red tape over the punctured area This can be repeated a brief number of times but when the number of layers impedes the cricothyrotomy all existing tape must be removed and replaced with new tape 165 166 Pulmonary METIman uses both physical and mathematical models to achieve an extremely accurate simulation of respiration METIman s chest rises and falls mimicking inspiration and expiration METIman Prehospital s lungs also react realistically to intubation as well as to pathophysiologic states Pulmonary System Anatomy Clinical Interventions Patient Monitoring Software Control Manual Control
174. rt 2 Using a syringe slowly push air into the IV FILL port The fluid drains out of the IV DRAIN port 3 Continue to push air until empty Emptying the Genitourinary Reservoir To empty the Genitourinary reservoir have a catheter in place and a basin to catch fluid Use a syringe to slowly push air through the GU port until only air flows through the catheter Emptying the Head Secretions Lines Prehospital Only To remove fluid from the Head Secretions lines connect a syringe to the NOSE port and vacuum out fluid until empty Repeat this process for the MOUTH and EYES ports Emptying the Airway Secretions Reservoir Nursing Only To empty the Airway Secretions reservoir connect a 60 mL syringe to the AIRWAY FILL port and vacuum out fluid until empty Flushing the Subclavian Catheter Nursing Only When flushing the Subclavian Catheter the catheter must be in place To flush the Subclavian Catheter 1 Connect an external drain to the IV DRAIN port and place a basin to catch fluid 2 Using a syringe slowly push air into the IV FILL port The fluid drains out of the IV DRAIN port 3 Continue to push air until empty 4 Using the same syringe push air through the Subclavian Catheter until empty 3 CAE Healthcare Care and Maintenance Handling CO Canisters Prehospital Only Careful handling is required in the use of CO canisters Please read and follow all appropriate cautions and warnings Removing CO Can
175. rt screen click the Print button located in the bottom right corner of the 12 lead ECG report The Print dialog box appears 2 From the drop down menu select Microsoft XPS Document Writer 3 The report saves on the Windows Instructor Workstation To print a report 1 From the 12 lead ECG report screen click the Print button located in the bottom right corner of the 12 lead ECG report 2 Select the appropriate network printer NOTE A network printer must be configured in order to appear as an option 3 Click the Print button The report prints to the designated network printer 147 Using TouchPro METIman NIBP Cycling and Manual NIBP When non invasive blood pressure NIBP is displayed the patient s NIBP can be updated at specified intervals using NIBP Cycling or the current NIBP can be displayed immediately using the Manual NIBP button To set the patient s NIBP to be updated at regular intervals from the Settings menu click NIBP Cycling The NIBP Cycling menu appears From the NIBP Cycling menu select the desired interval for the cycling and click Start NIBP Cycling BM eT o x 2 0 mins 3 0 mins 5 0 mins 10 0 mins 15 0 mins 30 0 mins 60 0 mins Custom Cycling The NIBP Cycling Menu Custom cycling is also available 148 Using TouchPro To display the patient s current NIBP click the Manual NIBP button The Manual NIBP button br min The TouchPro Display The current NIBP
176. ry has not completed charging within the specified time e When leakage or foul odor is detected do not use and keep away from heat or flame e Immediately wash thoroughly with fresh water if liquid leaks onto your skin or clothes e If liquid leaking from the battery gets into your eyes do not rub your eyes Immediately wash eyes completely with clean water and seek medical attention e If the amount of time the battery is able power the equipment diminishes significantly the battery life is at an end Replace the battery with a new battery of the exact same make and model e Immediately remove a battery whose life cycle has expired from the equipment e When the battery is thrown away apply vinyl tape to the positive and negative terminals to avoid short circuits e When not using battery for an extended period remove it from the equipment and store it in a place with low humidity and temperature e In all instances keep the battery away from objects or materials with static electric charges e The battery can be used within the following temperature range Do not exceed this range Charge temperature range 0 C 32 F to 45 C 113 F xii CAE Healthcare Cautions and Warnings System Requirements If you are not using a TouchPro computer provided by CAE Healthcare please be sure to utilize a computer with wireless capability When operating the TouchPro software a computer with a Macintosh or Microsoft Wi
177. s as may be directed by CAE Healthcare At CAE Healthcare s request Licensee shall promptly provide a written certificate signed by an officer of Licensee confirming that such items have been returned to CAE Healthcare or destroyed as so directed by CAE Healthcare 4 5 The following shall survive and continue in full force and effect notwithstanding any termination of this License the obligations of Licensee under Sections 2 License 5 Non Disclosure as well as any other clauses which by their nature and context are intended to survive 5 NON DISCLOSURE 5 1 Licensee agrees to keep this License and all Confidential Information obtained hereunder in strict confidence and shall only disclose same a to Authorized Users solely for the Purpose and provided such access to the Product conforms at all times to the terms and conditions governing the use of the Product contained herein or b if required to be disclosed by law and only to the extent of such disclosure and limited to the purpose requested with prior notice to CAE Healthcare to permit it to seek an appropriate remedy to prevent the disclosure or alternatively to agree to the terms of such disclosure 5 2 The obligations of confidentiality use and non disclosure referred to in this Section 5 shall not apply to information which i is or becomes publicly available through no fault of Licensee ii was already in the rightful possession of Licensee prior to its receipt from CAE Healt
178. sentatives at any time during Licensee s normal business hours and upon reasonable prior notice the right to access to Licensee s premises to ensure that the use of the Product is done at all times in compliance with the terms and conditions of this License 2 6 CAE Healthcare reserves the right to embed a software security mechanism within the Product to monitor usage of the Product to verify Licensee s compliance with this Agreement as well as to control access to the Software through use of a a hardware lock device and or b a license administration software and or c a license authorization key collectively the Key 2 7 Some Products may provide Licensee with the option of saving and reproducing the images created by such Products Work during their use In this regard Licensee hereby recognizes that the entire rights title and interests in and to such Work remain the exclusive property of CAE Healthcare Licensee shall not modify such Work in any way whatsoever and shall not remove or alter any CAE Healthcare notices However Licensee is permitted to produce and reproduce such Work only for non commercial educational purposes 3 FEEDBACK Licensee agrees to provide CAE Healthcare from time to time with comments suggestions data information or feedback Feedback on the Product Licensee acknowledges and agrees that such Feedback may be freely used by CAE Healthcare at its sole discretion for the design development improv
179. shing after turning the power off and back on each time to see if communication has been established between the base station and the handset l m experiencing static or dropouts in the simulator audio output Reduce the range between the base station and the handset Most likely the handset is out of range of the base station or there may be too many obstacles walls windows doors between the handset and the simulator Audio Problems The sound output from the simulator is low when using a microphone on my lapel Increase the microphone gain on the handset by moving the dial towards the plus sign DIP switch 7 must be in the OFF position for this to work I m hearing feedback from the microphone when am close to the simulator Decrease the microphone gain on the handset by moving the dial towards the minus sign DIP switch 7 must be in the OFF position for this to work B 11 Appendix B Wireless Voice Link METIman The sound output from the simulator is too high or too low The volume level is configured at the factory for optimal performance However if you want to adjust the volume level of the base station located inside the simulator set the handset DIP switch 7 to ON Remember to turn the handset power off and on after each DIP switch change After this step is complete you will be able to adjust the volume level of the base station by adjusting the handset volume dial The sound output from the simulator is no
180. simulator using the anterior contacts The simulator automatically detects and responds to pacing signals from 20 mA to 200 mA in increments of 10 183 Using METIman METIman Subclavian Catheter Nursing Only The Subclavian Catheter feature allows for cleaning and dressing practice When using the Subclavian Catheter feature users can infuse up to 50 mL of distilled water in the line Subclavian Catheter NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal Intramuscular Injection METIman allows for the administration of a deltoid intramuscular IM injection Injection sites are located on both of METiman s arms For supported needle size see Recommended Clinical Supply Sizes on page 221 Intramuscular Injection 184 CAE Healthcare Using METIman IV Cannulation Veins for the IV Cannulation feature are located in the dorsum of the hands forearms and antecubital region of the arms For supported needle size see Recommended Clinical Supply Sizes on page 221 To simulate realistic flashback the system must be primed prior to use Ensure all fluids have been removed from previous uses before each new use to prevent overfilling Please refer to the Care and Maintenance section for directions on fluid removal IV Cannulation To prime the IV access ports connect a 60 mL syringe filled with distilled water with clinically
181. sma When used the Fluid Loss Plasma parameter reflects a decrease in plasma volume Plasma loss decreases the plasma volume without changing the red blood cell volume It refers collectively and generically to all fluid losses including evaporative transcellular bowel and third space fluid losses Range 0 mL 4000 mL Colloid Infusion When used the Colloid Infusion parameter reflects an addition to the plasma volume without changing the red blood cell volume Colloids include modified fluid gelatin starch solutions dextran and human albumin Range 0 mL 4000 mL A 17 Appendix A Parameter Descriptions METIman Crystalloid Infusion When used the Crystalloid Infusion parameter reflects an addition to the plasma volume without changing the red blood cell volume The term crystalloid is used to describe salt solutions for infusion i e normal saline dextrose in water and Ringer s Lactate Range 0 mL 4000 mL PRBC Infusion Packed red blood cells are a preparation of 7096 red blood cells and 3096 liquid plasma often administered in severe anemia to restore adequate levels of hemoglobin and red cells without overloading the vascular system with excess fluids Range 0 mL 4000 mL Whole Blood Infusion The term whole blood is used to refer to blood that has not been separated into its various components It represents a preparation of 4096 red blood cells and 6096 liquid plasma Range 0 mL 4000 mL Bleedin
182. specific needs of a wide variety of education environments METIman Replacement Lithium Battery Under normal usage a battery pack should last up to two years External Compressed Air Kit The External Compressed Air Kit gives the user the ability to connect METIman to a CAE Healthcare compressor tank or wall air using the kit s hose and fittings When connecting to wall air the kit attaches to the customer s wall adapter Introduction METIman External Compressed Air Kit The internal pump turns off automatically when external compressed air is sensed The External Compressed Air Kit includes a flexible 30 ft 9 m hose attached to a preset air regulator a fitting for air compressors and adapters for wall or tank air External CO Kit The External CO Kit gives the user the ability to connect METIman to an external source of CO 30 120 psi The External CO Kit includes a flexible 30 ft 9 m hose attached to a preset air regulator and an adapter for wall or tank fittings Air Compressor An air compressor product AIR 003 designed for quiet operation is available for same room use and an alternative air compressor product AIR 002 is available for situations where the compressor resides in a location such as a storage room set apart from the simulator Both Air Compressors are AC powered and include a regulator and an air hose with the appropriate connector fitting A 220VAC 50 Hz version of the Quiet In Room A
183. ss that 48 hours notice will be charged at the premium hourly rate On site time is described as the time period commencing from arrival at customer site through departure from customer site 207 208 Care and Maintenance METIman Breakdown After each use METIman should be properly disassembled and stored in a secure place To ensure that METIman remains in good working condition follow the prescribed CAE Healthcare breakdown procedures below These procedures are estimated to take less than 30 minutes Breakdown Steps Step 1 Stop All Running SCEs Stop any running SCEs using the Stop button in the upper right corner of the Muse software for each SCE Step 2 Clean the Simulator and the Fluid System Refer to the Maintenance Advice on the following pages for detailed instructions Step 3 Shut Down the Software To shut down the Muse software 1 Click the Account Name in the lower right hand corner of the screen The Logout Shutdown dialog box appears 2 Click Logout to exit the software or click Shutdown to shut down the computer To shut down the TouchPro software optional 1 Clickthe Settings button from the bottom right hand corner of the TouchPro screen 2 From the Settings menu click Shutdown A warning box appears asking if you want to exit 3 Click Shutdown 9 CAE Healthcare Care and Maintenance Step 4 Power Off the Simulator 1 Carefully pull back the skin on METIman s left hip
184. stem Settings System Configuration Disk Space 193 75 GB available 6596 free System Time Tue Jun 18 15 01 00 GMT 0400 2013 Data Management Back Up Data Restore Data Product Licensing License Manager Error Log View Error Log Export Localization Change Language The System Settings Panel NOTE System Settings functions are available only to users with the System Management privilege System Configuration Under System Configuration Disk Space and System Time are displayed Data Management The Data Management feature allows users to back up data to an external device Users can also restore the backup data 126 CAE Healthcare Using Muse Backing Up Data Back up data to protect and store content and user data To back up data 1 On the System Settings panel click the Back Up Data button Back Up Data The Back Up Data Button A Save dialog box appears 2 Select a location to save the backed up data 3 Click Save IMPORTANT To protect content and user information data should be backed up weekly Restoring Data Restore data when the backed up data needs to be replaced on the software Restoring data only restores the last backup and does NOT merge the backup data with the current data To restore backup data 1 On the System Settings panel click Restore Data The Back Up Data Button 127 Using M se METIman The System Restore warning
185. sure the roller clamp is closed and insert the IV spike into the IV bag 6 Connect to the simulator by attaching the end of the IV spike set tubing to the corresponding CHEST TUBE port LEFT or RIGHT on the simulator s right shoulder Chest Tube ports E PIE METIman s Right Shoulder 7 Open the clamp and allow fluid to flow into the simulator until fluid is seen in the METIman Priming Tube 8 Once fluid appears in the METIman Priming Tube remove the METIman Priming Tube The simulator is ready for chest tube insertion 9 Keep the IV bag attached and adjust the flow rate manually using the roller clamp The chest tube must be fully inserted for the fluid to flow NOTE Cleanup is very important when using simulated fluids Please refer to the Care and Maintenance section for directions on fluid removal 171 Using METIman METIman Cardiovascular With METIman s Cardiovascular system users can replicate the clinical signs associated with cardiac activity including palpable pulses heart sounds and electrical activity Cardiovascular System Manual Control ECG monitor may be utilized None required Use of modified blood pressure cuff 172 CAE Healthcare Using METIman To access the Cardiovascular parameters of METIman on the Run screen click the heart on the human form The cardiovascular features appear on the Run screen Blood Pressure Modeled Click the heart t
186. t in whole or in part and or its rights and obligations in CAE Healthcare s sole discretion to any party This Agreement shall be binding upon and enure to the benefit of the parties hereto and their permitted successors and assigns Any assignment of this Agreement or any license granted herein in violation of the provisions of this Section shall be void 9 9 Entire Agreement This License constitutes the complete agreement of the parties with respect to the subject matter referred to herein and supersede any other agreements written or oral concerning the subject matter hereof 9 10 Language The parties declare that they have requested and hereby confirm their express wish that this License and related agreements and documents be drawn up in the English language and that any notification letter or any other communication from a party to the other pertaining thereto shall be solely in the English language End of License METIman Specifications METIman METIman Specifications Size Mannequin Simulator 74 Hx26 W x11 D 188cm x 66cm x 28cm Weight Mannequin Simulator 100 Ibs 45 36 kg Environmental Requirements Ambient Temperature Range Mannequin Simulator Operation 40 F to 104 F 4 C to 40 C Storage 40 F to 122 F 4 C to 50 C Relative Humidity 0 to 90 non condensing Power Mannequin Simulator AC Input AC 90 240VAC 50 60Hz Consumption 70W nominal Internal Batteries 18 5V lithium ion rechargeable
187. t Instructor Workstation Microsoft Windows ig mr S 22 Optional Connect the SpO Probe eere reete tette tete entere rene en eese teta ta ta tntuos 23 Optional Connect External AUN sacseocesassaecacsessscsavvegeessssacevdecusssiavssscosssaverscaesssinicesdesssssadecciedsviiees 24 XV Table of Contents METIman Optional Insert the CO Canister Prehospital Only eere eee 25 iXX RE MCI e Hm 25 Accipe ECO REGUIANOL m 25 Insertion ofthe CO Canister Prenospital DlyJ sssusiesseiuiseri ospite rs FHYER IH IU ONES Rer torpet 26 Optional Detach the ATIS cossvessssscescasscvsedcswestscscecuecsusvssuecevisavescoeseceyusdbocseateussccencessivetesestaneres 28 Optional Prepare the Bleeding System ccssssscssssssesssssscsssssccssssccssesscssssssssssssssssssssssseess 30 Using the MAMI HT JOD aactor deer ctii rore te tm ma Eden aei ditur mend 30 Attaching the Overflow Bottle to the Trauma Fill Tank Assembly ss 31 Operating the Trauma Fill TOLIKGcoeieuaeteeied etum siete ce trae br aeter fieri tom ere eerte tente enitn 3 Preparing TURCO o NER 33 Optional Connect a TouchPro Computer to the Wireless Network eee 34 Step T SOCOM UM UN a meatus re HERES EUER THU QNEM 34 Step 2 Obtain METlmans IP AdTOSS cicesercses
188. t the tidal volume to a given volume per breath Once Tidal Volume is set to a numeric value arterial oxygen and carbon dioxide values have no effect on the tidal volume but continue to influence other components of the physiological models For example with the tidal volume set to 600 mL in the adult simulator the tidal volume A 7 Appendix A Parameter Descriptions METIman A 8 remains a constant set 600 mL even in the event of falling arterial oxygen levels In such situations the patient can only respond to arterial oxygen or carbon dioxide levels when the respiratory rate is adjusted Default Modeled Range 0 mL 2500 mL Intrapleural Volume Vol Left and Right The Intrapleural Vol parameters allow intrapleural volume to accumulate for example as happens during pneumothorax hydrothorax or hemothorax To simulate a pneumothorax set the corresponding Intrapleural Vol to a value greater than 0 mL Values more than 1500 mL reduce the corresponding lung volume significantly The breath sounds are automatically diminished on the appropriate side due to decreased ventilation of the affected lung Default 0 Range 0 mL 2500 mL Chest Tube Flow Left and Right The Chest Tube Flow parameter is used with the chest tube feature of the simulator The Chest Tube Flow specifies the rate at which fluid can be removed from the simulated pleural space via a chest tube drainage system As the chest tube drains the volume
189. there is too much interference at the initial channel the WVL pair changes frequency automatically and continues operating The WVL pair repeats this process automatically as needed and changes frequencies when interference is too high Multiple WVL pairs can be set to the same initial frequency However setting different initial frequencies helps the WVL pairs quickly find a stable operating frequency For example if there are 12 or fewer simulators in the same vicinity set all of the WVL pairs to use channel 0 of RF Channel Group 1 To give unique initial RF frequencies assign each WVL pair to its own RF channel with the settings found in CH 0 through CH 11 B 7 Appendix B Wireless Voice Link METIman If you have 13 to 20 simulators in the same vicinity set all of the WVL pairs to use channel 12 of RF Channel Group 2 To give unique initial RF frequencies assign each WVL pair to its own RF channel with the settings found in CH 12 through CH 31 RF Channel Group 1 RF Channel Group 2 ON 12345 CH 6 H e I c ON o CH 18 We CH 24 1234 H BJ Tm O n eg a NO wi EET uL IE NN wi ye a ui Tg Ca II rat I On La os a X ha e I ca e m M3 e e a B cn ir T ba I un j C I R3 Lo eE OW o Ero DL ESlo eg roger e ee eo eo mm wi wi wi wi wo oo TE TE BT E tC EE EET EET EET EET e I M d d i 3 Hoo fec
190. tient s physiology NOTE Not all medications affect the patient s physiology but all are logged The G Medications Medications Acetaminophen button Albuterol Amiodarone At n 5 hi Quick Links Atrovent Epinephrine 1 1 000 Epinephrine 1 10 000 Furosemide LOLs mx The Medications Palette NOTE Quick Links can only be added while creating or editing an SCE 63 Using M se METIman Or to apply a medication that is not set up as a Quick Link in the Medications palette 1 Click the Medications button Medications are organized by type and all available medications are listed under ALL MEDICATIONS 2 Navigate through the menus to locate the desired medication 3 Once the medication has been located click the medication s name from the list ALL MEDICATIONS Aceraminophen AcCUwated charcoal Adenosine Albuterol Alfentanil Amiodanrone Aspirin ALrecurturn Atropine ArroWent Bicarbonate Bretylum Calcium chloride Captoonl Lisarracurnium Curare d Tubocurarime Dextrose 5056 Diazepam Digoxin D tiazem Diphenhydramine The All Medications Menu The Medication Dose menu appears displaying the pre defined does and custom does routes for the chosen medication Morphine Intramuscular IM The custom a Intravenous Iv Intransseous I0 dose options L mg Iv 2 5 mg IV 5 mj Iv i mg Iv 15 mg IV 20 mg Iv mg TO The 5 mg 10 predefined 10 mg IO
191. time the performance by Licensee of any of the provisions hereof shall not be construed to be a waiver of such provisions nor in any way affect the validity of this License or any part thereof or the right of CAE Healthcare thereafter to enforce any such provision 9 4 No third party beneficiaries Nothing in this Agreement shall be construed as creating or giving rise to any rights for any third parties or any persons other than the parties to this Agreement 9 5 Notices Notices or communications pertaining to this Agreement must be given in writing and delivered to the addressee as indicated in the HEPGTC CAE Healthcare METIman Specifications 9 6 Preamble Headings The preamble forms an integral part of this Agreement The division of this Agreement into Clauses Articles sections subsections and other subdivisions and the insertion of headings are for convenience of reference only and will not affect the construction or interpretation of this Agreement 9 7 Severability If any one or more of the provisions of this License shall be held to be invalid illegal or unenforceable the validity legality or enforceability of the remaining provisions of this Agreement shall not in any way be affected or impaired thereby 9 8 Assignment and Succession Licensee may not assign or delegate this Agreement in whole or in part expressly or by operation of law without CAE Healthcare s prior written consent CAE Healthcare may assign this Agreemen
192. ting that the states are now linked by a transition The orange e Dopamine Greater than or Equal 5 mcg kg Hypotension Improves connector line Transitions The Scenario Designer 104 CAE Healthcare Using M se ELSE Transitions An ELSE transition is used to transition to a state automatically when none of the other programmed transitions occur Before specifying an ELSE transition from a state the state must first contain at least one other transition To add an ELSE transition click ELSE in the original state The ELSE menu appears listing all the available states gt The ELSE button Rapid Trauma Assessment Pulseless Electrical Activity Casualty Evacuation Th e E LS E m e n u Unresponsive None The Scenario Designer Select the desired state A black connector line appears indicating that the states are now linked by an ELSE transition Black connector line The Scenario Designer 105 Using M se METIman Deleting Scenario States To delete a state drag and drop the state into the Trash Pulsebess Electrical Activity 7 o0 Barespemsive remm tete Corte veisbie d wecncten Lp mot db Conte anal mua Rath 34a Cover Purto Dat rat m b Low ote A dragged state to The mandi The Scenario Designer States can be dragged and dropped to the Trash from the Graphical vie
193. tion product MTV 001 METIVision Console METI FX CAE Healthcare takes realism to the next level with METI FX a realistic set of advanced moulage wound simulation and special effects METI FX includes incredibly lifelike wounds that accurately replicate muscle tissue and subcutaneous fat and reflect the true physical nature of a wound and its treatment And METI FX comes complete with CAE Healthcare s own educational learning tools a set of how to treatment cards explaining procedures and learning objectives for both civilian and military patient scenarios product 4MFX 100 METI FX Simulation 11 Introduction METIman Moulage Kit The kit provides the materials needed to create wounds on METIman product MODS 999 Moulage Kit The Moulage Kit may also be ordered separately 12 CAE Healthcare Setup METIman Setup The following pages will guide you through assembling and configuring METIman Below is a list of steps required to prepare METIman for operation 13 Setup 14 METIman Before Beginning Setup Proper operation of the METIman simulation unit requires correct configuration Before setting up the system keep in mind these basic guidelines Understand the Cautions and Warnings information located in the Introduction section of this User Guide Follow the sequence of steps carefully e Complete all steps in order e Do not power on any components until instructed in the text
194. tive both pupils re size in a consensual manner The Non Reactive Pinpoint and Blown settings allow the user to fix one or both pupils to a specific size The Non Reactive setting fixes pupils to a normal size the Pinpoint setting fixes pupils in the pinpoint position and the Blown setting fixes pupils in the blown position Default Reactive Eyes Blinking In Auto mode the eyelids are normally blinking under the following conditions Minute Ventilation is greater than 1500 mL SpO is greater than 7096 and neuromuscular blockade NMB is less than 3096 The Blinking and Closed settings allow the user to have one or both eyes either blinking or closed and override the automatic response Default Auto The Slow Normal and Fast parameters control the eyelid blinking frequency Presently blinking frequency is not linked to the physiological models However the response can be done on the fly or scripted using the Scenario Designer Default Normal Convulsions The Convulsions parameter is used to simulate the presence of convulsions They are either ON or OFF Default Off o CAE Healthcare Appendix A Parameter Descriptions Intracranial Pressure ICP The ICP parameter is used to set the ICP displayed as a numeric value on the TouchPro monitor The base value is set at 8 mmHg This parameter is uninfluenced by physiological models Default 8 mmHg Range 0 0 mmHg 65 0 mmHg Neuromuscular Blockade NMB The p
195. tubes a On each leg at the knee remove the locking pin from its position Removing the Locking Pin b Place lower limbs in their correct positions leaving enough room to manipulate connectors c On each leg match and connect the color coded tubing to the three white tubing connectors Connecting Tubing 16 ZF CAE Healthcare Setup d Match and connect the color coded tubing to the three black electrical connectors Connecting Electrical e Carefully place tubes and cables in the hole on the lower leg f Align holes on the knees and insert the locking pin g Screw the nut on the locking pin holding it in place Affixing the Locking Pin 17 Setup METIman Step 3 Power On METIman a Locate the ON OFF button beneath the skin covering METIman s left hip The ON OFF Button METIman s ON OFF Button b Press and hold the ON OFF button for one second The power light blinks indicating the system is busy In approximately one minute the light stops blinking and remains solid indicating the simulator is now ready NOTE METIman can be operated continuously for approximately four hours without recharging the battery 18 ZF CAE Healthcare Setup Step 4 Power On the Instructor Workstation a Place the Laptop or Tablet Instructor Workstation near METIman in a convenient location b Ensure the Instructor Workstation battery is fully charged or connect the AC adapter to the wor
196. ubation Endobronchial rene piatan intubation results in unilateral chest excursion and breath sounds Trachea Left and Right Tracheal intubation results in bilateral None required None required Mainstem Bronchi chest excursion and breath sounds Prehospital only Airway Management and Alveolar and arterial gas concentrations Oxygen None required Ventilation appropriately reflect the efficacy of administration input ventilation and oxygen administration by the instructor VIEW Respiratory Gastric Distention Esophageal intubation results in gastric None required None required distension and the absence of breath Prehospital only sounds chest excursion and CO output Breakaway Teeth Upper front teeth can be dislodged if None required See Breakaway laryngoscopy is performed incorrectly Teeth Prehospital only Tongue Edema Hinders but does not prevent VIEW Respiratory None required On Off intubation Posterior Pharynx Obstructs view of larynx to prevent VIEW Respiratory None required Swelling intubation but allows mask ventilation can t intubate can ventilate scenario Prehospital only Laryngospasm Closes vocal cords and prevents VIEW Respiratory None required intubation and ventilation When used Prehospital only with posterior pharynx swelling creates a can t intubate can t ventilate scenario Cricothyroid Membrane Allows needle cricothyrotomy None required See transtracheal jet ventilat
197. ular Contraction 10 Premature Ventricular Contraction 25 Pulseless Electrical Activity Sinus Sinus Bradycardia Sinus Bradycardia HR 40 Sinus Tachycardia Sinus Tachycardia HR 120 ST Elevation with Chest Pain Torsade de Pointes Trifascicular Block Ventricular Fibrillation Coarse Ventricular Fibrillation Fine Ventricular Tachycardia Ventricular Tachycardia Pulseless Ventricular Tachycardia HR 151 Ventricular Tachycardia Pulseless HR 151 Wellen s Syndrome WPW Syndrome Left Lateral Pathway A 11 Appendix A Parameter Descriptions METIman Arterial Catheter The arterial pressure displayed on the Patient Status Display or TouchPro software is set using this parameter A non pulsatile zero pressure signal is emitted when the Atmosphere position is selected and can be used to simulate zeroing a pressure transducer This may also be used to remove the arterial pressure waveform if desired The Left Ventricle position is useful for simulating cardiac catheterization procedures or for demonstrating left ventricular end diastolic pressure and its relationship to pulmonary artery occlusion wedge and central venous pressure Default Peripheral Artery Options Atmosphere Peripheral Artery Left Ventricle Central Venous Catheter The venous pressure displayed on the Patient Status Display or TouchPro software is set using this parameter A non pulsatile zero pressure signal is emitted when the Atmosphere p
198. ure click the switch again The feature is deactivated when Off appears Neuromuscular Blockade To manually adjust the Neuromuscular Blockade NMB Set click NMB The NMB slider appears Set the percentage by dragging the arrow up or down Click Accept to exit and save the changes Body Temperature To control a patient s body temperature click Temperature Body The Body Temperature slider appears Set the body temperature by dragging the arrow up or down Click Accept to exit and save the changes Blood Temperature To manually control a patient s blood temperature click Temperature Blood The Blood Temperature slider appears Set the temperature by dragging the arrow up or down Click Accept to exit and save the changes 155 Using METIman METIman Head Secretions Prehospital Only Secretions of the eyes nose and mouth are manually controlled with a gravity feed NOTE An IV bag is needed for each site in use To use the head secretion features 1 Using a 60 mL syringe prime the line of the desired secretion by injecting fluid into the NOSE MOUTH or EYES port on METIman s left shoulder until fluid emerges from the secretion sites 2 Set up the IV pole near the simulator 3 Fill an IV bag with the clinically appropriate fluid Use distilled water only with food coloring if desired 4 Hang the IV bag on the IV pole 5 Ensure the roller clamp is closed and insert the IV spike into the IV bag 6 C
199. w or the Line Item view Deleted states remain in the Trash until you log out of the software or the Trash is cleared 106 CAE Healthcare Using Muse Deleting Parameters and Transitions To delete a parameter or transition from an active state drag and drop the desired parameter or transition into the Trash To drag a parameter click anywhere within the parameter To drag a transition click the yellow selection bar to the left of the transition il wee i donee arm Collapse Al 9 apani A be Rapid Trauma Assessment Dirse jm p The yellow selection bar Ea Pulseless Ehechr zal Activity Qntesponsben ap Li RE EE Cumar Vaan A dragged a n transition The Tes Il The Scenario Designer Parameters and transitions can be dragged and dropped to the Trash from the Graphical view or the Line Item view Deleted parameters and transitions remain in the Trash until you log out of the software or the Trash is emptied 107 Using M se METIman Saving the Scenario At any time during scenario creation or modification the scenario can be saved To save a scenario 1 Click the Scenario button in the upper left of the Scenario Designer The Scenario drop down menu appears d EIE Rename New State Rename selected Stare Delete selected State The Scenario Drop Down Menu 2 To save the most recent version of a modified scenario click Save OR To save a modified scenario as a new scenario leavi
200. ysiologic models with subsequent changes in hemodynamics Blood loss occurs at a rate dependent on wound size and Mean Arterial Pressure MAP Setup must be completed before using the bleeding feature To enable bleeding on the Run screen click the blood droplet The Fluids view appears Fluid Loss Blood Fluid Loss Plasma Colloid Infusion Crystalloid Infusion Bleeding parameters hole Blood Infusion Bleeding Upper Bleeding Lower Click the blood droplet to access the Bleeding view The Fluids View Simulated blood MUST be removed from the simulator after each use Failure to remove simulated blood from the simulator can void the warranty For instructions on how to clean the simulator after using the Bleeding feature please refer to the Care and Maintenance section for directions on fluid removal 186 p CAE Healthcare Using METIman Hemorrhage Setup The user determines the type and placement of the bleeding moulage for the lesson An optional Moulage Kit can provide molded gunshot wounds broken and protruding bones amputations and an abdominal wound as well as theatrical components To decrease the likelihood of staining apply a thin coat of petroleum to the area of bleeding To use one of the moulage wounds from the Moulage Kit 1 Secure the wound over the simulator using the integrated straps 2 Connect the wound haptic to the one of the moula

User Guide

Contents

Download Pdf Manuals

Related Search

Related Contents