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1. 161 NIBP Cycling alid Mantal NIBD sii eo rk ha rH DENS EEEEN SR CHE EEROENONYR RE KMS NS FEEROENI EIE Y SN VE DEN PEE YVES eY E HAY Y IS 162 lif 164 Configuring the TouchPro Software 4 11e eere eee ee eene eerte eee ene e eee tn eset ao esee ea aee eo oae 165 Changing the TouchPro Language 44 e eere eene eee eee en eee eee tn neos teen eee teens eese tas e e eas 166 Exiting the ToucnPro SoftWare irre risk ivit Fi E EEN IEEE EN SEP PIN EUPE FIT SUELE NE EE FUN YE EYE USE TRFER Een PIS ERE ERE 166 Using Ine SUSIGIT ciesscccxvavescesescayscessueccsesvesncessvecshssvenesseceuvessssacssscatsesnsseussscoasisssseeniens 167 dil M 168 Neurological SVSTGHL roa OON EBAEUOUREERURR TERME REINBURKUSEPUVISPANDUA ERI HER EERISEREEPME 170 qj S 171 pp e m 172 JUI M 172 xxiii TableofContents O Z O O DabyslW EE B SySEOI E T E AE E E RM 173 E E E E AE E E DUI N 175 Chest Tube SetUp sseesssessseesssessseesseesseesseeesseesseeeseessseesseeeseeesetesstenseeesstesstesseteetenstensteesetessteoseesseresses 176 Needle Decompression Setup scccsssssscssssssssssssssssssesssscssssssssssssesessssessesseessesssessesssesesssseses
2. The Scenario Designer 119 Using M se BabySIM Deleting Scenario States To delete a state drag and drop the state into the Trash Pulsebess Electrical Activity 7 o0 Omwespensive remm p tete contem Vai d eecnston ee ee Comte Rath 34a Operas Dunt Dat rt m Lew ote A dragged state to The mandi The Scenario Designer States can be dragged and dropped to the Trash from the Graphical view or the Line Item view Deleted states remain in the Trash until you log out of the software or the Trash is cleared 120 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 121 Using M se BabySIM Saving the Scenario At any time during s
3. eene eee eere ee eere eee erroe etta ee eaa a seno 201 BabysiM Warranty PrOGFalTIS csescini sib uua e RERO VRONEER TPYWVXE ENSE TRUE NE ETE PAX S AER EAE ENG n iini 201 General YES NE E OE 201 How to Contact Customer Service cissccsscsscsscecosscvedicessasentecedesuarwecudescassseuadseussveooavesdensianedcnessess 202 Basic Warranty Service Program ssssssssssssssssssssssessssssscsessssessesessesssescsesussesusscsessesesecsesscsesseseseesess 204 Enhanced Warranty Service REOUNAIN scvccssavessansxeersnsncetssnoensoesureninvcasatenarsnceenunepeesncesinencisannsuanerianier 204 System Software Upgrade SUP OOM oce A UEM Dern Hoo Rag maine 205 A EAC E a E A A tases vsousar A A dana A E E A CTERMIN 205 rop T SEEE AEE EE EEA AE E EE S 206 Step 1 Stop AIL RUNNING SCES IE 207 o AN E E e EE E EE EG ME esanauenianedsianvesantosesinuenccaaverseneniouenenns 207 Step 3 Turn the Air and Gas Supplies Off eee 209 Step 4 Shut Down the Software ccccssccsssessssessssessssesssssssssesssscsssscsssscsesecessasessscesacessacesacessaceeees 210 Step 5 Disconnect the Computer Components eese retento toten tontnnnnns 211 Step 6 Snut Down te PCU piirsin aan PRSE niai 211 Step 7 Disconnect the Hoses and Cables from the PCU eene 212 Step 8 Ready the PCU for Storag Bose oe irr REIR o PH EE Dor QURE EOERU irr Dai erc IPIE 212 Step 9 Disconnect the Umbilical from the M
4. 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 button from the Home page The System Administration Button The System Administration screen is displayed Healthy Female Enfant Rose Jackros months cia temea o ly Mose Jackson Healthy Male Infant Ryeo boruners amp months ci lt vas yan Tar Conditions Patient Records o wo aye The System Administration Screen 127 Using M se BabySIM 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 Healthy Female Intant Management 9 xp button The Content aerial T Management m options ib lt 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 MSOS neat Fe
5. CSA INTERNATIONAL ie Supplement to Certificate of Compliance Certificate 1 50492 Master Contract 223202 The products listed including the latest revision described below are eligible to be marked in accordance with the referenced Certificate Product Certification History Project Date Description 1704296 2005 09 23 Addition of Model BAB 101 1629830 2005 01 28 Alternate Construction 1504921 2004 01 16 Original Certification Emergency Care Stimulator Model BCS100 BabySIM CAE Healthcare DECLARATION OF CONFORMITY In accordance with EN 45014 Medical Education Technologies Inc 6000 Fruitville Road Sarasota Florida 34232 USA declare under our sole responsibility that the product Type of Equipment Human Patient Simulator Manikin Model Number ECS X AC Input to which this declaration relates is in conformity with the following standards or other normative documents EMC EN 55011 1998 A1 1999 Group 1 Class A EN 61326 1997 A1 1998 EN 61000 4 2 1995 EN 61000 4 3 200 Al 2002 EN 61000 4 4 1995 AT 2001 A2 7001 EN 61000 4 5 1995 EN 61000 4 6 1996 EN 61000 4 11 1994 EN 61000 3 2 2000 EN 61000 3 3 1995 A1 2001 following the provision of the EMC Directive 89 336 EEC Sarasota Florida 3123 USA European Contact BabySIM CAE Healthcare DECLARATION OF CONFORMITY In accordance with EN 45014 Medical Education Technologies Inc 6000 Fruitville Road Sarasota F
6. 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 135 68 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 Scenarios nija Add Scenario The Add Scenario Button The Choose Scenario dialog box appears Scenarios Name Last Modified Heart Failure with Pulmonary Edema 2010 02 23 16 33 25 Severe Young Asthmatic 2010 02 23 14 30 08 Subdural Hematoma z0i0 02 253 15 51 06 The Add button The Choose Scenario Dialog Box 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 eh Add Scenario Anaphylaxis Begi
7. 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 103 154 Using TouchPro Changing a Waveform or Numeric Display Waveforms and numeric displays can be changed to suit the user s 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 I ECG IIT ECG V5 ABP PAP CVP Pleth Capnogram Blank Set Alarm Set Color Set Scale 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 155 Using TouchPro BabySIM Adding a Waveform The TouchPro software supports up to six waveforms To add
8. Mannequin The BabySIM mannequin displays the physical characteristics of a three to six month old patient and has interchangeable male and female genitalia Fully operational in the supine position the mannequin can be placed on standard operating room tables in ICU beds on the ground or even in a vehicle in the case of a simulated accident The BabySIM Mannequin The mannequin allows for the physical assessment of various clinical signs i e heart and breath sounds palpable pulses chest excursion airway patency etc that are dynamically coupled with the mathematical models of human physiology and pharmacology 19 20 Clinical Features BabySIM Physiological and Pharmacological Features The BabySIM simulates patient reactions based on complex neurological cardiovascular respiratory and pharmacological models Neurologic System The BabySIM is equipped with a number of features specifically targeted to support training for neurological care The following provides a general overview of each feature In addition to the preconfigured sounds provided with the system phonation and patient voice are available via a wireless microphone transmitter receiver and speaker in the head of the mannequin A palpable anterior fontanel displays bulging upon activation via the software Eye Signs Each eye has functional eyelids that blink and pupils that can be adjusted independently to three levels of dilation e g pinpoint
9. state F tees EI tica activity y Bi ypiteeni b Medleder ves mo cee Heard Gate Tacky Pee ee Rin F The States Taciypasa E r Teirapiesrel Vek Lei 1B e graa button The Scenario Designer 123 Using M se BabySIM To access the State Library click the States button in the bottom right corner of the Scenario Designer Es States The States Button The State Library appears listing all saved states Hpertension Begins 4 Conditions Estates The State Library Click Conditions to exit the State Library Emptying the Trash To empty the Trash click the Trash icon in the lower left corner of the Scenario Designer Anaphylaxis x rmm ral I gp Hee State jy Collapse AD 9 Expand All The Trash a icon The Scenario Designer 124 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 125 Using M se BabySIM Administrative Tools The M se software has administrative tools that allow users to manage logs stored content users and system settings The administra
10. Cardiovascular System The mannequin produces realistic heart sounds and a wide range of pathophysiologic conditions synchronized to the ORS complex of the ECG and audible to a standard stethoscope Heart Sounds can be auscultated over the left and right of the sternal border Heart Sounds are discussed further on page 197 of this User Guide The Cardiovascular View Ei CAE Healthcare at Using the System Cardiovascular System Software Control Manual Control Clinical Interventions Patient Monitoring and Scenarios ECG waveforms can be viewed on a standard monitor the Patient Status Display and or the TouchPro Software Normal and abnormal cardiac rhythms are linked to patient physiology e g blood pressure cardiac output Cardiovascular system automatically compen sates for changing hemodynamic conditions The desired arrhythmia can be selected Transthoracic cardiac pacers can be used with the BabySIM Pacing results in appropriate physi ological changes in blood pressure and cardiac output Effective chest compression results in artificial circulation cardiac output central and peripheral blood pressures palpable pulses and CO return Normal and abnormal circulation e g hypov olemia hypervolemia and right left heart failure The BabySIM supports operation with a variety of manual defibrillators See the Invasive Hemodynamic Monitoring chart Systemic blood pressure can be
11. Heart Sounds Heart sounds emanate from speakers and are synchronized with the cardiac cycle Normal and abnormal heart sounds are selected using this parameter By default heart sounds are set to Normal The following sounds are available 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 S3 S4 S3 and S4 Early Systolic Murmur Mid Systolic Murmur Vocal Sounds Late Systolic Murmur Holosystolic 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 NOTE A patient must be running on the BabySIM simulator for any sounds to be available 3 CAE Healthcare Appendix A M se Parameter Descriptions Vocal Sounds A variety of programmable vocal sounds are available Vocal sounds are androgynous Vocal Sounds High pitched Cry 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 Bowel Sounds Breath Sounds Vocal Sounds I I I High pitched Cry em Baby Talk Cooing Heart Sounds Cough Crying Gooing Screaming Sneezing Vocal Sounds Menu Vocal Sounds are emitted immediately and play contin
12. 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 79 Using M se BabySIM Using the Interventions Palette There are two ways to perform and or administer interventions using the Interventions palette 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 button Bag Valve Mask Crystalloids 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 S asc Wired 1 A selected Non Rebreather Mask intervention The Selected Intervention Options NOTE Quick Links can only be added while creating or editing the SCE
13. 10 pounds 5 kg Conveniently contained in a rolling hard sided case the PCU is the most central of all the BabySIM system components Inside the PCU is a DC power supply and the Wireless Ethernet Switch BabySIM PCU When in operation the PCU should be placed horizontally so that the cover opens upward as shown in the picture above Located beneath the cover on the PCU Interface Panel is the Wireless Receiver the power switch and a number of labeled ports M OFF DISCONNECT SUPP Y 2S A SERVICING AUX POWER MONITOR IN BOWER 12VDC 4A PCU Interface Panel o CAE Healthcare Introduction PCU Power Ports Fuses and Switch Located in the upper left of the PCU are the electrical controls and the source of the power for the PCU and the monitor gt e POWER acn 2 switcH ruse 250V T 2A ON 250V T 10A F2 OFF 250V F 5A DISCONNECT SUPPLY POWER F3 BEFORE ON 3 250V T 1A SERVICING UX POWER MONITOR IN F4 POWER 12VDC 4A 250V T 4A 4 he 2 F5 250V T 5A PCU Power Ports Fuses and Switch In a standard laboratory configuration using AC Power the power cord is plugged into the AC IN port This should be done prior to plugging the cord into the power source which should be a surge protected outlet to protect the integrity of the electrical system and reduce the chance of blowing fuses NOTE Beside the AC IN port is a small fuse panel labeled Fuse 250V T2A Before replacing a burnt fuse
14. Ditazem Diphenhydramine The All Medications Menu 77 Using M se BabySIM The Medication Dose menu appears displaying the pre defined does and custom does routes for the chosen medication Morphine Intramuscular IM The Cu stom i Intravenous IV e Intraasseciis i J r dose options L mg iv 2 5 mg iv 5 mg iv 10 mg Iv 15 mg IV 20 mg IV 1 mg Io The 2 5 mg IO 5 mg 10 predefined 10 mg IO 15 mg 10 dose options 70 mg IO 5 mg IM 10 mg IM The Medication Dose Menu 4 Select a dose option This can be done one of two ways a Choose a pre defined dose Q Morphine Intramuscular IM Intravenous IV Intraosseous IO 1 mq IV 2 5 mg IV 5 mg IV 10 mq IV 15 mg IV 1 mg IO h 2 5 mg 10 T e 5 mg IO d fi d 10 mg IO pre e Ine 15 mg 10 20 mg IO dose options 5 mg IM 10 mo IM The Medication Dose Menu The dose is applied and appears in the patient s physiology 78 CAE Healthcare Using Muse OR b Choose a route of administration to administer a custom dose Morphine Intramuscular IM The custom dose options Intranssenus ICH L mg Vy 2 5 mg TV 5 mg iv 10 mg Iv 15 mg IV 20 mg IV mg IO 2 5 mg IO 5 mg TO 10 mg Io 15 mg IO 20 mq IO 5 mg IM LO mq IM The Medication Dose Menu The Custom Dose Administration menu appears Morphine Intravenous Tv The Administer button
15. The SCE stops running IMPORTANT Always stop all running SCEs before logging out of M se 95 Using M se BabySIM 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 96 CAE Healthcare Using Muse The Patients Palette appears The selected base patient Rose Jackson Age 6 months old Name Ryan Summers Name Age 6 months old Gender Female Weight 8 0 kg Gender Male The Create c Weight 8 0 kg b u tto n he Create 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 The Save Name field button The SCE Editor Screen
16. The TDCK is optional Healthy Female Infant 00 09 32 imma D OO ob The Run Screen 167 Using the System 168 Parameters BabySIM The M se software has a number of parameters that control the physiological features of the BabySIM The parameters are grouped by category Neurological Respiratory Cardiovascular Fluids and the TDCK Optional Each screen lists default Basic parameters However when the Basic Additional switch located on the Run screen is activated more parameters become available Below is a table that lists all of the Basic BabySIM parameters Eyes Blink Speed ICP NMB Temperature Body Temperature Blood Fontanel The Basic Additional Switch Laryngospasm Needle Decompression Seesaw Breathing Bronchial Occlusion Respiratory Rate Respiratory Rate Factor Shunt Fraction SpO NMB Tidal Volume Intrapleural Volume Left Intrapleural Volume Right Fraction of Inspired O Basic Parameters Blood Pressure Heart Rate Heart Rate Factor Cardiac Rhythm Arterial Catheter Central Venous Catheter PA Catheter PA Balloon Defib Pacing Current Pacing Rate Pacing Capture Threshold Fluid Loss Blood Fluid Loss Plasma Colloid Infusion Hemorrhage Channel 1 Hemorrhage Channel 2 Hemorrhage Channel 3 Hemorrhage Channel 4 Hemorrhage Channel 5 Hemorrhage Channel 6 o CA E Healthcare Using the System Additional parame
17. Using M se BabySIM 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 indicating 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 118 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
18. Vocal Sounds The Bowel Sounds Menu 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 controls one or both of the intestinal regions to change the type of sound Click and drag the Bowel Sounds slider to adjust the volume Normal bowel sounds are present by default NOTE A patient must be running on the BabySIM simulator for any sounds to be available S CAE Healthcare Appendix A M se Parameter Descriptions Breath Sounds Breath sounds are independently synchronized with ventilation of the left and right lungs Speakers in the anterior regions provide breath sounds that can be auscultated Breath sounds can be adjusted by clicking the Sounds button on the Run screen When the Sounds panel appears select Breath Sounds Biphasic Wheeze Bronchovescular Click any one of the Breath Sounds in the drop down menu to select a Breath sound Click and drag the slider to adjust the volume NOTE A patient must be running on the BabySIM simulator for any sounds to be available By default Normal breath sounds are heard Bowel Sounds Breath Sounds LU LU LU LU LU Biphasic Wheezing ul Bronchovesicular Crackles Heart Sounds Prolongation Rhonchi Stridor Wheezing Vocal Sounds The Breath Sounds Menu A 31 M32 Appendix A M se Parameter Descriptions BabySIM
19. above for the Instructor Workstation If using the battery to power the Instructor Workstation or if using the Wireless Remote Control recharge the battery using the power cable and a surge protected power source The Instructor Workstation and Wireless Remote Control power cables both have a green light that indicates a fully charged unit when lit CAE Healthcare Care Maintenance Step 5 Disconnect the Computer Components To disconnect and store the computer components a b C d e f If using the optional TouchPro computer shut down the computer Power off the Instructor Workstation Unplug the Instructor Workstation and the optional TouchPro computer power cables from the outlet Disconnect the Ethernet cable from the Instructor Workstation Disconnect the power supply cable from the Instructor Workstation Coil the cords and store them along with the Instructor Workstation NOTE If using the battery to power the Instructor Workstation or if using the Wireless Remote Control recharge the battery using the power cable and a surge protected power source Step 6 Shut Down the PCU With the air and gas supplies turned off from Step 1 d d Power off the PCU by pressing the POWER SWITCH on the Interface Panel into the OFF position Unplug the power cord from the power outlet If using the OPTIONAL Auxiliary Power Supply disconnect the cable from the Auxiliary Power Supply Remove the power cord
20. pressure In addition the following responses and interventions are available with the invasive hemodyamic monitoring package The introduction and progressive insertion of a pulmonary artery catheter synchronous with the appropriate waveforms can be simulated with the results shown on the TouchPro software The patient has a baroreceptor reflex the sensitivity of which can be controlled by the instructor The Cardiovascular System simulates both hypovolemia and hypervolemia as well as right and or left heart failure The patient s cardiovascular response to medications is automatic and dose dependent Chest Compression In accordance with PALS guidelines effective chest compression of the patient s sternum results in artificial circulation cardiac output central and peripheral blood pressures palpable pulses and CO return Pressure fluctuations are seen on invasive catheter waveforms The presence or absence of exhaled CO is directly related to chest compression effectiveness and automatically and significantly increases when cardiac resuscitation is successful Cardiac Arrhythmias The instructor is able to select and maintain a desired arrhythmia and control the simulated patient s response to clinical interventions Electrical Therapy Conventional defibrillators can be applied to the simulator With this device the delivered energy is quantified in real time to trigger the appropriate patient response The ECG can be moni
21. Infant Mannequin and Umbilical Assembly eene 4 Hard Sided Mannequin Carrying Case c cuisses osea et voe EROR HERREERFN EE CEREEV ELS YER EPT ERE EUER ERG ebaS 5 JO 200103 1 T 5 Power and Communications Unit PCU m 6 Laptop Instructor Workstation accesses ocaaecedccscshexeuecectass siamet bu Hen pud Het quer retta cS o IEMEE S 11 Optional Equipment Tor the BabySIM sessssoessoessocesscessoessocesocessossooessocesocesoossoosesosessossoosssoses 12 Tablet Instructor Workstation ccssssssssssssssscssesecsscssssscssessessccscscssccsccusssssssessenscsseseeseesecasensessensensenees 12 Virel ss hemofe CODTTOL AAEN E A E E A ET N E 12 Soi OS ESI EI 13 Shoulder Ad NCSI BIRSL ee qe Etr et tva titio raul re HEREDES UII 13 Aay POWET SUDDIY P 14 PT EOE ES OM E AEE EAE IA E E EN T I A A A A T 15 BEEE AEE E 9Y 16 X X TableofContens Baby EGS zu gr TOR Ap neat 17 Trauma Disaster Casualty Kit TDCK n 18 UE e 18 MISC lm ee 19 Manne quil EE E EE E E A E A E E 19 Physiological and Pharmacological Features sssesssoosssoocesoocssoosesoosesoosessocessosessoosesossessosesss 20 OEE CCM A E E E E E E A E aeni Ean 20 Respiratory System essesessesssse
22. Metabolic acidosis and alkalosis are simulated with a few simple adjustments to the ABG pH level made by the instructor For example simple calibrations can accurately simulate a patient response to metabolic acidosis Genitourinary System The mannequin 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 Replacing the Mannequin s Genitalia The BabySIM comes with interchangeable male and female genitalia To replace the mannequin s genitalia 1 Detach the existing genitalia 2 Disconnect the white tubing connector from the genitalia tubing 3 Connect the white tubing connector of the selected genitalia to the genitalia tubing 4 Attach the selected genitalia ensuring it is secure in the grooves The genitourinary features are now ready for use o CAE Healthcare Using the System Utilizing the Genitourinary Features To use the Genitourinary features 1 2 3 Insert the genitalia desired for the exercise Set the assembled IV pole near the PCU Fill an IV bag and attach it to the supplied IV solution set to yield a clinically appropriate colored liquid e g for simulated urine add 1 to 2 mL of yellow food coloring per liter of distilled water and mix to achieve the desired color Be careful not to make the mixture too thick as this can clog the system Verify that the dark bl
23. Raising the value increases the resistance while lowering the value decreases the resistance With less blood returning to the heart there is a reduced volume entering the ventricles prior to ventricular contraction This results in a drop in the cardiac output and decrease in arterial blood pressures The heart rate increases due to feedback from the physiological control mechanisms in an attempt to maintain adequate blood pressures Default 1 Range 0 10 100 00 Baroreceptor Gain Overall Factor The Baroreceptor Gain Overall Factor parameter adjusts the influence of mean arterial pressure MAP on heart rate contractility systemic vascular resistance and venous capacity Use this parameter to adjust how vigorously the heart and vasculature respond to blood pressure changes The degree of increase in heart rate or vascular response is influenced by the baroreceptor gain overall factor For example when blood pressure falls the heart rate increases the arteries increase their vascular tone resistance and there is less pooling of the blood in the venous system all in an attempt to maintain adequate blood pressure A barorecptor gain overall factor value of less than 1 corresponds to baroreceptor depression A barorecptor gain overall factor value greater than 1 leads to a stronger response to MAP changes Default 1 Range 0 00 100 00 Baroreceptor Gain Cardiac Factor The Baroreceptor Gain Cardiac Factor paramete
24. 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 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 arterial oxygen or carbon dioxide levels by adjusting the Tidal Volume parameter Default Modeled Range 4 breaths per minute 80 breaths per minute Respiratory Rate Factor The Respiratory Rate Factor parameter along with the Tidal Volume Factor parameter is used to change the baseline respiratory rate before the control of breathing and drug influences are taken into account A value of 2 doubles the baseline respiratory rate A value of 0 5 decreases the baseline respiratory rate by 5096 Default 1 Range 0 01 6 00 TIP First decrease the respiratory gain factor to reduce the influence of the respiratory control mechanism on the respiratory rate and tidal volume Shunt Fraction The Shunt Fraction parameter is frequently used to assist in desaturating a patient This
25. Scenario states can be created by dragging and dropping conditions medications and interventions from their respective menus on the right side of the Scenario Designer to the canvas Drag and drop a condition onto the canvas to create a state BP Hypotension O BP Hypertension k 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 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 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 E Notes F Custom variable _ Create The Expanded State 112 CAE Healthcare Using Muse 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 The State ension Pneurnothorax The Save Name field button The Rename State Window 4 Enter a new state name NOTE When naming a Scenario State the state name may
26. The 10096 setting indicates that chest compressions are completely effective while the 096 setting prevents them from having any effect on intrathoracic pressure Default 10096 Options 10096 096 Aortic Valve Resistance Factor The Aortic Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the aortic valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through the aortic valve Default 1 Range 1 1000 Mitral Valve Resistance Factor The Mitral Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the mitral valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through the mitral valve Default 1 Range 1 1000 o CAE Healthcare Appendix A M se Parameter Descriptions Pulmonic Valve Resistance Factor The Pulmonic Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the pulmonic valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through the pulmonic valve Default 1 Range 1 1000 Pulses The table below shows the defaults and ranges for the pulses and pulse deficits for the BabySIM Pulse Default Range erachialDefict 30 9 29 Femoralbefct 39 9 39 All pulses unless altered by an SCE are enabled by default To disable a pulse
27. The Scenario Designer allows users to create and edit scenarios To access the Scenario Designer create a new scenario or choose an existing scenario 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 The Pre Loaded Scenarios Heading The Choose Scenario dialog box appears Scenarios kay Name Last Modified Anterior Myocardlal Infarction 2011 09 12 05 38 35 COPD Exacerbation with Resplratary Fallure 2011 09 12 05 35 10 Elevated Heart Rate 2011 09 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 35 The New button Add New Cum Q x The Choose Scenario Dialog Box 106 CAE Healthcare Using Muse 2 Click New The Scenario Designer appears displaying the new untitled scenario Untitled Scenario E Ed E fp How Sate o je Colles AN C9 Expand All ALL CONDITIONS Cardio ilar Hemorrhage M urvdnniz Interventions The Scenario Designer 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 The Add Scenario button 4 Add Scenario The Pre Loaded Scenarios Heading 107 Using M se BabySIM The Choose Scenario dialog box
28. a light dusting of baby powder to the mannequin s skin This application makes cleaning the skin easier For cleanup use alcohol and gauze or a gentle cleaning solvent such as Goof Off or Orange Sol If any of the trauma genitourinary or IV features of the BabySIM have been used flush out the mannequin as described in the previous pages Failure to flush the systems may cause problems for the system during attempts at future use e Store the mannequin in the hard case provided for storage and transport e Do NOT stack items on top of the mannequin case 213 214 Care Maintenance BabySIM Airway Inspection The BabySIM is equipped with an anatomically accurate airway which supports the practice of difficult airway management techniques In the process of performing these techniques improperly or aggressively the upper airway can be damaged While such damage may be readily apparent manifested as a leak in the breathing circuit during mechanical ventilation it may not be obvious during spontaneous or bag and mask ventilation Because damage can occur occasional visual inspection of the airway is recommended Using the light of a laryngoscope blade or a flashlight visually examine both the upper and lower airway While tears in the upper airway resulting from intubation may be obvious needle holes in the lower bronchus resulting from techniques such as transtracheal jet ventilation may not be readily apparent If damage to the ai
29. allows for intravenous access through a permanent access catheter located at the left femoral vein Bolus injections are administered utilizing standard syringes while continuous intravenous infusions can be administered utilizing a wide variety of standard infusion pumps Both injection methods are entered from either the Instructor Workstation or optional Wireless Remote Control Once the dosage is entered the patient response is automatic and dependent on patient weight physiological status ongoing therapeutic interventions and injury disease status The patient appropriately and automatically responds to incorrect medications with no user interven tion necessary Likewise over and under dose response is appropriate The Medication Log feature of the software allows the instructor to quickly review all boluses and cur rent drug infusions given by the learner Pharmacological Therapy Common IV drugs required by the PALS algorithms are supported 27 28 Clinical Features BabySIM Simulated Clinical Experiences The BabySIM is a model driven script controlled system designed to simulate a patient s physiological condition clinical signs symptoms and responses to certain clinical interventions Simulated Clinical Experiences or SCEs are process tools that enable the faculty educator to execute a learning strategy using simulation Each process tool provides an extensive overview and outline of the learning exercise and requi
30. bag valve mask and endotracheal intubation Administration of supplemental oxygen is entered by the instructor with automatic and appropriate patient clinical responses 21 Clinical Features BabySIM Pulmonary System Features The simulated patient breathes spontaneously with a self regulated rate and tidal volume sufficient to maintain a target arterial carbon dioxide partial pressure typically 40 mmHg which can be adjusted by the instructor The respiratory system is capable of simulating crisis events The patient s lungs simulate consumption of oxygen and the production of carbon dioxide in accor dance with the principles of uptake and distribution Alveolar and arterial gas concentrations are dynamically coupled with spontaneous or mechanical ventilation The lungs are realistically modeled with respect to the range of tidal volumes and functional residual capacity Lung and chest wall compliance are modeled with independent control of the left and right lungs Ventilation results in the appropriate concentrations of alveolar and arterial carbon dioxide Presence or absence of exhaled carbon dioxide can be monitored using a colormetric indicator Spontaneous and mechanical modes of ventilation are supported Symmetric and asymmetric lung ventilation are automatically supported in response to bilateral and unilateral compliance and resistance changes proper or incorrect intubation and pathophysiologi cal states s
31. 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 qee button The Save a Copy of the Patient Dialog Box 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 89 BabySIM Using M se 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 ti
32. can be created and saved and existing Base Patients can be modified depending on the needs of the instructor Scenarios Each scenario is a set of simulator commands that instruct or cause the simulator to react or respond in a specific manner Scenarios are used to determine the initial and subsequent physiological states as well as the different conditions that arise during the simulation exercise Each scenario also includes logged documentation to support its use By utilizing the Scenario Designer feature of the M se software users can modify the preconfigured scenarios or create custom scenarios to meet specific educational objectives Instructors may also modify events within a given scenario in real time to increase or decrease event severity and shorten or prolong the duration of an event at any time during a simulation exercise Any Base Patient can be combined with any scenario creating a wide variety of clinical care simulations For instructions on modifying scenarios and creating new scenarios refer to the Using the Software section of this User Guide 29 30 Clinical Features BabySIM System Controls The BabySIM has been designed to allow the instructor to focus attention on learner actions and reactions by providing a flexible set of tools that adjust readily to the instructor s needs Main Application Software The M se software is the main application software that provides the instructor a means to contro
33. conveniens EACH PARTY HERETO 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 Li
34. dextran and human albumin Range 0 mL 100 mL 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 100 mL Packed Red Blood Cells PRBC Infusion PRBCs are a preparation of 70 red blood cells and 30 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 100 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 100 mL A 29 Appendix A M se Parameter Descriptions BabySIM A 30 Sounds A variety of simulated sounds are available to enhance realism Click the Sounds button on the Run screen to access the Sounds controls Bowel Sounds Learners can auscultate bowel sounds over two intestinal regions Left Bowel Sounds and Right Bowel Sounds The sounds can be set to Normal Hypoactive Hyperactive or None bowel sounds are absent Bowel Sounds rema ET toma Breath Sounds i i i i Hypoactive SEs Hyperactive None Heart Sounds Left Bowel Sounds Right Bowel Seana a ISEGUENNNN
35. e Replace F4 with a 250V T 4A slow blow fuse Recommended replacement Littelfuse 218 004 series e Replace F5 with a 250V T 5A slow blow fuse Recommended replacement Littelfuse 218 005 series Latex Warning CAE Healthcare simulators 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 xiv CAE Healthcare Cautions and Warnings General Use Warnings USE OF THIS EQUIPMENT IN AN UNSPECIFIED MANNER MAY IMPAIR DESIGNED PROTECTION Power and Communications Unit PCU Do not drop step on or stack anything on the PCU Do not operate the system in rain e Do not clean the PCU front panel with chemical solvents Disconnect the PCU from the power source Using a clean cloth dampen with soapy water and lightly wipe Afterwards dry with a clean towel Mannequin e Do not disassemble factory assembled parts of the mannequin e Make sure that mannequin is set up on a stable sturdy work surface to avoid collapsing and causing injury to users e Do not introduce foreign substances into the airway with the exception of small amounts of approved lubricant e The BabySIM should be operated in ambient temperatures below 104 F 40 C Prolonged operation 2 hrs in ambient temperatures greater than 104 F 40 C will result in anomal
36. enter the Username METI User and leave the Password field blank CAE Healthcare Getting Started Step 9 Connect and Turn On the Compressed Air CO Connect either a compressed air source hose or a CO supply hose to the port labeled MAIN SUPPLY GAS AIR OR CO This connection provides either the air or carbon dioxide used to create various mannequin life signs Connecting Air or CO to the PCU In remote settings or in locations without a central air supply an OPTIONAL Air Compressor is connected to the PCU at the MAIN SUPPLY GAS AIR OR CO port This system is factory calibrated to apply pressure only at 50 psig 345 kPa The OPTIONAL Gas Accessory Kit is available for locations with a central air and gas supply The regulators included with the assemblies are user adjustable to psig 345 kPa 43 Getting Started BabySIM 44 For the mannequin to expire CO attach a clear CO source hose to the EXPIRED CO SUPPLY port Connecting Expired CO to PCU CO sources must be pressurized to 50 psig 345kPa In remote settings or in locations without a central gas supply the OPTIONAL CO Adapter connects with a portable CO supply and the PCU to enable the mannequin to expire CO and operate off the portable gas source OPTIONAL CO Adapter The branches of the Y shaped adapter are connected to the MAIN SUPPLY GAS AIR OR CO and the EXPIRED CO SUPPLY ports and the remaining connection is made to the portable CO supp
37. in tidal volume When the volume rate control factor is less than 1 ventilatory changes are affected primarily by changes in respiratory rate For example set the volume rate control factor to 0 1 and increase the shunt fraction to 0 4 to decrease the arterial O The patient responds to falling arterial oxygen levels with increased minute ventilation Increasing the respiratory rate with minimal increase in tidal volume produces this Default 1 mL Range 0 1 mL 10 0 mL Chest Wall Compliance Factor This Chest Wall Compliance Factor parameter describes the interaction of the chest wall with the lungs The Chest Wall Compliance Factor parameter defines the volume pressure relationship in the normal operating lung volumes Once distended however the chest wall rapidly becomes much less compliant i e much stiffer and resistant to further inflation Default 1 Range 0 15 10 00 Functional Residual Capacity The Functional Residual Capacity parameter sets the combined left and right lung volume remaining at the end of a normal spontaneous exhalation Default 200 mL Range 50 mL 300 mL CAE Healthcare Appendix A M se Parameter Descriptions Lung Compliance Factor Left and Right These two parameters independently set the left and right lung compliance Lung compliance factor determines how easily the lungs inflate Low compliance factors less than 1 create stiff lungs requiring more pressure for expansion High c
38. indicates a locked SCE AN The Lock icon A ealthy Adult Male Stan 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 58 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 59 Using M se BabySIM Base SCEs Base SCEs are fundamental SCEs with no scenarios and no progression of events Ea
39. mL min xvi CAE Healthcare Specifications Power PCU and Mannequin AC Input AC 100 240VAC 50 60Hz Consumption Approx 94W DC Input DC 12 0 13 5VDC Consumption Approx 72W Instructor Workstation AC Input AC 100 240VAC 50 60Hz Consumption Approx 50W DC Input N A Internal Battery Wireless Remote Control AC Input AC 100 240VAC 50 60Hz Consumption Approx 50W DC Input N A Internal Battery Waveform Display Monitor AC Input AC 100 240VAC 50 60Hz Consumption Approx 28W DC Input N A Powered by the PCU TouchPro Computer Please see your product s user guide for power specifications xvii xviii M se and TouchPro Specifications BabySIM System Requirements If you are not using a TouchPro computer or Wireless Remote provided by CAE Healthcare please be sure to utilize a computer with wireless capability When operating the TouchPro or M se software a computer with a Macintosh or Microsoft Windows operating system may be used To run the TouchPro or M se 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 mini
40. maximum 32 Joules in a sequence Do NOT exceed an average of two 2 defibrillator discharges per minute during the training session Do NOT let the mannequin 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 mannequin chest dry Special attention should be taken when using the urinary system or the chest tube feature To prevent pitting of the chest skin electrode do NOT apply conductive gel or conductive defibrillation pads intended for patient use Do NOT use cables or connectors having visible damage Do NOT spill fluids over any component inside the mannequin torso This could damage the system and may also present a possible hazard for the operator 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 187 188 Using the System BabySIM With each defibrillation the BabySIM 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 For paddle placement on the che
41. measured using the return to flow technique Korotkoff sounds can also be auscultated Brachial and femoral pulses can be palpated bilaterally and are synchronous with the cardiac cycle A pulse deficit automatically occurs if the systolic arterial blood pressure falls below speci fied thresholds See the Palpable Pulse Thresholds chart None required but specific rhythms can be selected VIEW Cardiovascular PARAMETER S Cardiac Rhythm Override None required but adjustable VIEW Cardiovascular PARAMETER S All Baroceptor Selections The response to clinical interven tion must be controlled by the instructor VIEW Cardiovascular PARAMETER S Cardiac Rhythm Override The instructor can set the level at which electrical capture and mechanical capture occur VIEW Cardiovascular PARAMETER S All Pacing Parameters None required but adjustable VIEW Cardiovascular PARAMETER S Chest Compression Efficacy None required but adjustable VIEW Cardiovascular PARAMETER S Left Ventricle Contractility Factor and Right Ventricle Contractility Factor Defibrillation can be simulated by the instructor VIEW Cardiovascular PARAMETER S Defibrillation None required but adjustable VIEW Cardiovascular PARAMETER S Multiple None required None required but adjustable VIEW All PARAMETER S Pulses None required See ECG Signals for lead locations and instruc tions See Pacing for cardiac
42. 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 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 74 CAE Healthcare Using Muse 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
43. 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 patient s physiology NOTE Not all medications affect the patient s physiology but all are logged The In Medications Medications Acetaminophen button Albuterol Amiodarone Atropine Quick Links Atrovent Epinephrine 1 1 000 Epinephrine 1 10 000 Furosemide aa Ta LPck The Medications Palette NOTE Quick Links can only be added while creating or editing an SCE 76 CAE Healthcare Using Muse 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 Acetaminoaphen AcUtwvated Charcoal Adenosine Albuterol Alfentanil Amiodarone Aspirin Atrecurium Atropine Atrovent Bicarbonate Bretylium Calcium chloride Captopril Lisatracurium Curare d Tubocurarime Dextrose 5056 Diazepam Digoxin
44. parameter creates a physiologic bypass of the normal pulmonary circulation resulting in changes in O CO and anesthetic gases at the alveolar level Typically values of 0 1 to 0 4 are needed to create large alveolar arterial oxygen gradients sufficient to cause arterial hypoxemia Default 0 03 Range 0 00 0 50 TIP If the parameter is set high 0 5 the patient desaturates rapidly and responds to the administration of supplemental O CAE Healthcare Appendix A M se Parameter Descriptions 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
45. physiology of any of the parameters conflicts the M se software reflects the physiology of the last parameter entered 115 Using M se BabySIM 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 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 116 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 117
46. refer to the Cautions Warnings found in the Introduction section of this User Guide 2 POWER SWITCH is used to turn the PCU ON and OFF whether running on standard AC current or utilizing a 12 volt DC power supply A green indicator light labeled POWER ON illuminates when the PCU is running If users have a Waveform Display Monitor optional it can be operated on 12 volt DC power using the MONITOR POWER port and the supplied adapter cord The AUX POWER IN 12VDC 4A port allows the BabySIM system to be run from a 12 volt DC power source such as the optional Auxiliary Power Supply 6 The five fuses housed in the ports labeled F1 through F5 are identified by their voltage and amperage To change a fuse open the port cap with a flathead screwdriver so that the burnt fuse pops out Be sure to choose the correct fuse from the Spare Fuse Kit when selecting a replacement The new fuse is secured by replacing the cap and tightening it with a flathead screwdriver NOTE Before replacing a burnt fuse refer to the Cautions Warnings found in the Introduction section of this User Guide Introduction BabySIM Umbilical Ports The two large circular fittings labeled UMBILICAL are used to connect the mannequin via the umbilical to the PCU UMBILICAL Umbilical Ports EN upper circular port is the receptacle for the umbilical s electrical cable and has a notched fitting where the cable connects and locks into place This connection estab
47. 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 institutions not under agreement service will be provided as required on a Time and Material basis Technical Support CAE Healthcare s prevailing labor rate with a minimum of four hours of 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 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 less 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 205 206 Care Maintenance BabySIM Breakdown After each use the BabySIM should be properly disassembled cleaned and stored in a secure place To ensure that the BabySIM remains in good working condition follow the prescribed CAE Healthcare breakdown procedures below These procedures are estimated
48. te lacia Saphua Alben to cnecabe Use abreulator weg The precbeliad cemiiticna mredecalkona asd babere or bo det piala as needed Sa alatian Triiluac eal Apnea Az a Healey Female Inlamk tna patient demonstrates a HF in the Late EP m the PUn TOs RR im the ZUs and Sod in ihe upper u m The pabhiesni m ardia repite rrmal simum Hasr sumele sre egrmal beets gung se rlaar in all kumg falre bai Isabella Wilharne and bows mounds era normal on all foo quacracts Shock Learning Objectives Brody Hail tated d letuaed himesy ane phy amp aral acsetiirr Scpmnarius The Home Page NOTE To activate a fullscreen view in Internet Explorer press F11 to toggle Internet Explorer s fullscreen mode 56 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 Tabs The selected SCE Healthy Male Infant Ryan Summers Ei Increased Intracranial Pressure Ethan Walker 5 Base SCEs RSV Bronchiolitis Sophia Allen A Sedation Ind
49. to expose the PCU Interface Panel The PCU Positioned for Connections NOTE Do NOT plug in the PCU at this time C Leave the power switch in the OFF position 36 CAE Healthcare Getting Started d Attach the fluidic pneumatic coupler to the lower UMBILICAL port on the PCU Connecting the Fluidic Pneumatic Coupler to the PCU The fitting slides into position and locks into place 37 Getting Started BabySIM Step 4 Connect the Electrical Umbilical to the PCU To connect the Electrical Umbilical to the PCU i n Foy h P EG Pa e p N x s Fat N m i E n rm T F Electrical Umbilical Connected to PCU b Line up the small tabs and notches on the fittings to slide them together before turning and tightening the connection Step 5 Set Up the Instructor Workstation Place the Laptop or Tablet Instructor Workstation at the location e g desk table where it will be used Ensure the battery is charged or connect the Instructor Workstation to AC power 38 CAE Healthcare p Getting Started Step 6 Establish the Ethernet Cable Connection a Plug one end of the Ethernet cable into the Laptop or Tablet Instructor Workstation b Plug the other end of the Ethernet cable into the port on the PCU labeled INSTRUCTOR WORK STATION Connect the Ethernet Cable to the PCU 39 Getting Started BabySIM Optional Set Up the TDCK If the Trauma Disaster Casualty Kit T
50. to take less than 30 minutes The table below outlines the steps required for disassembling cleaning and storing the BabySIM system Breakdown Steps Flush the Genitourinary GU System Flush the IV System Flush the Chest Tube System Decompress the Chest Wipe Off the Mannequin Further details for each of these steps are included in the pages that follow CAE Healthcare Care Maintenance Step 1 Stop All Running SCEs Stop any running SCEs using the Stop button in the upper right corner of the M se software for each SCE Step 2 Clean Systems To maintain the BabySIM in top condition thoroughly clean the outside and flush those systems that were used during the session A Flush the Genitourinary GU System To flush the GU system 1 zn Replace the GU source IV bag with a 1 liter IV bag of distilled water 2 Prime the bulb of the IV stake and ensure that flow has started 3 Run the IV supply of distilled water until the bag is empty 4 5 Remove the IV bag from the stake set and disconnect the stake set from the GU Close the clamp on the GU source IV bag fitting on the Umbilical Assembly Drain the Umbilical Assembly and the stake set 7 Connect a large e g 60 mL syringe filled with air to the orange hose the GU 9 fitting of the Umbilical Assembly Using the syringe force the air through the system until no water remains in the system Disconnect and drain the urine collect
51. ventilation of the affected lung Default 0 Range 0 mL 100 mL Fraction of Inspired O FiO This parameter is used to simulate changes in the FiO such as would occur with the administration of supplemental oxygen Use this parameter to simulate supplemental oxygen Default 2196 Range 096 10096 CAE Healthcare Appendix A M se Parameter Descriptions Respiratory Additional Parameters Respiratory Parameters Additional A 9 Appendix A M se Parameter Descriptions BabySIM A 10 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 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 arterial oxygen or carbon dioxide levels by adjusting the Tidal Volume parameter Default Modeled Range 4 breaths per minute 80 breaths per minute Tidal Volume The Tidal Volume parameter is used to set the tidal volume to a given volume per breath Once tidal volum
52. 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 i e one for which an RMA number has not been issued will 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 203 204 Care Maintenance BabySIM Basic Warranty Service Program The CAE Healthcare patient simulator comes with a one year Basic Warranty Service Program The Basic Warranty Service Program provides return to factory hardware and software maintenance Basic service provides corrective maintenance support for the timely repair or replacement of CAE Healthcare products CAE Healthcare may either repair or replace failed components The Basic Warranty Service option includes e Labor and materials for the repair of products at a CAE Healthcare facility e Timely replacement of faulty modules sub modules e Software upgrade services see System Software Upgrades Support section e Basic application support e Customer Service Hotlin
53. 3 Enter the name for the SCE NOTE The name of the SCE may 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 97 Using M se BabySIM 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 The SCE title Healthy Female Infant k a L3 The Return button 5 The Print button The Run button Content gt Management ca Patient profile SCE Configuration 7 Preloaded Z men 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 98 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 Untitled SCE The Edit button The SCE Editor Screen The Profile Editor appears 5 pi mo
54. 39 XX CAE Healthcare Optional set Up tne pe uem 40 Sten Z Power On Wie PCU sec oen oreet ERE VES cdir irt tonnene reesi TE VeE HOC IFTE PH EFE IX IE Ee Pn VPN EA EE 40 Step 8 Option 1 Power On the Laptop Instructor Workstation eee 42 Step 8 Option 2 Power On the Optional Tablet Instructor Workstation 42 Step 9 Connect and Turn On the Compressed Air CO eere eere 43 Optional Set Up the Wireless Microphone 41er eee eere ee eee eren eee eee tno o ono oooo 45 Optional Configure the TouchPro and Wireless Remote Computers eren 45 USMO MUSO roren 53 Starting the APPiCatON o cer On EEXRYOHURERRES POESIE neiitran resino HER HAE raini Pr Ve Cer 53 Navigating Ine Home Pau seurain einnsean E OCURRA EIE DE ER SEEE 56 The SCE Selection Panel ssctescscussstessteaveccoossesssnaintessessdnznnsatenststanececdeatvasniacedousdeeinedsckteuansttncbushbeviasacasdedins 57 TS SCE LIDIGL earar aA E E E E E AEN 59 e C Palleb E E EN E E S E KU dUR 61 ADITU P E 8 PA NEEE E OE AN EAE A A SE 63 OFM CHING BONES TU S19 RR EE T 63 Using the Patient Status Display C 64 EE AE EEEE I E E T 66 Displaying Patient RECOFAS sisivssscorcsseesvseoanrsvivennsasonedssusi
55. 80 CAE Healthcare Using Muse 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 Navigate 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 81 BabySIM Using M se 4 Click the desired option Face Mask Room Air 4096 FIO 20 FiO 60 FIO2 The Intervention Options The intervention is applied and appears in the patient s physiology Transitioning Scenario States from the Run Screen To move between scenario states from the Run screen 1 Click the desired scenario Anaphylaxis Beginning Anaphylaxis A Scenario The Scenario Management pop up menu appears and all available states are listed Scenarios D s Ad
56. A 12 PaCO Set point The PaCO Set point parameter is a set point for PaCO The control of breathing model adjusts tidal volume and respiratory rate in order to bring the PaCO toward this set point Factors that influence the success of this control effort include baseline tidal volume baseline respiratory rate respiratory gain O consumption respiratory quotient lung compliances chest wall compliance bronchial resistances the presence of artificial airways in the simulator and the inspired gas mixture When the PaCO Set Point is set to a new value the physiological controls adjust the simulator s respiratory pattern in an attempt to attain the desired set point For example when the set point is raised from 40 to 50 mmHg there is a transitory decrease in respiratory rate and tidal volume as the physiological controls attempt to drive the PaCO toward 50 mmHg When the PaCO reaches the new set point the simulator s respiratory rate and tidal volume should return to normal values Default 40 mmHg Range 20 0 mmHg 70 0 mmHg PaO Set point The PaO Set point parameter is a set point for PaO When PaO is below the set point value progressive stimulation of spontaneous minute ventilation occurs Both tidal volume and respiratory rate rise which under appropriate conditions results in PaO moving closer to the set point Factors that influence this control effort include baseline tidal volume baseline respiratory rate respi
57. BabySIM wis MUSE User Guide al gann E KYS Technology CAE Healthcare e CAE Healthcare License Copyright CAE Healthcare BabySIM 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 modificati
58. DC power source The bundle of colored hoses connects to the receptacle beneath the electrical cable on the PCU These hoses provide for a variety a functions Red IV Source unused CAE Healthcare Introduction Hard Sided Mannequin Carrying Case The Hard Sided Mannequin Carrying Case is designed to keep the mannequin secure during transport and storage Hard Sided Mannequin Carrying Case Inside the case are foam inserts that hold the mannequin in place and enough extra room for storing clinical accessories With heavy duty wheels and durable handles the case can be rolled or carried easily between locations Inventory Kit The Inventory Kit which includes replacement parts comes with the BabySIM Details on how to use the replacement parts can be found in the Using the System section of this User Guide The Inventory Kit includes BabySIM Startup Kit e Manual Blood Pressure Adapter e PCU Fuse Kit e Silicone Lubricant Spray e Red Tape e PCU Hose Fittings 2 e Cable Clamps 2 e Secretion Adapters 3 e Interchangeable Female Genitalia The mannequin is shipped with the male genitalia attached e Chest Tube Priming Tube e Male Quick Connect Fitting for the Air Hose Introduction BabySIM Power and Communications Unit PCU The PCU is the hub of communication and power for the BabySIM system This unit is about 24 tall x 15 wide x 10 deep 610 mm tall x 380 mm wide x 254 mm deep and weighs about
59. DCK is to be used with the BabySIM system set the TDCK up at this time using the instructions included in the TDCK User Guide Step 7 Power On the PCU To power on the PCU a In standard laboratory settings plug the power cord into the PCU port labeled AC IN Kg Rte Connecting the Power Cord to the PCU b Connect the remaining end into a surge protected AC power outlet 40 CAE Healthcare Getting Started C Press the POWER SWITCH on the PCU into the ON position Powering On the PCU OPTIONAL If operating at a remote setting with the OPTIONAL Auxiliary Power Supply connect the supplied power cable to the Auxiliary Power Supply before connecting the other end to the PCU port labeled AUX POWER IN 12VDC Power on the Auxiliary Power Supply before pressing the PCU POWER SWITCH to ON The Auxiliary Power Port on the PCU The PCU s Auxilary Power Port 41 42 Getting Started BabySIM Step 8 Option 1 Power on the Laptop Instructor Workstation Power on the Laptop Instructor Workstation by pressing the Power button located to the upper right of the keyboard The Instructor Workstation powers on and the desktop appears Step 8 Option 2 Power on the Optional Tablet Instructor Workstation Power on the Tablet Instructor Workstation by pressing the Power button on the side of the tablet computer The computer automatically logs in and the desktop appears If the computer does not automatically log in
60. ECTRICAL EQUIPMENT FOR LABORATORY USE Certified to US Standards CLASS 872104 LABORATORY EQUIPMENT Electrical PART A Adult Emergency Care Simulator Model ECS100 cord connected rated 115 230V 50 60Hz 2 1 A I2V dc 5A PART B Baby Sim Emergency Care Simulator Model BAB 101 cord connected rated 115 230V 50 60Hz HTA 12V dc 5A Phe amd US indicators adjacent ta He CSA Mark signify that the product has been evaluated to the applicable CSA and ANSUTT Standards or use in Canada and the MS respectively This US indicator includes products eligible to bear the NRL indicator NRL ie National Kecognived Testing Laboratory 13 designation pranted hy the LUS Occupational Safety and Health Administration OSHA te labortones which have been recosnized Lo perform cenifiention ta EC S Standards DOD S07 Rev 2004 6 360 dp CSA INTERNATIONAL a a Certificate 150492 Master Contract 223202 Project 1704296 Date Issued 2005 09 2 CAN CSA C22 2 No 1010 1 92 Safety Requirements for Electrical Equipment for Measurement Control and Laboratory Use Part 1 General Requirements Includes Amendment 1 CAN CSA C22 2 No 1010 1B 97 Amendment 2 to CAN CSA C22 2 No 1010 1 92 Safety Requirements for Electrical Equipment for Measurement Control and Laboratory Use Part 1 General Requirements UL Std No 61010A 1 Electrical Equipment for Laboratory Use Part 1 General Requirements DOD 507 Kev 2003 06 30
61. H while falling arterial CO levels result in rising pH values To simulate pH changes with metabolic changes acidosis or alkalosis the pH Shift value is a mathematical addition to or subtraction from the displayed pH value to that which is desired Default 0 Range 0 50 0 50 Positive End Expiratory Pressure PEEP The PEEP parameter specifies the amount of positive end expiratory pressure applied during mechanical ventilation Setting this parameter results in clinically appropriate intrathoracic pressures and hemodynamic responses PEEP must be set both in the software and on the ventilator Default 0 cmH O Range 0 0 cmH O 25 0 cmH O O Consumption The O Consumption parameter is used to change the rate of consumption of oxygen and production of carbon dioxide When O Consumption is increased and used with increased Shunt Fraction profound levels of hypoxia can be achieved Default 64 mL per minute Range 0 mL per minute 300 mL per minute CO Production Factor The CO Production Factor parameter allows for the manipulation of metabolic CO production to simulate a variety of pathophysiological conditions CO production is determined by the O Consumption and Respiratory Quotient settings A CO Production Factor value of 2 doubles the CO production while a value of 0 5 decreases the CO production by 5096 Default 1 Range 0 50 4 00 M11 Appendix A M se Parameter Descriptions BabySIM
62. 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 renamed 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 Hypotension Begins The T Parameters _ Notes of Custom Variable Collapse State button Eyes Blink Speed Fast BP Systolic 145 mmHg BP Diastolic Temperature Body Respiratory Rate ae Ss c Create A State Click the Collapse State button to minimize the state Double click the collapsed state to expand it 113 Using M se BabySIM 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 eo Cardiovascular Acute ventricular Failure Both oe uL See EE 8 o m I cai Acute ventricular Failure Right 1 Anxiety er j Stress BF Hy
63. O00 amp The Stop button SCE time controls Physiological display widgets Condition Medications and Interventions Scenarios v ZI um palettes Event Logs Nis u MM 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 Connecting to the Simulator After starting an SCE by clicking the Run button click Connect to connect to the simulator The Connect button is located in the upper right corner of the Run screen The Connect Button An SCE must be running before you can connect to the simulator 63 BabySIM 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 the Mute All button to mute all Patient Status Display alarms To adjust the widget layout click the Setup button 64 CAE Healthcare Using Muse The Widget Setup menu opens displaying available widget types Waveform Numeric an
64. Patient Records Patient records can be uploaded to Muse and displayed in the TouchPro software while an SCE is running To display an uploaded patient record 1 From the Muse Run screen click the Patient Records button The Patient Records Button 66 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 67 Using M se BabySIM The Start Displaying button at the bottom of the Patient Records list changes to a red Stop Displaying button Patient Records Normal Abdominal Ultrasound The Stop Displaying button
65. Pulmonary Arteries Compliance Factor The Pulmonary Arteries Compliance Factor parameter adjusts the pulse pressure difference between systolic and diastolic pressures of the simulated patient s pulmonary blood pressure Increases in the compliance factor decrease narrow the pulse pressure while smaller values increase the pulse pressure Additionally when the pulse pressure increases as a result of a reduced compliance factor both systolic and diastolic pulmonary pressures increase Conversely with a narrower pulse pressure higher compliance factor both the systolic and diastolic pulmonary pressures also drop Default 1 Range 0 20 5 00 Pulmonary Vasculature Resistance Factor The Pulmonary Vasculature Resistance Factor parameter adjusts the baseline pulmonary vascular resistance Raising the value increases the pulmonary vascular resistance while lowering the value decreases the vascular resistance Raising the parameter value is analogous to increasing the resistance to blood flow through the pulmonary vasculature Under such conditions the pulmonary artery pressure PAP and central venous pressure CVP increase due to back pressure through the right side of the heart Default 1 Range 0 10 10 00 CAE Healthcare Appendix A M se Parameter Descriptions Venous Return Resistance Factor The Venous Return Resistance Factor parameter adjusts the resistance between the extrathoracic and intrathoracic venous compartments
66. Store the Mannequin Place the mannequin in the hard mannequin case for storage using the foam inserts to hold it in place Use any remaining room in the case for clinical supplies and other teaching tools used in the next session Before storing the wireless microphone be sure the transmitter has been turned off to maintain battery power for the next session CAE Healthcare Care Maintenance Maintenance Advice Simple care and maintenance helps to ensure that the BabySIM system 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 General Mannequin Care e Avoid the use of writing instruments and sharp objects near the patient mannequin to prevent unattractive markings on or tears in the skin e 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 If more stubborn markings appear on the mannequin CAE Healthcare suggests a specialty cleaning product such as Goof Off or Orange Sol available at home improvement or hardware stores Following the manufacturer s practices and warnings when using these types of cleaners should allow for gentle and easy removal of the marks and stains e Prior to using moulage of any kind CAE Healthcare suggests the application of a very light coating of petroleum jelly followed by
67. 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 ad dd d d LL The Add Waveform An empty and Remove waveform Waveform _ field buttons ier eet Pree eee Liane Ro eee The TouchPro Display Settings 3 Click the empty waveform field 156 Using TouchPro The Wave Vital Selection menu appears Wave Vital Selection ECG I ECG II ECG III ECG V5 ABP PAP CVP Pleth Capnogram Blank Set Alarm Set Color Set Scale The Wave Vital Selection Menu 4 Select the desired waveform from the Wave Vital Selection menu The new waveform is reflected on the screen 157 Using TouchPro BabySIM 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 m
68. ablishing an educational simulation center for the study of infant care Standard Equipment E babysim Mannequin and Umbilical Assembly E Menneauin caring case P vemo 00 0 0 0 0 0 0 0 O PA rcuwitnwiretessRecever 0 EE vrees microphone EA kaptop instructor woristation O Detailed descriptions of this equipment can be found in the section BabySIM Standard Equipment beginning on page 4 IMPORTANT CAE Healthcare packaging is specially designed to protect CAE Healthcare products during shipping It is important that you KEEP all of your original SHIPPING MATERIALS including the boxes All warranty and repair items must be return shipped to CAE Healthcare in the original packaging CAE Healthcare Introduction Optional equipment is available to accommodate special customer requirements For example options like auxiliary power air compressors and a Wireless Remote Control enable instructors to create real life scenarios at authentic locations Optional Equipment Tablet Instructor Workstation Wireless Remote Control Laptop Beress Oooo Bee orses Broso UOO I XN Bee Beeems 7 B leeesesowey mms O icc Detailed descriptions of this equipment can be found in the section Optional Equipment for the BabySIM beginning on page 12 As you would with any shipment cross check this inventory with your CAE Healthcare packing invoice to verify that all components have been
69. ained using a small plug at the one end Remove the plug and tip the unit toward the opening to drain Replace the plug after the procedure has been completed Turn off Gas Supply If CO was used Close the CO supply using the supplied wrench to tighten the valve and properly store the tank Once the air and gas supplies have been turned off remove the Regulator Assembly from the CO source coil the assembly and set it aside for storage 209 210 Care Maintenance BabySIM Step 4 Shut Down the Software Shut down any optional TouchPro computers optional Wireless Remote Controls and M se software To shut down the M se software on the Instructor Workstation a In the M se software click the Disconnect icon on the Run screen e f Stop any running SCEs The Stop Simulation dialog box appears Click the Stop Simulation button The Simulation stops and returns to the Home page Click the Account Name in the lower right hand corner of the screen The Logout dialog box appears Click Logout to exit the software Disconnect the Instructor Workstation from the PCU To shut down the TouchPro software optional d Ci Click the Settings button in the bottom right hand corner of the TouchPro screen From the Settings menu click Shutdown A warning box appears asking if you want to exit Click Shutdown If using a Wireless Remote Control quit the M se application using the same steps described
70. aintenance BabySIM Care and Maintenance Maintaining the BabySIM requires careful treatment of the electronic and mechanical components Each time the BabySIM system is assembled or disassembled make sure all components are properly handled and either removed from or placed into storage correctly BabySIM Warranty Programs General Information CAE Healthcare patient simulator products come with a one year Basic Service Warranty at no additional charge All warranties begin at date of shipment or CAE Healthcare installation You may upgrade your first year Basic Service Warranty to an Enhanced Warranty and receive remedial and preventative 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 below 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 201 202 Care Maintenance BabySIM How to Contact C
71. annequin eerte 212 Step 10 Store the Wy AUN DTE REO 212 HUE TIC LE DEC DIC e 213 General Mannequin CalG ouosucscesexckueexe inum ette bn coast iocos eio keine rte Rena So En Ere Reni oct hi erai sier rbi tea ni beet 213 PRUE VAY THIS D CHOTI iere irte tee E E E E E E oneri trema dee 214 Larger Hectronic EQUITDTDLO DUE rie ra NE 214 TableofContents O Z O O O DabyslW Recommended Clinical Supply Sizes sssssssosessocsesoccessocessoccesoosessoceesossesoosesoosessssseso Condition Guidelines for Programming BabySIM with M se Appendix A Muse Parameter Descriptions e c eee e eee eene eee ern o eoe enouueee xxvi p CAE Healthcare Introduction Introduction As the worldwide leader in patient simulation technology and education CAE Healthcare is excited to introduce the BabySIM With the powerful Muse software the BabySIM incorporates highly developed infant patient physiological models that generate realistic and automatic responses to clinical interventions and medication administrations that are specific to infant patients BabySIM What makes the BabySIM so unique is its versatility and usability Combining intricate systems design and flexible user oriented software achieves a high tech high touch synergy that creates realistic learning experiences The ultra sophisticated system capt
72. any other proprietary 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 2 5 Licensee agrees to grant CAE Healthcare i
73. appears Scenarios Anterior Myocardlal Infarction 2011 09 12 09 38 35 COPD Exacerbation with Resplratory Fallure 2011 09 12 09 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 The Scenario Designer appears displaying the selected scenario Anaphylaxis ci Sranane m afe hes Sate fy Collapse A Expand All ALL CONDITIONS Lardiewasculer Werurrhage Weurnlpgi Resplratony Iste reeniicns The Scenario Designer 108 CAE Healthcare Using Muse 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 Susman Es d di hey State fy Collapse AE 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 b
74. arios Conditions Preview Rename Delete Export The Patient Records Panel The following patient record file types can be uploaded to M se 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 135 Using M se BabySIM 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 100GB 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 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 66 136 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 ca
75. ars Select the desired SCE and it automatically appears in the Favorite SCEs panel 148 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 Medication 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 149 Using M se BabySIM 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 s
76. ations and interventions or to set parameters as needed As a Healthy Female Infant the patient demonstrates a HR in the 120s BP in the 80s 50s RR in the 20s and SpO2 in the upper S0s on room air The patient s cardiac rhythm is normal sinus Heart sounds are normal breath sounds are clear in all lung fields and bowel sounds are normal in all four quadrants Learning Objectives Performs a focused history and physical assessment Scenarios The Continue Review f continue button The SCE Summary Panel 93 94 Using M se 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 The Stop the Simulation dialog box appears Stop the Simulation St crm I 4 a I l RS F Do you want to stop the simulation The Stop The Simulation Dialog Box 2 Click Stop Simulation The SCE stops running and the M se Home page is shown BabySIM The Stop Simulation button CAE Healthcare Using Muse To stop an SCE from the Home page 1 Click the Stop button in the bottom left corner of the SCE Summary Panel hn The Stop Button The Stop the Simulation dialog box appears Stop the Simulation Do you want to stop the simulation The Stop Simulation ur E rem cm button The Stop The Simulation Dialog Box 2 Click Stop Simulation
77. ations and interventions or to set parameters as needed The SCE Content As a Healthy Female Infant the patient demonstrates a HR in the 120s BP in the 80s 50s RR in the 20s and SpO2 in the upper 90s on room air The patient s cardiac rhythm is normal sinus Heart sounds are normal breath sounds are clear in all lung fields Summa ry and bowel sounds are normal in all four quadrants Learning Objectives Performs a focused history and physical assessment Scenarios The Review The Run button fh Review E da 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 61 Using M se BabySIM Printing SCEs To print an SCE 1 From the Home page select the SCE to print The SCE summary panel appears Healthy Female Infant Rose Jackson ME Prntsce The Print s Add To Favorites SCE button Age 6 months old Gender Female Weight 8 0 kg Base Rose Jackson Overview The purpose of this Simulated Clinical Experience SCE is to provide facilitators with a baseline SCE to run simulations on the fly or from which to design their own SCEs This SCE can also be used to orient learners to the simulator and the simulation environment The patient is a six month o
78. be used as a ground Connect to three of the ECG contacts ECG Contacts 183 Using the System BabySIM Manual Blood Pressure To use noninvasive blood pressure monitoring techniques i e a blood pressure cuff configure a standard infant cuff with the supplied T fitting and adapters Blood Pressure Cuff Splice Kit 1 Cut the hose that connects to the pressure gauge on the cuff Cutting the Hose 2 Insert one of the supplied adapter fittings into each of the open ends of the tube using a female fitting on one end and a male fitting on the remaining end Inserting the Adapter Fitting 3 Attach the adapter cuff around the tubing to hold the adapter fitting into place 184 CAE Healthcare Using the System 4 Insert the T fitting into the hose adapters noting the male and female connections Inserting the T fitting into the Hose Adapters 5 Connect the remaining portion of the T fitting to the hose located on the mannequin s shoulder just behind the left arm Connecting the Remaining Portion of the T fitting into the Hose 6 Attach the cuff to the upper left arm and take the noninvasive blood pressure reading using the return to flow technique An Adapted Blood Pressure Cuff Store the modified blood pressure cuff with the BabySIM system for future reuse 185 Using the System BabySIM Korotkoff Usage To use this feature 1 Have the learner palpate the left brachial pulse
79. cenario 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 tom Be Rename New State Rename selected State 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 leaving 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 122 CAE Healthcare 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 The state is stored in the library e ee Using Muse ALL CONDITIONS api suma Anima Cardiovascular ormsn omm db conn rna ropa GP rin EIS boUuparin d rn Rese etery Haar Mate Teckyrentis ko urdea EJ tachypaen Vis E alis um OE npa xl Klee iae onem e DUAE A dragged r E atm Tw
80. cense or to require at any 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 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 Agreement in whole o
81. ch base SCE is designed to provide facilitators with a baseline to run simulations 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 60 CAE Healthcare Using Muse The SCE Summary Panel The SCE Summary Panel provides information about the selected SCE The Print button Healthy Female Infant Rose Jackson m Print SCE Age 6 months old s Add To Favorites The Add to ee range Favorites Weight 8 0 kg Base Rose Jackson button Overview The purpose of this Simulated Clinical Experience SCE is to provide facilitators with a baseline SCE to run simulations on the fly or from which to design their own SCEs This SCE can also be used to orient learners to the simulator and the simulation environment The patient is a six month old female infant who is being seen for a well baby checkup This SCE is designed to allow the facilitator to operate the simulator using the predefined conditions medic
82. cha Click OK Cancel Clicking OK The computer has joined the BabySIM network You can now proceed to Step 5 The BabySIM WPA password contains eight characters The password is BABY followed by four numbers The numbers are the BabySIM unit number preceded by the number of zeros required to make the password total eight characters Examples BABY0123 BABY0012 or BABYOOO where 123 12 or 1 is the BabySIM unit number The password is case sensitive and BABY is typically all capital letters 49 Getting Started BabySIM Step 4 Option 2 Join the BabySIM Network Using a Windows Operating System a Click the Wireless Network icon located in the bottom right hand corner of the screen of the TouchPro Computer Clicking the Wireless Network Icon b Click Connect to a network Not Connected A Wireless networks are available Click Connect to a network Connect taa network Network and Mun g Center Clicking Connect to a Network C Select the network labeled BABYXXXX where XXXX is the unit number of your BabySIM Selecting the BabySIM Network Connect J Cancel Selecting the BabySIM Network d Enter the Password See note at the end of this step 50 p l CAE Healthcare Getting Started e Click Connect Re Connect ta a netwerk Select network to cann ct t thew n E BABY OOK Clicking Connec
83. 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 A 27 Appendix A M se Parameter Descriptions BabySIM 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 Fluid Loss Plasma Colloid Infusion Crystalloid Infusion PRBC Infusion Whole Blood Infusion A 28 CAE Healthcare Appendix A M se Parameter Descriptions 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 200 mL Fluid Loss Plasma 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 200 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
84. ct a category NOTE Conditions CANNOT be added to the Interventions category 2 From the Condition Group panel select a group 3 In the Conditions panel click the Add button The New Condition Name dialog box appears 4 Enter a name for the condition in the New Condition Name dialog box 5 Click Save The condition is added to the selected Condition category and group 6 From the Conditions panel select the new Condition 7 Click the Edit Parameters button The Parameters screen appears 8 From the Parameters screen select the desired Condition parameters 9 Click Complete The condition is saved with the selected parameters New condition categories and groups can also be added by clicking the Add button in the Condition Categories and Condition Groups panels Use the Delete and Rename buttons in each panel to delete or rename a Condition group or category NOTE CAE Healthcare Conditions groups and categories cannot be deleted or renamed 134 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 Upload Patient Records Cumlemi Hanagerienl Learning Modules Type upload Date CEs Normal Abdominal Ultrascund Base Patients Patient records Scen
85. ctor Chest Compression Efficacy Aortic Valve Resistance Factor Mitral Valve Resistance Factor Pulmonic Valve Resistance Factor A 21 Appendix A M se Parameter Descriptions BabySIM A 22 Baroreceptor Maximum Pressure Baroreceptor maximum pressure defines the mean arterial pressure MAP at which the baroreceptor inhibitory activity on the heart is maximal When a simulated patient s MAP increases above baseline pressure the baroreceptor response exerts greater inhibitory controls on the MAP e g reduction in heart rate in an attempt to return the MAP to the patient s baseline pressure However these controls have an upper limit and this maximum pressure is defined as the baroreceptor maximum pressure In other words as the MAP increases the physiological controls i e baroreceptor response work to bring the pressure back toward baseline primarily by reducing the heart rate For every 5 mmHg increase in MAP the heart rate may decrease by 2 beats per minute in an attempt to keep the MAP in check However there is an upper limit maximum pressure after which these controls are no longer effective Once the MAP reaches the baroreceptor maximum pressure there is no additional reduction in heart rate if the pressure continues to rise For example should the pressure continue to rise the heart rate would not show a corresponding slowing Default 91 mmHg Range 40 mmHg 220 mmHg NOTE It is important to s
86. d Clinical Signs anual Contro All administered IV fluids are collected in the bag attached IV Fluid Administration JETER In lloids to the blue IV Drain ll hose t All administered IV medications are collected in the bag attached to the blue IV Drain hose IV Medication Administration l N juired See Intraosseous Site Intraosseous Site 193 Using the System BabySIM Intraosseous Site The intraosseous site is located on the anterior tibia of the right leg The Intraosseous Site After multiple injections into the site the plug should be removed and replaced Currently there are six fluids that can be controlled using the Fluids view Fluid Parameters Fluid Event Fluid Loss Volume Blood Fluid Loss Volume Plasma Infusion Colloids Infusion Crystalloids Infusion Packed Red Blood Cells Infusion Whole Blood 194 l CAE Healthcare Using the System Sounds A variety of simulated sounds are available to enhance realism Click the Sounds button on the Run screen to access the Sounds controls Bowel Sounds Learners can auscultate bowel sounds over two intestinal regions Left Bowel Sounds and Right Bowel Sounds The sounds can be set to Normal Hypoactive Hyperactive or None bowel sounds are absent Bowel Sounds rema ET oma Breath Sounds i i i i Hypoactive Das CS Hyperactive None Heart Sounds Left Bowel Sounds Right Bowel Sere C ee Vocal Sound
87. d Scenario Anaphylaxis Je Show Scenario Begining Anaphylaxis Event aq 4 Beginning Anaphylaxis oo 00 04 B Mild Anaphylaxis Moderate Anaphylaxis 00 00 00 Ww Severe Anaphylaxis Epinephrine Administered Condition Improves The Scenario Management Pop Up Menu 2 Select the desired state The scenario proceeds to the selected state The scenario can also be paused or continued by selecting the Pause and Play options from the Scenario Management Pop Up menu 82 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 vi
88. d Volume Widget Setup Waveform Numeric volume 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 Numeric Widget Options HR RR BP PAP CVP MAP SpO2 EtCO2 VT PCWP TBlood TRectal TBody The Set Color The Set Alarm button L button The Numeric Widget Options Panel 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 65 Using M se BabySIM 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 mcgi kai min IM Administered 00 00 00 SCE was started The Event Logs Event Logs can also be exported For more information see History on page 126 Displaying
89. development improvement marketing and commercialization of its products and services without any restrictions based on confidentiality or intellectual property rights 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 p CAE Healthcare License Copyright 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 ke
90. dix A M se Parameter Descriptions 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 275 beats per minute Heart Rate Factor The Heart Rate Factor parameter is used to change the baseline heart rate before physiological controls are taken into account A value of 2 doubles the baseline heart rate while a value of 0 5 decreases the heart rate by 50 Use this parameter to raise or lower the heart rate Default 1 Range 0 30 3 00 A 17 Appendix A M se Parameter Descriptions BabySIM Cardiac Rhythm The Cardiac Rhythm parameter is used to change the patient s underlying cardiac rhythm displayed on the Patient Sta
91. dusscvsesseensecenosdsavan tconbendduosesdnerneddoeseeessandoeeas 66 Adding a Scenario to a Running SCE esee esee eene erento tnnt tnnt otn nnns 69 CHANGING PHYSIOIOOY PR RR 70 SCE MEA ONTO IS eeren ne e EE E E E E E 85 Using the Event Recorder to Save States cssccssssssssssssssssssessssessscessnsessnsessncessnsessncessacessncessncesencess 87 Creating a NeW Patient o ete ot EPIRI RUE Ea RAI ORDEI IR PERNE 89 Table of Contents Table of Contents xxii Resertimg ab atlelib osse E E E E UBI UTERE E NRI HHESP EUH 90 MIME PVE CUCM ON MONO esce cece ardet ipae m UU DRE 91 Returning to the Home d RR 93 OPPII E CE posa EE AIEE stars E N E A E 94 Deyelopind SCE S ariere ee EG Pr UO E PIRE AEE TE E EEA 96 Creating a New e qM M 96 ll SCE ECU 98 D yelopind Scelldil S cou oi ORE IRUAEFORUENE ATIS EUER QE CHE PEU SERUEE ER EXC EEUECEE EGRE E S ETEEVCA E EARA CEU RN 106 Creating a New Scenario cobiitunieha RUE GUT OTHER PERRO Er EU E Frob EUR RCM iste tena then Denier 106 ECU d SCerdllO E E E EO E AE E A ORDEN NIME 107 The Scenario Desio NN 109 Bidding Scenario States sea asta er ini terit sue letti ntum OUS 112 Modifying Scenario SII BS essai editada eden ud FEROCES EH 113 Deleting Scenario States sccssscssssssssssssssssssssssssssssessssessssnssssnssssnsessnssssnssssnsessasessnsessasesenseseaseees 120 Deletin
92. e Flathead screwdriver Paper towels or clean cloth Power strip or surge protector A Setup Map and Quick Start Chart cover these same steps in abbreviated fashion and are included with the BabySIM system 32 CAE Healthcare Getting Started Step 1 Place the Mannequin in the Work Area Select a work area with enough room for the equipment as well as necessary hoses and cables providing ample space for easy access to the mannequin As least a 10 foot x 12 foot 3 meter x 4 meter work area is recommended for movement and positioning of components around the mannequin The BabySIM Mannequin and Case Place the mannequin in the supine position on the work surface e g gurney table ground etc and prepare all other components In a lab environment make sure that a multi plug AC power outlet exists within the workspace This outlet should be surge protected In a remote setting the OPTIONAL Wireless Remote Control Air Compressor and Auxiliary Power Supply may be used in the place of the Instructor Workstation laboratory gas and power supplies 33 Getting Started BabySIM Step 2 Attach the Umbilical Assembly to the Mannequin A bundled system of hoses and the electrical pigtail known as the fluidic pneumatic pigtail extend from the left side of the baby mannequin Both pigtails attach to the Umbilical Assembly The electrical pigtail N The fluidic pneumatic pigtail The Mannequin with Pigtails Attac
93. e telephone fax and e mail e On site repair provided at CAE Healthcare discretion e Freight costs to the CAE Healthcare center are not covered However CAE Healthcare bears the return freight costs utilizing a standard delivery service selected by CAE Healthcare CAE Healthcare assumes the responsibility for loss or damage of goods in CAE Healthcare s Sarasota Facility during maintenance or service Enhanced Warranty Service Program The Enhanced Warranty Service Program provides the same features as the Basic Warranty Service Program with the addition of Preventative Maintenance PM of CAE Healthcare products PM takes place at CAE Healthcare s facility and is performed once per year Freight costs to and from the customer site shipped by standard ground transportation will be paid by CAE Healthcare Preventative Maintenance consists of evaluation and performance testing of the following e Physical inspection and cleaning e Functional check of equipment e Lung calibration e Calibration of CAE Healthcare produced equipment e Pneumatic adjustments as necessary e Electrical checks and adjustments as applicable e Mechanical inspection and adjustments e Repairs alignments as necessary o CAE Healthcare Care 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
94. e 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 NOTE The Chest Tube and Needle Decompression features cannot be enabled simultaneously Seesaw Breathing During normal spontaneous infant breathing the chest rises and the abdomen follows with only a brief lag In seesaw or paradoxical respiration the abdominal wall moves inward during inspiration and rises during expiration It is observed as a sign of upper airway obstruction or less frequently can be a sign of decreased compliance pneumonia or elevated resistance asthma When On is selected the mannequin exhibits a seesaw pattern of respiration chest retraction with abdominal distension such as seen with respiratory distress and impending respiratory failure in the infant Default Off Bronchial Occlusion Left and Right 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 A 5 Appendix A M se Parameter Descriptions BabySIM A 6
95. e Reset Medication dialog box appears asking you to confirm that you wish to reset the medication Reset Medication Reset the medication rocuronium re ae ER 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 infusion continues To stop the infusion you must select the medication from the medication library and set the infusion rate to zero 92 J CAE Healthcare Using Muse Returning to the Home Page To exit the SCE and return to the Home page click the Return button 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 Healthy Female Infant Um Print SCE Rose Jackson Age 6 months old Add To Favorites Gender Female Weight 8 0 kg Base Rose Jackson Overview The purpose of this Simulated Clinical Experience SCE is to provide facilitators with a baseline SCE to run simulations on the fly or from which to design their own SCEs This SCE can also be used to orient learners to the simulator and the simulation environment The patient is a six month old female infant who is being seen for a well baby checkup This SCE is designed to allow the facilitator to operate the simulator using the predefined conditions medic
96. e closed position Blinking frequency can be set at one of three speeds Normal the default Slow and Fast To adjust the blinking frequency click the desired option on the Neurological view 171 172 Using the System BabySIM Secretions Fluids can be excreted from the baby mannequin s eyes ears and mouth using the three tubes extending from the left side of the baby Connect the Secretion Adapters to the fittings located at the ends of the three tubes extending from the baby s left side The Secretions Connections The fittings at the ends of these tubes connect to the three Secretion Adapters included in the Replacement Parts Kit The opposite end of the Secretion Adapter connects to either an IV bag for gravity flow secretions or to a syringe which can be used to push fluid through the baby s eyes ears and or mouth When disconnected a small valve in the fittings prevents leakage into the system Fontanel The fontanel can be activated to simulate increased intracranial pressure or hydrocephalus The fontanel feature is activated on the Neurological view by setting the Fontanel parameter to Bulging The Fontanel Parameter CAE Healthcare Using the System Respiratory System The mannequin s lungs produce carbon dioxide and react realistically to intubation as well as to pathophysiologic states The patient s upper chest rises and falls synchronously with the inflationary state of the underlying lun
97. e 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 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 400 mL Tidal Volume Factor The Tidal Volume Factor along with the Respiratory Rate Factor parameter is used to change the baseline tidal volume before the control of breathing and drug influences are taken into account A value of 2 doubles the baseline tidal volume A value of 0 5 decreases the baseline tidal volume by 5096 Default 1 Range 0 10 4 00 TIP First decrease the respiratory gain factor to reduce the influence of the respiratory control mechanism on the respiratory rate and tidal volume CAE Healthcare Appendix A M se Parameter Descriptions pH Shift The pH Shift parameter is used to create a metabolic acidosis or metabolic alkalosis under script control The default pH value displayed on the Patient Status Display or TouchPro software is dependent on respiratory arterial CO values Under default conditions PaCO 40 mmHg the pH is approximately 7 4 Rising arterial CO produces a subsequent drop in p
98. e 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 Fontanel The anterior fontanel is a ibrous membrane covered gap in the bony cranium located at the juncture of the two parietal and two frontal bones The fontanel should feel flat When the infant is calm a bulging fontanel can indicate increased intracranial pressure When Bulging is selected the anterior fontanel on the mannequin expands to simulate conditions such as increased intracranial pressure in an infant Default Normal A 3 Appendix A M se Parameter Descriptions A 4 Respiratory Basic Parameters Respiratory Parameters Basic Laryngospasm Needle Decompression Seesaw Breathing Bronchial Occlusion Left and Right Respiratory Rate Respiratory Rate Factor Tidal Volume Intrapleural Volume Left Intrapleural Volume Right Fraction of Inspired O BabySIM p CAE Healthcare Appendix A M se Parameter Descriptions Laryngospasm 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 Off Needle Decompression The Needl
99. ecompression None required but adjustable VIEW Respiratory PARAMETER S Shunt Fraction None required None required but adjustable VIEW Respiratory PARAMETER S Multiple None required but adjustable VIEW Respiratory PARAMETER S Multiple None required but adjustable VIEW Respiratory PARAMETER S Multiple CAE Healthcare Using the System Airway Management The mannequin s anatomically realistic upper airway provides for the opportunity to intubate the infant patient while various clinical signs e g breath sounds chest excursion airway patency can be simulated using software commands Other airway features include e Hard and Soft Palate e Oropharynx e Nasopharnx e Laryngopharynx e Conical Trachea e Carina Intubation The upper airway of the BabySIM is designed to allow for intubation and laryngoscopy Direct laryngoscopy as well as oral and nasal tracheal intubation can be performed using devices such as LMAs endotracheal tubes nasopharyngeal airways and oropharyngeal airways For supported sizes see Recommended Clinical Supply Sizes on page 215 Intubation of the BabySIM WARNING 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 SILICONE SPRAY to lubricate the adjunct NEVER use a water based lubricant because of resultin
100. ege 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 140 CAE Healthcare Using Muse 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 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
101. enu click System Preferences Finder File Edit View Go About This Mac Software Update Mac OS X Software System Preferences Dock Location From the Apple menu click System Preferences Recent Items Force Quit Sleep Restart Shut Down Accessing the System Preferences The System Preferences dialog box appears 45 Getting Started BabySIM c On the System Preferences dialog box click the Network icon MobileMe Network QuickTime Clicking the Network Icon The Network dialog box appears d On the panel on the left side of the Network dialog box select Ethernet and ensure it is connected Ethernet Connected AirPort ie Of Select Ethernet 46 9 CAE Healthcare Getting Started e From the bottom right hand corner of the Network dialog box click the Advanced button Location HPS LAN Hn Ethernet Connected Status aS Configure IPv4 IP Address Subnet Mask Router DNS Server Search Domains 3j Click the lock to make changes Assist me j Connected Ethernet is currently active and has the IP address XX XXx XX XX Manually 10 X090C XX XX 255 0 0 0 Click the Advanced button Revert Clicking the Advanced Button The TCP IP Network screen appears f Write down the IP address next to the IPv4 Address heading Configure IPv4 IPv4 Address Sub
102. enu 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 158 Using TouchPro Moving a Waveform or Numeric Display Waveforms and numerics can be moved on the screen to suit the user s needs 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 159 Using TouchPro BabySIM 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 160 Usi
103. er 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 position 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 Right Atrium Options Atmosphere Extrathoracic Vein Intrathoracic Vein Right Atrium 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 zero
104. er 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 54 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 55 Using M se BabySIM 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 the 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 Healthy Female Infant Rose Jackson 5 months ond Healthy Female Infant HE HR Female ai kg y Rasse Lech ann Healthy Male Infant Ryan Sammars T Overview increased Intracrantal Pressure The purpose of this Somulated Clinical Expariance SCE ia bo provida facilitwbors with a basena GCE ta rum simulaians an the Thy Bihan Welker ar hom ehirh ba da n the Cip Thir DIE can siro be upad to iam fo the mimeulatcor and tha girmulaticon s a Rie RSV Bronchiolitis Tha Danes amp iuw menp g Want whe ba gees for a verli ars thech fhe SLE tb duasarmed to aom
105. es to provide at its sole discretion CAE Healthcare shall have a reasonable time after determining that a defective product exists to repair or replace defective product CAE Healthcare s replacement product will be manufactured from new and or serviceable parts CAE Healthcare s agreement applies to repaired or replaced products for the balance of the applicable period of the original warranty or ninety days from the date of shipment of a repaired or replaced product whichever is longer 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 on page 205 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
106. et both the baroreceptor maximum pressure and the baroreceptor minimum pressure at the same time for the software to recognize the baroreceptor reset Baroreceptor Minimum Pressure Baroreceptor minimum pressure defines the mean arterial pressure MAP at which the baroreceptor inhibitory activity on the heart is minimal When a simulated patient s MAP decreases below baseline pressure the baroreceptor response exerts inhibitory controls on the MAP e g increase in heart rate in an attempt to return the MAP to the patient s baseline pressure However these controls have a lower limit and this minimum pressure is defined as the baroreceptor minimum pressure In other words as the MAP decreases the physiological controls i e baroreceptor response work to bring the pressure back toward baseline primarily by increasing the heart rate For every 5 mmHg decrease in MAP the heart rate may increase by 2 beats per minute in an attempt to keep the MAP in check However there is a lower limit minimum pressure after which these controls are no longer effective Once the MAP reaches the baroreceptor minimum pressure there is no additional increase in heart rate if the pressure continues to fall For example should the pressure continue to fall the heart rate would not show a corresponding increase Default 51 mmHg Range 20 mmHg 160 mmHg NOTE It is important to set both the baroreceptor maximum pressure and the baroreceptor minimum
107. ew 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 export a scenario file to an external device The scenario file extension is mss NOTE Preconfigured CAE Healthcare scenarios CANNOT be exported 132 J CAE Healthcare Using Muse Conditions From the Content Management options click Conditions to access the Conditions Editor The Conditions Editor appears Learning Modules Condition Categories SCEs Th e Base Patients Conditions EE link Patient Records The Rename button The Edit Parameters button The Delete button The Add i dcm The Conditions Editor All conditions can be viewed in the Conditions panel by selecting their associated categories and groups from the Condition Categories and Condition groups panels 133 Using M se BabySIM From the Conditions Editor users can create new Conditions to be used in SCEs To create a new condition 1 From the Condition Categories panel sele
108. f 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 License Copyright BabySIM 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
109. from the PCU port labeled AC IN If using the OPTIONAL Auxiliary Power Supply remove the cable from the port labeled AUX POWER IN 12VDC Coil and set aside the power cord If using the Auxiliary Power Supply recharge the internal battery by plugging the component into an AC power outlet when one becomes available 211 212 Care Maintenance BabySIM Step 7 Disconnect the Hoses and Cables from the PCU To disconnect the PCU s hoses and cables Disconnect the EXPIRED CO hose connected to the PCU Disconnect the MAIN SUPPLY GAS AIR OR CO hose Disconnect the Fluidic Pneumatic Coupler from the lower UMBILICAL port Fo Disconnect the Electrical cable from the upper UMBILICAL port Disconnect the Ethernet cable from the INSTRUCTOR WORK STATION port f Coil the hoses and cables and set them aside to be stored Step 8 Ready the PCU for Storage D a n Once all of the hoses and cables are disconnected from the PCU Interface Panel fold the Wireless Receiver antennas back into position and close the PCU door Lock the clamps on all three sides of the PCU into place to ensure the safety of the equipment Step 9 Disconnect the Umbilical from the Mannequin To disconnect the Umbilical Assembly from the mannequin a Unlock the fluid pneumatic hose system by pressing the red lever b Disconnect the electrical cable by twisting the outer fitting c Wind the umbilical carefully and set it aside to prepare it for storage Step 10
110. g Parameters and Transitions cccsscscssscsscsssssssssssssssssssssssssassssessssassssnsessasessasessnsessaseee 121 Saving I6 NCO NA IO eese imn ut NEE E S RM MEE 122 Saving States to the SEOIGILIDEOEM Loser ERES REUS ORO OUS ERE EHRRBONEUER MISC SE n SHEER 123 xut er o DUST SETTORE 124 Administrative TOOS p 126 xls m tases 126 System Administration ssp snsorexsovereeir ie v eaN YO PR ce Pk H N CORR CUP VEHE EYE PEU FR Erb UH UO RUE 127 du 145 CAE Healthcare Table of Contents SUNG POUCIE NO ces 151 Accessing tne TouchPro SOTEWAEG ooi roe tx nee YN E RP LU SEI HEY dXXa YE YPF E EUIS FECE EE Y ELS EXE ivan 6n 151 Modifying th Touch Pro Display iaxekaver eH VEN YAN NIYYASEYYNH UE MEAN VEEYRSERESA VEA NIV FERES Mk YYYE TM Ya kEXEY aed 153 Selecting a Preconfigured AVOUT ossis RUE UTOR PUER Pat REPE OPPEHEFER RETI Yr 153 Changing a Waveform or Numeric Display s sscsscssssssssossssssssssssssssessesssssessesscascarsassatsscsscaseasens 155 Adding a Waveform ad cese teretumetxedtim ves mes rite eats tex re tutus tait rabies ier etum e tierce inu net 156 Adding a Numeric Display ME 158 Moving a Waveform or Numeric Display s ssssssccsssssssssssssssssscsssassessassssssesscascassassassscsscascaseens 159 Del ILC at AY OME E E E vat E E E EE E 160 De aaa
111. g residue damage 175 Using the System BabySIM Chest Tube Setup A chest tube can be inserted on the left side of the mannequin To use the chest tube feature 1 2 Set up an IV pole near the PCU Fill an empty IV bag with the appropriate colored liquid e g for simulated blood mix distilled water with 5 mL of red food coloring and fill the bag Be careful not to make the mixture too thick as this can clog the system Attach the IV solution set to the IV bag and ensure the blue clamp is closed Simulated Blood Hang the bag on an IV pole set up near the PCU Connect the hose from the IV solution set to the white Trauma Source hose in the Umbilical Assembly Once the hoses are connected open the clamp and allow the fluid to flow into the mannequin A reservoir inside the mannequin collects the fluid Insert a chest tube lubricated with silicone spray into the insertion point at the mid axillary line of the fifth intercostal space on the right side of the mannequin For supported chest tube size see Recommended Clinical Supply Sizes on page 215 The tube must be inserted far enough to engage the valve on the reservoir The system is primed when water flows from the hose Chest Tube Insertion Point 8 Remove the chest tube if the procedure is to begin with chest tube insertion 176 ZW l CAE Healthcare Using the System Needle Decompression Setup A needle decompression can be
112. ge 0 9 10 0 Respiratory Gain Factor The Respiratory Gain Factor determines how strong an influence arterial CO levels have on the simulated patient s tidal volume and respiratory rate Under default conditions value 1 when arterial CO levels rise the patient s respiratory rate and tidal volume show a transitory increase in an attempt to return the patient to the physiological control CO set point If the Respiratory Gain Factor is increased to more than 1 the patient has a more pronounced response while values less than 1 correspond to a blunted response Default 1 Range 0 00 10 00 Respiratory Quotient Respiratory Quotient is the rate of carbon dioxide production divided by the rate of oxygen consumption Changes to the Respiratory Quotient parameter alter the rate of carbon dioxide production relative to the rate of oxygen consumption Default 0 8 Range 0 70 1 20 A 13 Appendix A M se Parameter Descriptions BabySIM A 14 Volume Rate Control Factor Ventilatory responses to increased arterial carbon dioxide or decreased arterial oxygen may take the form of increased tidal volume increased respiratory rate or both The volume rate control factor determines these relative changes At a value of 1 increased and decreased ventilatory drive affect tidal volume and respiratory rate equally When volume rate control is greater than 1 increased or decreased minute ventilation is predominantly achieved by changes
113. gical 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 9890 96 97 94 95 90 93 87 89 84 86 80 83 71 19 74 76 70 73 lt 69 Cardiovascular Blood Pressure Hypertension Hypotension 80s 50s 80s 50s 90s 50s 70s 50s 605 405 505 405 405 305 217 Condition Guidelines for Programming BabySIM with Mise BabySIM Cardiovascular Heart Rate Tachycardia Bradycardia 70s Respiratory Respiratory Rate Tachypnea Bradypnea 218 CAE Healthcare Appendix A M se Parameter Descriptions Appendix A M se Parameter Descriptions The M se software has a number of parameters that control the physiological features of the BabySIM The parameters are grouped by category Neurological Respiratory Cardiovascular Fluids and Sounds Each screen lists the Basic parameters by default However when the Basic Additional switch is activated additional parameters become available Click the Basic switch to see Ba Additional Click the Additional switch to Additional parameters ko LA return to the Basic parameters The Basic Additional Switch The following is a brief description of each parameter Each parameter description lists the defaul
114. gned to support the Instructor Workstation or the optional Wireless Remote Control unit Wireless Remote Control and Computer Stand Each stand is made of sturdy metal and weighs less than 2 pounds less than 1 kg Shoulder Bag and Sleeves The optional Shoulder Bag with padded sleeves can be used to carry computer components to another location or to store the system when it is not in use Shoulder Bag and Sleeves The shoulder bag is soft sided and large enough to hold all of the available computer components as well as the various power supply and cables 13 Introduction BabySIM 14 Auxiliary Power Supply CAE Healthcare makes available two different Auxiliary Power Supply options for running the BabySIM system in a remote location Both components include a 12 volt DC power source and a 25 7 5 meter cable with the appropriate fittings to connect to the PCU Interface Panel in the port labeled AUX IN 12VDC Auxiliary Power Supply Kit Auxiliary Power Supply Kit APS 001 APS 002 The Auxiliary Power Supply should run the system for approximately three hours Both of the options are rechargeable using a local AC power source Any auxiliary power supply used with the BabySIM must agree with the following specifications AC Input AC 100 240VAC 50 60 Hz Consumption Approx 94W DC Input DC 12 0 13 5VDC Consumption Approx 72W 9 CAE Healthcare Introduction Air Compressor For educational envir
115. gs The mannequin s anatomically realistic upper airway provides for the opportunity to intubate the infant patient while various clinical signs i e breath sounds chest excursion airway patency can be simulated using software commands Breath Sounds can be auscultated over the left and right apex axilla and posterior Breath Sounds are discussed further on page 196 of this User Guide The Respiratory View 173 Using the System BabySIM 174 Respiratory System Clinical Interventions Patient Monitoring and Scenarios Alveolar and arterial gas concentrations appro priately reflect the efficacy of ventilation and oxygen administration PaO PaCO and pH are continuously calculated and displayed on the Patient Status Display and the TouchPro software Completely obstructs the right and left mainstem bronchi simulating a lower airway obstruction e g mucus plug This yields an inability to ven tilate the lungs Synchronized with ventilation spontaneous or mechanical Excursion depth proportional to tidal volume Chest tubes can be inserted into the mid axillary line of the fifth intercostal space on the right Suction equipment can be applied to withdraw fluid from the simulated intrapleural space Software Control Manual Control Oxygen administration must be input by the instructor VIEW Respiratory PARAMETER Fraction of Inspired O Override See Chest Tube Setup None required b
116. h a standard stethoscope over the left and right upper sternal border right lower sternal border and apex A 3 lead ECG is emitted from the appropriate positions on the patient s chest for display on a standard monitor The simulator generates a normal sinus ECG as well as a broad range of abnormalities such as sinus tachycardia bradycardia ventricular fibrillation and asystole The hemodynamic response to the arrhythmias is physiologically correct Palpable brachial and femoral pulses are provided and are synchronous to the ECG A pulse deficit auto matically occurs if the systolic arterial blood pressure falls below the following thresholds Brachial 30 mmHg Femoral 30 mmHg The pulse threshold set points can be adjusted by the instructor to meet specific clinical and educa tional requirements The left and right brachial and femoral pulses are independently controllable by the instructor for presence and absence in the case of trauma to a specific extremity A standard blood pressure cuff and sphygmomanometer can be used to assess blood pressure by pal pation or by auscultating Korotkoff sounds 24 CAE Healthcare Clinical Features The invasive hemodynamic monitoring package provides the capability to measure and monitor the following Arterial blood pressure Left ventricular pressure Central venous pressure Right arterial pressure Right ventricular pressure Pulmonary artery pressure Pulmonary artery occlusion wedge
117. h the fluidic pneumatic pigtail fitting to the Umbilical Assembly using the end with the rounded hose attachment called the pneumatic coupler Fluidic Pneumatic Connection to Umbilical 34 CAE Healthcare Getting Started Once the two assemblies are fit into place the tab lock secures them into position There are four unattached hoses coming from the attached Umbilical Assembly red IV Source currently not used blue IV Drain orange GU Source and white Trauma Source These hoses are used in various clinical procedures and are discussed with those procedures later in this User Guide Connect the electrical cable from the Umbilical Assembly to the fitting on the electrical pigtail Use the small notches on the inside edge of the pigtail as a guide when sliding the fittings together pen di en ee Line up notches for proper connection Electrical Connection to Umbilical Once the two ends are connected rotate the fitting on the outside portion of the connection clockwise until tight Tighten the Fitting 35 Getting Started BabySIM Step 3 Connect the Fluidic Pneumatic Umbilical to the PCU To connect the Fluidic Pneumatic Umbilical to the PCU a Position the PCU to allow enough space for movement around the mannequin without jeopardizing the 15 foot Umbilical Assembly that extends from the mannequin to the PCU b Place the PCU case flat on the floor like an open suitcase and open the door
118. he HEPGTC and 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 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 License Copyright BabySIM a not copy save and except for normal back up and disaster recovery purposes provided such copy shall include CAE Healthcare s copyright and
119. he 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 Account Profile From the Account Profile screen users can view update and reset personal 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 145 Using M se BabySIM 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 146 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 me
120. he 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 138 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 roups System Settings The Groups ta b Groups Privileges Educators Deactivated Users The Groups panel The New button The Delete Save button button The Groups Panel NOTE Groups functions are available only to users with the User Management or System Management 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 139 Using M se BabySIM 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 privil
121. hronized with the cardiac cycle Normal and abnormal heart sounds are selected using this parameter By default heart sounds are set to Normal The following sounds are available S3 and S4 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 Heart Sounds S3 S4 S3 and S4 Early Systolic Murmur Vocal Sounds yv Mid Systolic Murmur Late Systolic Murmur Holosystolic 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 NOTE A patient must be running on the BabySIM simulator for any sounds to be available 197 Using the System BabySIM Vocal Sounds A variety of programmable vocal sounds are available Vocal sounds are androgynous Vocal Sounds 198 p CAE Healthcare Using the System 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 Bowel Sounds Breath Sounds Vocal Sounds LU LU I High pitched Cry Heart Sounds a Baby Talk Cooing Cough Crying Gooing Screaming Sneezing Vocal Sounds Menu Vocal Sounds are emitted immediately and play continuously when selected from the Vocal Sounds dro
122. ia 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 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 Default 50 mA Range 0 mA 119 mA o CAE Healthcare Appendix A M se Parameter Descriptions Cardiovascular Additional Parameters Cardiovascular Parameters Additional Baroreceptor Maximum Pressure Baroreceptor Minimum Pressure Left Ventricle Contractillity Factor Right Ventricle Contractility Factor Systemic Vascular Resistance Factor Venous Capacity Factor Systemic Arteries Compliance Factor Pulmonary Arteries Compliance Factor Pulmonary Vasculature Resistance Factor Venous Return Resistance Factor Baroreceptor Gain Overall Factor Baroreceptor Gain Cardiac Factor Baroreceptor Gain Peripheral Fa
123. ing 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 A 19 Appendix A M se Parameter Descriptions BabySIM A 20 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 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 60 Joules Pacing Current The Pacing Current parameter is used to simulate a specified amount of current discharged v
124. installed or run on the BabySIM computer system 11 Introduction BabySIM 12 Optional Equipment for the BabySIM Additional components enable the BabySIM system to be customized to fit the specific needs of a wide variety of education environments Tablet Instructor Workstation The Tablet Instructor Workstation is an optional ruggedized tablet computer that can be used instead of the Laptop Instructor Workstation to run the Muse software An additional Muse license is provided with this option NOTE The Tablet Instructor Workstation cannot perform calibration utilities The Laptop Instructor Workstation is needed to perform these functions Additionally the Tablet Instructor Workstation and the Laptop Instructor Workstation cannot be used at the same time Muse content is not shared between the Tablet and Laptop Instructor Workstations IMPORTANT All computer components are preconfigured for use with BabySIM Only approved CAE Healthcare applications should be installed or run on the BabySIM computer system Wireless Remote Control CAE Healthcare offers an optional Wireless Remote Control laptop to be used when the use of an Ethernet cable is restrictive Wireless Remote Control After configured into the BabySIM network the Wireless Remote Control connects to the PCU using a wireless signal p CAE Healthcare Introduction Computer Stand CAE Healthcare offers an optional computer stand that is desi
125. ion bag After the flushing procedure is completed make sure the mannequin s skin is clean and dry To prevent mold mildew and fungus from fouling the GU occasionally flush the GU system with a 1 liter IV bag of distilled water mixed with 20 mL of bleach Follow the procedure outlined above for flushing the system first using the beach solution Repeat the procedure using distilled water only The system should be cleaned in this way about once every two months or as appropriate 207 208 Care Maintenance BabySIM B Flush the IV System To flush the left femoral IV site 1 M Ur see E Remove the IV source bag from the red hose in the Umbilical Assembly Fill a 60 mL syringe with air and insert the tip into the end of the red hose Force air through the hose until no moisture exists IF COLORED WATER WAS USED Fill a 60 mL syringe with fresh distilled water Insert the tip of the syringe into the red hose Inject all the water from the syringe into the hose and let it collect in the drain bag attached to the blue hose Continue to inject water until the water flowing into the bag is clear Refill the syringe with air and force the air through the hose until no moisture exists C Flush the Chest Tube System To flush the Chest Tube system 1 2 p Disconnect the Trauma source bag from the white hose in the Umbilical Assembly Lubricate the priming tube with silicone spray Push the priming tube int
126. ister Attaching the CO Regulator CO Regulator Connected A 22 Amp Portability Kit is also available Please refer to the Cautions Warnings section of this User Guide for safety instructions Follow local warnings for the handling and use of compressed gas Use extreme caution when fastening the regulator into place Keep the CO canister in an upright position when attached to the regulator Failure to do so could cause damage to the CO regulator 17 Introduction BabySIM Trauma Disaster Casualty Kit TDCK The TDCK adds to the fidelity of a training session by providing the means to add the flow of blood mucous and secreted fluids from the mannequin while using the moulage kit to give a realistic look to the injury or condition The Trauma Disaster Casualty Kit Moulage Kit The Moulage Kit may also be ordered separately Moulage Kit The kit provides the materials needed to create wounds on BabySIM 18 CAE Healthcare Clinical Features BabySIM Clinical Features The BabySIM represents the latest in the state of the art simulation technology for educating clinicians at all levels of medical education Sophisticated mathematical models of human physiology and pharmacology automatically determine the effect of user actions and interventions on the patient embodied by the mannequin In this way patient outcomes result from clinical interventions and provide a platform for objective performance assessment
127. its receipt from CAE Healthcare 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 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 any o
128. ize drop down menu appears From the Font size drop down menu select Normal Small or Large 150 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 computers 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 151 Using TouchPro BabySIM When TouchPro opens the simulated patient monitor appears 9 d E e R EN E E e seen eee so d eo die ate The TouchPro Display NOTE The capnogram waveform is not displayed on the TouchPro software from the Instructor Workstation Capnogram informa
129. k Links Click the minus sign to remove a Quick Link from the SCE 102 CAE Healthcare Using Muse Modifying the TouchPro Setup 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 Ld TouchPro Pre selected Layout EMS ED Telemetry e The On Off switch ICU Arterial Line Only Off ICU OR NO CVP on ICU OR fe The TouchPro Setup Panel 103 Using M se BabySIM 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 displa
130. l all features of the simulator Instructors can select SCEs as well as control the flow of the scenarios via the user interface Various medication cardiovascular respiratory fluid and other parameters can be individually applied on the fly to enhance the course of a simulation exercise A Patient Status Display and set of simulation log entries provide a real time display of vital signs blood gases medications administered and other events This data can be exported into permanent storage or printed for future reference System Tools Instructor Workstation An Instructor Workstation enables the instructor to control all aspects of the simulator Instructors can select an SCE and control the flow of a simulation exercise while monitoring patient parameters medications administered and other interventions Additionally all patient parameters can be adjusted on the fly to enhance the teaching points of the simulation in progress The software provides an intuitive easy to learn and easy to use operator instructor interface Wireless Remote Control Optional A fully functional Wireless Remote Control laptop enables the instructor to control all aspects of the simulator from the bedside Because the user interfaces on both the Instructor Workstation and Wireless Remote Control are identical instructors only have to familiarize themselves with a single control interface CAE Healthcare Getting Started Getting Started The BabySIM sys
131. ld female infant who is being seen for a well baby checkup This SCE is designed to allow the facilitator to operate the simulator using the predefined conditions medications and interventions or to set parameters as needed As a Healthy Female Infant the patient demonstrates a HR in the 120s BP in the 80s 50s RR in the 20s and SpO2 in the upper S0s on room air The patient s cardiac rhythm is normal sinus Heart sounds are normal breath sounds are clear in all lung fields and bowel sounds are normal in all four quadrants Learning Objectives Performs a focused history and physical assessment Scenarios Review i 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 3 Save the PDF to an external storage device to print from another computer OR 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 Muse 62 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 Connect button ana aaa
132. les data entry IMPORTANT Text can be copied and pasted into the fields from TextEdit or Notepad only Jma Faaa E The Rich Text Editor Click Save when all data for the field has been entered 101 Using M se BabySIM 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 Quic
133. lishes the communication of electrical input output and computer signals to the mannequin The lower circular port is the receptacle for the pneumatic fluidic portion of the umbilical and has a white plastic fitting into which the five hoses wrapped in the umbilical are secured The pneumatic fluidic assembly allows gases CO and air to flow to the PCU and back to the mannequin p CAE Healthcare Introduction Instructor Workstation Uplink and Expansion Ports There are three Ethernet and two RS 232 ports on the PCU INSTRUCTOR WORK STATION UPLINK Instructor Workstation Uplink and Expansion Ports EM INSTRUCTOR WORK STATION port connects the Instructor Workstation to the PCU through an Ethernet cable A Wireless Ethernet Switch inside the PCU directs signals from the Instructor Workstation to the patient mannequin The switch is maintenance free and requires no usage or care instructions EN two RS 232 ports are used to connect accessories such as the Trauma Disaster Casualty Kit TDCK EN UPLINK and SPARE Ethernet ports can be used with METIVision Gas Supply Connections At the bottom left of the PCU Interface Panel are two ports labeled MAIN SUPPLY GAS AIR OR CO and EXPIRED CO SUPPLY along with their pressure specifications 50 psig 345 kPa MAIN EXPIRED SUPPLY CO GAS SUPPLY AIR OR CO 50 PSIG 345 kPa 50 PSIG 345 kPa Gas Supply Connections EN MAIN SUPPLY GAS AIR OR CO port is used to connect co
134. lorida 34232 USA declare under our sole responsibility that the product Type of Equipment Human Patient Simulator Manikin Model Number ECS X DC Input to which this declaration relates is in conformity with the following standards or other normative documents EMC EN 55011 1998 A1 1999 Group 1 Class A EN 61326 1997 A1 1998 EN 61000 4 2 1995 EN 61000 4 3 200 A1 2002 EN 61000 4 4 1995 A1 2001 A 2001 EN 61000 4 5 1995 following the provision of the EMC Directive 89 336 EEC Sarasota Florida 34232 USA European Contact xi BabySIM CAE Healthcare Cautions and Warnings Cautions Warnings Please read and understand these cautions and warnings before beginning use of the BabySIM 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 BabySIM 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 or the PACE patient electrodes Contact between defibrillator paddles and the ECG PACE electrodes may cause injury to the user and damage to the equipment e The BabySIM has been tested to work with the Physio Control Model LifePak 11 defibrilla
135. lume of blood contained in the unstretched venous system without an increase in venous pressure Raising the value decreases the venous capacitance vasodilatation and decreased vascular tone while lowering the value increases the venous capacitance vasoconstriction and increased vascular tone The volume of blood in the venous system has an inverse relationship to the blood pressure Lowering the value is analogous to a shift in blood from the venous system to the arterial system and this shift when coordinated with increased systemic vascular resistance results in an increase in blood pressure arterial blood pressure ABP pulmonary artery pressure PAP and central venous pressure CVP Default 1 Range 0 10 100 00 A 23 Appendix A M se Parameter Descriptions BabySIM A 24 Systemic Arteries Compliance Factor The Systemic Arteries Compliance Factor parameter adjusts the pulse pressure difference between systolic and diastolic pressures of the simulated patient s systemic blood pressure Increases in the compliance factor result in a decreased narrower pulse pressure while smaller values increase the pulse pressure Additionally when the pulse pressure increases as a result of a reduced compliance factor both systolic and diastolic pressures increase Conversely with a narrower pulse pressure higher compliance factor both the systolic and diastolic blood pressures also drop Default 1 Range 0 50 5 00
136. ly After the PCU and Instructor Workstation are powered on turn on the compressed air or the CO being used as the main gas supply Compressed air and gas sources must be pressurized to 50 psig 345 kPa CAE Healthcare Getting Started Optional Set Up the Wireless Microphone To use the Wireless Microphone 1 Unfold the two antennas located on the front of the Wireless Receiver on the PCU 2 Attach the lapel microphone to the desired piece of clothing or surface 3 Turn on the microphone using the switch on the top of the unit Optional Configure the TouchPro and Wireless Remote Computers The BabySIM network supports up to four computers the Instructor Workstation and three additional computers a Wireless Remote Control and two TouchPro workstations All computers must meet the system requirements mapped out in the Specifications section of this User Guide Follow the steps below to be able to use the M se or TouchPro software on either a TouchPro computer or a Wireless Remote computer Step 1 Set Up the BabySIM The BabySIM simulator must be set up and powered on and the Instructor Workstation must be connected to the BabySIM Network via the Ethernet connection to the PCU Please refer to page 31 of this User Guide for directions on how to setup the BabySIM Step 2 Obtain the IP Address from the Laptop Instructor Workstation a On the Instructor Workstation that is connected to the BabySIM Network from the Apple m
137. male Intant Modules link sces 2 mp The Learning imi a Ep c App lications Conditions m rir ox E Patient Records Ad t o ug panel ak eds The Install Learning Module button The Remove button The Learning Modules Panel 128 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 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 129 Using M se BabySIM SCEs From the Content Management options click SCEs to access the SCEs panel The SCEs panel appea
138. me 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 Management pop up menu select Play The scenario is resumed 90 CAE Healthcare Using Muse 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 lt 0 0001 mg kg i a button name The Reset button 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 91 Using M se BabySIM Resetting a Medication To reset a medication from the Medication Monitor click the Reset button on the Medication Monitor Th
139. meters 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 field where the beats per minute value can be keyed in iocos Pressure Modeled eart nate eed Meart Rate Factor T2 Heart Rate SEDE The Override Mad Gc Er MES Modeled Gess vatns Qaibater k mgar arum switch PA Catheter Pulmonary _ PA Baboo MERI P Oetib Paces Correct o Pacing ate 80 Magog DEAD The value cota Pats Inject i 30 setting slider O aW 0 72 The Heart Rate Parameter Once the parameter has been set it is reflected in the patient s physiology 73 Using M se BabySIM 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
140. mpressed air or gas via a hose to the PCU With this connection various life signs can be displayed on the mannequin such as breathing and pulses A For the mannequin to exhale CO a CO source must be connected to the EXPIRED CO SUPPLY port An optional Gas Accessory Kit is available for connecting centrally supplied compressed air and CO to the PCU Introduction BabySIM 10 Audio Jack and Wireless Channel Set The small jack labeled AUDIO OUT allows you to connect the simulator s audio outputs directly into an available audio visual system to amplify the patient s sounds for a larger audience A AUDIO Audio Jack All sounds are reproduced from one channel The Wireless Receiver works in tandem with the Wireless Remote Microphone to provide the instructor with a means of verbal communication through the mannequin Wireless Channel Set The dual antennas of the microphone pull out to increase range and the receiver has a channel selection and volume control feature to produce high quality sound The receiver is powered from a power supply inside the PCU o CAE Healthcare Introduction Laptop Instructor Workstation The Laptop Instructor Workstation is a laptop computer that utilizes the M se software to operate as the main simulation control center Instructor Workstation IMPORTANT All computer components are preconfigured for use with BabySIM Only approved CAE Healthcare applications should be
141. mum 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 CAE Healthcare Table of Contents Table of Contents Licence COPY IN RTT M Declaration of Conformity Leon i Go TREE CORO FOTO WS PROS TPUR FEET ERAS IX CAUTIONS Warhllljs E E E E E O A E E E xiii SPENN S eiia EEEE NEE EE E T N EER xvi System HEGUIFEMIGNIUS isascascascesscssessenessccobessessesssesssensccaceavenasseasvecsesnaseavsartactcetsversens xviii Josie tei c H 1 inp e 1 Eauipiment OVOEVIGW ani edv Heri d ELI RE VER EERE ROTE STE UO PEE TEC EE EXE EE YEWRESDAC TUE PERUENS 2 Components INVENTOLY s sssseccssnssssessscnsssenscssnssscnsssencsscncesensescassucasesensencnsssenssscasescacenensavenctscasenenenses 2 BabysIM Standard EQUIDINGRE iei oe ERES EROOUA CURRERE RUPEE TEE VERTS EQUO YR EUR E a 4 Full Body
142. n 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 The user fields Content Management The Edit button Th l j i ete The New HOM button The User Accounts Panel NOTE User Accounts functions are available only to users with the User Management or System Management privilege 137 Using M se BabySIM 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 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 t
143. net Mask TEP IP DNS Manually 255 0 0 0 WINS 802 Write down the IP address next to the IPv4 Address heading The Instructor Workstation s IP Address g Click Cancel to close the TCP IP Network screen h Close the Network settings screen 47 Getting Started BabySIM Step 3 Configure the Wireless Remote 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 eee Network 32 bit s e Show All Goan Ethernet DNS WINS 802 1X P Configure IPv4 Manually IPv4 Address 10 XXX XX XXX Subnet Mask 255 0 0 0 Router TCP IP Network Screen Macintosh iternet Protocol Version 4 TCP IPv4 Properties 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 C Obtain an IP address automatically IP address Subnet mask Default gateway Internet Protocol Version 4 TCP IPv4 Properties Screen Windows Enter a unique IP address and the Subnet Mask listed below for the TouchPro or Wireless Remote computer The unique IP address must match the IP address obtained in Step 2 except for the number after the third and final period Thi
144. ng 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 automatically 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 161 Using TouchPro BabySIM 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 162 Using TouchPro To display the patient s current NIBP click the Manual NIBP button The Manual NIBP button 6L The TouchPro Display The curre
145. nguage 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 166 3 CAE Healthcare Using the System Using the System Once the BabySIM has been set up see the Getting Started section the software has been loaded and an SCE has been started see the Using the Software section the simulator is ready for learner interventions The method of producing a specific clinical situation may involve the mannequin the software or both Likewise user interventions can take place with the mannequin the software or a combination of the two From the Run screen the features of the BabySIM can be accessed On the following pages is a breakdown of the various clinical features and how they are utilized It is separated into the following categories Neurological Respiratory Cardiovascular Fluids and Sounds
146. nning Anaphylaxis 00 00 03 An Added Scenario 69 Using M se BabySIM 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 modify parameters or by using the Conditions Interventions and Medications palettes Using the Physiological Views From the Run screen users can select from six different views representative of various body systems and features Neurological Respiratory Cardiovascular Fluids TDCK Sounds 70 J CAE Healthcare Using Muse To access each view click the appropriate organ icon or button For Neurological click the brain For Respiratory click the lung e For Cardiovascular click the heart e For Fluids click the droplet of blood For TDCK click the TDCK icon For Sounds click the Sounds button From each view various parameters can be viewed and adjusted Brain The Physiological Views 71 Using M se BabySIM 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 72 CAE Healthcare Using Muse 3 Select the parameter and set the new value Para
147. normal blown Secretions Body fluids can be excreted from the eyes ears and mouth Respiratory System The BabySIM represents a realistic Respiratory System using both physical and mathematical models to achieve an extremely accurate simulation of respiration This system is tightly integrated with the Cardiovascular System as well as other models within the BabySIM system Zw CAE Healthcare Clinical Features Normal and Difficult Airway The mannequin provides an anatomically realistic upper airway oropharynx nasopharynx and larynx representing that of a three to six month old patient Airway Module Features Direct laryngoscopy as well as oral and nasal tracheal intubation can be performed Esophageal intubation is fully supported in which case breath sounds chest excursion and carbon dioxide output are absent and gastric distension occurs A laryngospasm actuator closes the patient s vocal cords and prevents both ventilation and intubation Bronchial Occlusion when enabled guarantees that no ventilation is possible creating a cannot ventilate cannot intubate crisis scenario Intubation In addition the patient s airway supports the use of standard clinical devices such as Endotracheal Tube Laryngeal Mask Airway Combitube Lighted Stylets Airway Management and Ventilation Alveolar and arterial gas concentrations appropriately reflect the efficacy of the employed ventilatory technique such as
148. nt NIBP is displayed NOTE Manual NIBP can be used at any time during cycling However this turns off auto cycling 163 Using TouchPro BabySIM 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 a Patients Rose Jackson The Available Patients NOTE When connected to the simulator the TouchPro only displays the active Patient 164 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 165 Using TouchPro BabySIM 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 La
149. nths old The Change Picture Change Picture button m Pm x M The Save button 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 lt gt 99 Using M se BabySIM Setting a Patient s Baseline To set the Patient s Baseline 1 From the SCE Editor click Baseline m se Untitled SCE t 9 K The Baseline button RAAS Preperation 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 100 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 enab
150. o the insertion site on the right side if not already present far enough to engage the valve and allow the water to drain out IF COLORED WATER WAS USED fill a 60 mL syringe with fresh distilled water 5 Insert the tip of the syringe into the end of the white hose Inject all the water from the syringe into the hose and let it drain out through the tube 7 Repeat this process until the water draining through the tube is clear Fill the syringe with air and inserting the syringe into the white hose force the air through the system until no water drains from the tube Remove the tube CAE Healthcare Care Maintenance D Decompress the Chest Always decompress the chest when using the Pheumothorax Needle Decompression feature before completing the shutdown procedures Do not store the mannequin until decompression has been performed E Wipe Off the Mannequin After all fluids have been removed carefully inspect the mannequin for evidence of any remaining colored liquids If a stain is found use a soft cloth with mild soap to wash the area Rinse and dry Once the mannequin is thoroughly flushed and cleaned it is ready for storage Step 3 Turn the Air and Gas Supplies Off Turn off Air Supply If air was used Shut off the air supply i e the central air supply resource Or Turn off the OPTIONAL Air Compressor drain any condensation and store the Compressor The Quiet In Room Air Compressor introduced on page 15 is dr
151. ompliance factors greater than 1 create loose lungs that easily inflate with less pressure Default 1 Range 0 15 10 00 Venous CO Shift The Venous CO Shift parameter affects the partial pressure of CO in the venous blood Changing this parameter allows large and rapid shifts in total body CO concentration Increases in alveolar and arterial CO follow rapidly in a physiologically correct magnitude and time course This parameter is useful for giving a bolus of CO to the venous system The alveolar and arterial CO levels rise rapidly in response to the added carbon dioxide but soon return to pre bolus levels as increased ventilation efforts work to eliminate the added CO Therefore the rise in CO levels is only transitory Default 0 mmHg Range 0 0 mmHg 60 0 mmHg Bronchial Resistance Factor Left and Right When using the Bronchial Occlusion parameter the rate of resistance can be set using the Left or Right Bronchial Resistance Factor parameters The rate of resistance can also be set to occur over time Default 1 cmH O Range 0 3 cmH O 1000 0 cmH O A 15 Appendix A M se Parameter Descriptions A 16 Cardiovascular Basic Parameters Cardiovascular Parameters Basic Blood Pressure Heart Rate Heart Rate Factor Cardiac Rhythm Arterial Catheter Central Venous Catheter PA Catheter PA Balloon Pacing Current Pacing Rate Pacing Capture Threshold BabySIM CAE Healthcare Appen
152. on of any sort 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 1 2 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 t
153. onments with power but no central air gas supply two air compressors are available as options An air compressor designed for quiet operation is available for in room use and an alternative air compressor is available for situations where the compressor resides in a location such as a storage room set apart from the simulator Out of Room Air Compressor Quiet In Room Air Compressor AIR 002 AIR 003 Both Air Compressors are AC powered and include a regulator and an air hose with the appropriate connector fitting 15 Introduction BabySIM Gas Accessory Kit The Gas Accessory Kit includes two complete assemblies for connecting a central supply of compressed air and CO to the PCU Gas Accessory Kit Both assemblies have color coded hoses yellow for air and gray for CO that are attached to independent adjustable pressure regulators These regulators are used to ensure the pressure supplied to the system is 50 psig 345 kPa The appropriate PCU fittings are attached to the other end of the hoses for easy configuration 16 CAE Healthcare Introduction ECS Portability Kit The ECS Portability Kit includes a power kit with battery and a CO regulator set for 50 psig 345 kPa that attaches readily to a small E cylinder CO canister A wrench is supplied with the regulator to open the CO valve on the canister A blue nylon bag is also included for the E cylinder The CO regulator attaches readily to a small CO can
154. or the United States and most international sites 15 MAHI AIRAS DLE KYS Technology 911 5233 F 02 2911 6855 E info kyst com tw www kyst com tw CAE Healthcare 02 N 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 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 service caehealthcare 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 49 0 6131 4950354 Email international service caehealthcare com Customer Service United Kingdom and Ireland Monday Friday from 9 00 a m to 5 00 p m GMT Phone 44 0 800 917 1851 Email uk service caehealthcare com 2013 CAE Healthcare 165K146400 v 2 1
155. ous behavior and out of spec performance e Only perform invasive procedures supported by the system as described in applicable sections of the User Guide Do not pick the mannequin up by the limbs support the head and leverage weight with torso e Apply water to the mannequin only in accordance with the supported clinical procedures identified in this User Guide CO Cylinders Follow the standard United States Department of Transportation or applicable national agency s warnings and regulations for handling and using compressed gases e Air and CO regulators are factory calibrated to 50 psig 345 KPa do not tamper with or attempt to adjust settings All external air and CO sources must be regulated to 50 psig 345 KPa XV Specifications BabySIM Specifications Size PCU 590 mm x 370 mm x 260 mm Mannequin 25 3 4 inches 65 4 cm Weight PCU 16 lbs 7 kg Mannequin 16 1 4 Ibs 7 37 kg Environmental Specifications Operating 41 F to 104 F 5 C to 40 C Storage 41 F to 122 F 5 C to 50 C The following is for Compliance with CSA 22 2 No 1010 1 UL 61010A 1 and EN61010 1 Pollution Degree 2 Installation Category Il Altitude up to 6 561 ft 2 000 M Humidity 92 5 up to 104 F 40 C Mains supply voltage fluctuations not to exceed 10 of nominal supply voltage Pneumatic Specifications Air 50 95 PSI with peak flow rates up to 1 5 liters per minute CO Maximum flow rate 200
156. p down menu To stop playing a selected vocal sound select None from the list 199 200 Using the System BabySIM Wireless Voice Capability A wireless microphone is available to provide phonation or a voice from the patient To use the wireless microphone attach the transmitter to a belt or pocket and snap the microphone to a lapel or shirt pocket Wireless Microphone Verify that the two antennas located on the front of the wireless receiver on the PCU are extended and that the transmitter has been set to the same channel as the receiver on the PCU the default setting Switch the receiver and the microphone to the ON position There are two ways to adjust the Wireless Microphone volume Adjust the volume using the volume setting on the receiver on the PCU or with the Vocal Sounds volume on the software For more information on the Vocal Sounds menu please see page 198 The receiver and transmitter are factory configured to the same channel However if they need to be reset e g when multiple simulators are in use adjust the frequencies using the Group and Channel settings on the microphone and receiver with a small screwdriver These settings must be identical Detailed instructions are shipped with the microphone The wireless microphone transmits over user selectable frequencies of between 790 and 806 MHz at 10 mW a range legally appropriate for the United States and most international sites CAE Healthcare Care M
157. pacing disk locations and instructions See Defibrillation for defibrillation disk locations and instructions See Manual Blood Pressure for using the modified blood pressure cuff 179 Using the System BabySIM Pulses The BabySIM has 4 pulse locations Brachial 2 Femoral 2 Pulses are visible and controlled from any physiological view 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 Deactivated pulse Pulses Activated and Deactivated 180 o CAE Healthcare Using the System Palpable Pulse Thresholds A pulse deficit automatically occurs when the systolic arterial blood pressure falls below the following thresholds Palpable Pulse Thresholds Location Systolic Pressure Threshold Brachial 30 mmHg Femoral 30 mmHg Click and hold a pulse location to adjust the pulse deficit The pulse deficit parameter appears Femoral Deficit Left Pulse Deficit Parameter 181 Using the System BabySIM Invasive Hemodynamic Monitoring The following parameters can be displayed on the Patient Status Display and the TouchPro software Invasive Hemodynamic Monitoring 182 p CAE Healthcare Using the System ECG Signals To produce ECG signals on a monitor connect a 3 lead unit to three of the four contacts or snaps located on the mannequin The fourth contact may
158. pears 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 143 Using M se BabySIM 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 The System Restore warning 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 144 CAE Healthcare Using Muse 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 t
159. performed on the left side of the mannequin To set up Pneumothorax Needle Decompression 1 In the M se software from the Respiratory view locate the Needle Decompression parameter 2 Toggle the switch to the On position After a few seconds toggle the switch to the Off position Needle Decompression Switch The momentary enabling of Needle Decompression allows air pressure into the mannequin s internal air reservoir charging the reservoir Once the air reservoir is filled the system is primed and ready for a Pheumothorax puncture 3 Insert a needle and catheter into the small hole located in the mid clavicular line of the second intercostal space until the hissing sound of the valve release is heard If no sound is heard the needle wasn t inserted properly either in terms of depth or location For supported needle size see Recommended Clinical Supply Sizes on page 215 Needle Decompression 4 n the M se software adjust the Right Intrapleural Volume parameter located on the Respiratory view Seesaw Breathing Seesaw breathing can be enabled when you want to simulate severe respiratory distress To enable seesaw breathing in the M se software from the Respiratory view locate the Seesaw Breathing parameter and toggle the switch to the On position Seesaw Breathing Switch To disable seesaw breathing toggle the Seesaw Breathing parameter switch to the Off position 177 178 Using the System BabySIM
160. pertension Acute ventncular Failure Laft py Me nto JN e BP Hypotension Cardinc Tamponada Chronic Hypertension I Depamine Greater than ar Equal menta Hart Rat e Bradycardia p Hypetendign lS pres e n Heart Rate Tachycardia IF Thee En State Gnrater than or Equal 3 amp 0 arcs A k Idiopathic Hypotension GOTO Hypaten ion Workers rg _ Patient Stability e w a RR Ventricular Failure Both ventricular Failure Left Vantricular Failure Right Parameters 4 ene tus ne Variable Tranaiticns Creare The Scenario Designer To add parameters to a state click the Parameters button within the state The Parameters button A State 114 CAE Healthcare Using Muse The State Parameters screen appears Hypotension Begins Fypobenzian Eyes Blink Speed Fal The State BP Systolic 145 MAH E Parameters Temperature body ig c pa n el Respiratory Rate 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
161. pressure at the same time for the software to recognize the baroreceptor reset CAE Healthcare Appendix A M se Parameter Descriptions Left Ventricle Contractility Factor The Left Ventricle Contractillity Factor parameter adjusts the contractility of the left ventricle and has a direct effect on cardiac output and blood pressure Use this parameter to raise or lower the cardiac output Default 1 Range 0 10 5 00 Right Ventricle Contractility Factor The Right Ventricle Contractility Factor parameter adjusts the contractility of the right ventricle and has a direct effect on pulmonary artery pressure and an inverse effect on central venous pressure Use this parameter to raise or lower pulmonary artery pressure PAP or to change the central venous pressure CVP Default 1 Range 0 10 5 00 Systemic Vascular Resistance Factor The Systemic Vascular Resistance Factor parameter adjusts the baseline systemic vascular resistance Raising the value increases the systemic vascular resistance while lowering the value decreases the vascular resistance Raising the parameter value is analogous to increasing the resistance to blood flow through the systemic vasculature Under such conditions the arterial blood pressure ABP increases and the heart rate may decrease due to feedback from the physiological control mechanisms Default 1 Range 0 10 10 00 Venous Capacity Factor The Venous Capacity Factor parameter adjusts the vo
162. r 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 iy CSA INTERNATIONAL Certificate of Compliance Certificate 150492 Master Contract 223202 Project 704296 Date Issued 2005 09 23 Issued to Medical Education Technologies Inc 6000 Fruitville Rd Sarasota FL 34232 USA Attention Mr Nigel Parker The products listed below are eligible to bear the CSA Mark shown with adjacent indicators C and US 5 Issued by Jim Saunders P Eng US Authorized by Gianluca Arcari P Eng IT Product Group Manager PRODUCTS CLASS 8721 84 EL
163. r selectively adjusts the influence of mean arterial pressure MAP on the heart rate and contractility influencing how much the heart rate increases or decreases with changes in blood pressure Use this parameter to adjust how vigorously the heart responds to blood pressure changes A baroreceptor gain cardiac factor of less than 1 corresponds to baroreflex depression e g less heart rate response to MAP changes A value greater than 1 leads to a stronger response to MAP changes Default 1 Range 0 00 10 00 A 25 Appendix A M se Parameter Descriptions BabySIM A 26 Baroreceptor Gain Peripheral Factor The Baroreceptor Gain Peripheral Factor parameter adjusts the influence of mean arterial pressure MAP on systemic vascular resistance and venous capacity influencing how much the vasculature responds to changes in blood pressure For example when blood pressure falls the arteries increase their vascular tone resistance and there is less pooling of the blood in the venous system in an attempt to maintain adequate blood pressure A factor of less than 1 corresponds to baroreflex depression e g less systemic vascular resistance response to MAP changes A value greater than 1 leads to a stronger response to MAP changes Default 1 Range 0 00 10 00 Chest Compression Efficacy The Chest Compression Efficacy parameter is used to determine the effectiveness of the chest compression administered by the caregiver
164. ratory gain O consumption respiratory quotient lung compliances chest wall compliance bronchial resistances the presence of artificial airways in the simulator and the inspired gas mixture Minute ventilation is not affected for PaO above the set point For example if PaO Set point is set to 100 mmHg and PaO drops to 90 mmHg ventilatory stimulation occurs When the PaO reaches the new set point the simulator s respiratory rate and tidal volume are again controlled to maintain PaCO at the PaCO set point see PaCO Set point Default 100 00 mmHg Range 20 0 mmHg 100 0 mmHg to E Ratio 1 X The I to E Ratio 1 X parameter sets the inspiratory expiratory I E ratio for spontaneous ventilation At the default setting the time for exhalation is twice that of inhalation Default 2 Range 0 0 7 0 CAE Healthcare Appendix A M se Parameter Descriptions PetCO PaCO Factor The PetCO PaCO Factor adjusts the end tidal CO relative to the PaCO At the default value of 1 PetCO very closely approximates PaCO When PetCO PaCO Factor is set at a value of 2 PetCO is approximately one half of PaCO PetCO depends on CO production and alveolar ventilation Because the alveolar dead space is not modeled physically in the hardware the responses to changes in mechanical ventilation settings may not be exact The use of the Onset feature e g onset over 1 minute is recommended for this parameter Default 1 Ran
165. received Contact a CAE Healthcare Sales Representative at 866 462 7920 if there are any questions or if optional equipment is needed Introduction babySIM BabySIM Standard Equipment The design of the BabySIM system allows students to focus on the patient mannequin while giving instructors the ability to create an endless number of possible clinical situations Full Body Infant Mannequin and Umbilical Assembly All patient assessments and clinical interventions are played out on the BabySIM mannequin which represents a three to six month old infant At 25 3 4 inches 65 4 cm in height and weighing 16 1 4 pounds 7 37 kg the mannequin is fully operational in the supine position and can be placed on any flat surface such as a gurney an emergency room operating table the ground or even in a vehicle The mannequin offers features like breath and heart sounds palpable pulses baby vocal sounds genitourinary features and airway management features Full Body Infant Mannequin A bundled system of hoses known as the fluidic pneumatic pigtail and an electrical cable called the electrical pigtail are attached to the mannequin in the perineum area Both pigtails attach to the Umbilical Assembly The Umbilical Assembly holds a bundle of color coded hoses and an electrical cable The electrical cable which provides power and transmits information from the Instructor Workstation has a specialized fitting that connects to the PCU s 12 volt
166. res minimal additional faculty development time for use Each SCE is comprised of a patient and can include up to four 4 scenarios The BabySIM system includes four preconfigured SCEs or clinical simulations that cover a range of events and crises Increased Intracranial Pressure Shock RSV Bronchiolitis Sedation Induced Apnea Each SCE includes the information below and can be printed from the M se software Background Information and Patient History Synopsis Learning Objectives Learning Performance Measures Equipment and Supplies suggested for the simulation Facilitator Notes Debriefing Points Teaching Q amp A References CAE Healthcare Clinical Features Base Patients In the software each patient is represented by a Base Patient that defines the initial condition of the simulated patient s physiology and sets the values of the parameters and variables upon which that patient s physiological and pharmacological models are based For example a Base Patient initially sets the respiratory rate of the simulated patient s lungs as well as other specific values Once a Base Patient is loaded the models automatically regulate the simulated patient s physiology in accordance with the type of patient defined The BabySIM is supplied with two preconfigured patients Ryan Summers and Rose Jackson representing six month old male and female patients Preconfigured Base Patients cannot be overwritten but new Base Patients
167. rs 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 130 CAE Healthcare Using Muse Base Patients From the Content Management options click Base Patients to access the 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 131 Using M se BabySIM Scenarios From the Content Management options click Scenarios to access the Scenarios panel The Scenarios panel appears The Scenarios link The Create The Import N
168. rterial and venous blood gases and pH This data can be displayed on the Instructor Workstation or on the optional Wireless Remote Control Seesaw respiratory patterns of breathing are demonstrated on the mannequin 22 CAE Healthcare Clinical Features Needle Decompression of Tension Pheumothorax Decompression of a tension pneumothorax can be performed by inserting a needle at the mid clavicular line of the second intercostal space on the right side of the mannequin Proper needle placement results in rapid decompression a rush of air exiting the proximal end of the needle and improvement in pulmonary mechanics and gas exchange Chest Tube Placement and Management A chest tube can be inserted into the mid axillary line of the fifth intercostal space on the right side of the mannequin Using ordinary pediatric chest tube suction equipment fluid and air can be withdrawn from the pleural space The volume removed influences the patient s physiology to reflect improvement in pulmonary mechanics and gas exchange 23 Clinical Features BabySIM Cardiovascular System Like the BabySIM s Respiratory System with which it is tightly integrated the Cardiovascular System accurately simulates a wide variety of hemodynamic conditions and responses Cardiovascular System Features The simulated patient generates heart sounds including a range of pathological ones that are synchro nized to the ORS complex of the ECG and are audible wit
169. rway is found small cuts or tears may be reparable However for permanent repair of damaged mannequins contact CAE Healthcare Customer Service Care of Electronic Equipment e Do NOT use any of the computer components associated with this system for any other use e Do NOT connect the computer components to any network of any kind Install any CAE Healthcare software updates as soon as they become available e NEVER stack other equipment on computer components or the PCU CAE Healthcare Recommended Clinical Supply Sizes Recommended Clinical Supply Sizes The following clinical supply sizes are recommended for use with the simulator Other sizes may cause damage and should not be used Clinical Supply Recommended Size 20 to 22 gauge 14 gauge 6cm Insertion only 215 Recommended Clinical Supply Sizes BabySIM ECS 216 Condition Guidelines for CAE Healthcare Programming BabySIM with Muse Condition Guidelines for Programming BabySIM with M se 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 Cardiovascular Blood Pressure Cardiovascular Heart Rate Respiratory Respiratory Rate The Muse software is physiologically driven When using multiple conditions e g Desaturation Hypertension Tachycardia Tachypnea physiolo
170. s The Bowel Sounds Menu 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 controls one or both of the intestinal regions to change the type of sound Click and drag the Bowel Sounds slider to adjust the volume Normal bowel sounds are present by default NOTE A patient must be running on the BabySIM simulator for any sounds to be available 195 196 Using the System BabySIM Breath Sounds Breath sounds are independently synchronized with ventilation of the left and right lungs Speakers in the anterior regions provide breath sounds that can be auscultated Breath sounds can be adjusted by clicking the Sounds button on the Run screen When the Sounds panel appears select Breath Sounds Biphasic Wheeze Bronchovescular Click any one of the Breath Sounds in the drop down menu to select a Breath sound Click and drag the slider to adjust the volume NOTE A patient must be running on the BabySIM simulator for any sounds to be available By default Normal breath sounds are heard Bowel Sounds Breath Sounds I LU LU L Biphasic Wheezing a Bronchovesicular Crackles Heart Sounds Prolongation Rhonchi Stridor Wheezing Vocal Sounds The Breath Sounds Menu p CAE Healthcare Using the System Heart Sounds Heart sounds emanate from speakers and are sync
171. s administered and the time course of their injection automatically determine 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 Temperature Blood The arterial blood temperature can be set using the Temperature Blood parameter The arterial blood temperature can then be displayed on the Patient Status Display and TouchPro software Note that changes in arterial temperature may alter the shape of th
172. s number can be any number between 2 and 254 BUT must be different from the final number of 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 10 XXX XX XXX Subnet Mask 255 0 0 0 Router Gateway Leave Blank Example If the IP address of your Instructor Workstation is 10 127 91 223 you could assign the TouchPro computer the IP address 10 127 91 224 and the Wireless Remote computer the IP address 10 127 91 225 48 o CAE Healthcare Getting Started Step 4 Option 1 Join the BabySIM Network Using a Macintosh Operating System a Click the AirPort icon located at the top right hand corner of the screen of the TouchPro or Wireless Remote Computer A list appears with the BabySIM network listed b Select the AirPort network labeled BABYXXXX where XXXX is the unit number of your BabySIM AirPort On Turn AirPort Off BabySIM Network v BABY XXXX Selecting the BabySIM Network An AirPort dialog box appears requesting the password for the BabySIM network c Enter the password See the note at the end of this step d Click OK Arbor The selected AirPort network requires a password to join Wireless Security WPA Personal Password eeseseeee Show password Remember password in my key
173. sible 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 83 Using M se BabySIM 3 Click the Jump to State button The Jump to State menu appears displaying the available states Beginning 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 84 CAE Healthcare Using Muse 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 bu
174. 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 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 53 Using M se BabySIM 2 Select M se The Login screen appears User Guide Support The M se 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 Us
175. sssensees 177 SELT a PEE TIES E QI AE A E 177 Cardiovascular SVSEGIBI cccicsicsresasnpeacssciunssscaxisssacctssvernsstesuvestincnstousssnsaesdaaseaeinsneciansiateetineveriaee 178 PUSS E E A A E A A E A A MERE 180 SEC MS a E T A E 183 EAE NE US E A E E A E A A T 184 xui E e EE E E E EN A AATA 186 Chest COMpression seesssesssessssessseesseesseessecesseesseesssessstessseeseeesetesstesseesusteostessstessteusteoseessseessteoseeossessses 186 Wal MENT 187 PACING M 189 MGCADOIIC SYS TOT So ce i9 E N TONENE EE I EE RECEIVE TURN EEEROE ARN HE DIS E EIU ES 190 Genitourinary Syste ooa eu E Nr FEXERE ERE GOE EXER IEEYAVEORU Pat XA SEI EXER S EE DR UXYON OR EEN SEENE 190 Replacing the Mannequin s Genitalia NT RT 190 Utilizing the Genitourinary Features sessesessseessssessssseresseeconsseeossserossseeossscresssecossserossserossseeossseees 191 Pharmacology System and FluidS eessoossssoessoosessosessosessosesoocessosessooessoceesoosssoosessosessosesooseso 192 EEE OUS DU e AE EEEE E E E E E T 194 Jn 195 Sp 195 BLEIU U e 196 ipei e 197 eB 198 xxiv p CAE Healthcare Table of Contents BabySIM Care and Maintenance
176. sssseesssrossreosssroosstosssrossnrosssrosssrosssrossntoossrosssrosssrossnrossrossstossnrossntosssrossss 20 Caraiovas cuiar SYS TONN raen eir oa E E A UO IURE 24 MOLDE VE a E A E R ER 26 EOE E SM EE ECCE 26 XU PT BS CTS RIETI TOTO E E E 2 Simulated Clinical Experiences eceeeeieevesqeese oe rae vu Ye PEPEEUN SS EPE IHE SHEER CE PER SEXE EFE FEIN HESSE FEr eua 00 28 Dose E N e catenis A menu N DD utut M IE RI IEEE 29 MCI T 29 SV SCC CONLIONS coe idea fea E RR ERREUR SE DHISEUEA EYE CEU ERIRE LOU SUR DA IE FREUE ETENYER EE EXU EPR FERRE EEATEUE 30 Main Application Software assess cmt es rid ereritere E Srt CH doe estet in 30 SY CN 30 Betting Started acoso rrr REO ir end i UHR E HIE 31 TApir Iu LITTLE 32 Step 1 Place the Mannequin in the Work Area 4 eere e eere ene eene eroe ooo enoe 33 Step 2 Attach the Umbilical Assembly to the Mannequin eee 34 Step 3 Connect the Fluidic Pneumatic Umbilical to the PCU eere 36 Step 4 Connect the Electrical Umbilical to the PCU eene eee eere rennen 38 Step 5 Set Up the Instructor Workstation eere eere eere eee tn enero aoo eooo 38 Step 6 Establish the Ethernet Cable Connection 4 e eere eene eee eee eren neenon
177. st the mannequin has two defibrillation disks which can be unscrewed leaving threaded connections if required Connect to three of the ECG contacts Defibrillation Disks The BabySIM is compatible with a wide variety of manual defibrillators 1 77 inch 4 5 cm rated for infants up to one year Defibrillators employing a monophasic waveform as used by Physio Control equipment and some biphasic defibrillators such as those made by Zoll automatically report the energy discharge p CAE Healthcare Using the System Pacing Disks on the front and back of the mannequin are used for cardiac pacing To use this feature make sure the metal pacing disks are attached to the mannequin Next attach the pacing pads from a standard transthoracic cardiac pacer to the mannequin at the site of the pacing disks the negative lead on the anterior location and the positive lead on the posterior location of the heart Anterior and posterior locations for pacing disks Pacing Disks The software automatically detects and responds to pacing signals 189 190 Using the System BabySIM Metabolic System The BabySIM patient mannequin delivers metabolic features that are physiologically modeled within the software so that the results are made available on the Instructor Workstation or the optional Wireless Remote Control The ABG data displayed corresponds accurately and dynamically to the alveolar concentration of CO and O
178. t The computer has joined the BabySIM network You can now proceed to Step 5 The BabySIM WPA password contains eight characters The password is BABY followed by four numbers The numbers are the BabySIM unit number preceded by the number of zeros required to make the password total eight characters Examples BABYO123 BABY0012 or BABYOOO where 123 12 or 1 is the BabySIM unit number The password is case sensitive and BABY is typically all capital letters 51 Getting Started BabySIM Step 5 Access the Software from the TouchPro or Wireless Remote Computer a On the TouchPro computer or Wireless Remote computer launch the web browser e g Safari b Enter the IP address obtained in Step 2 into the browser s address field The Muse Start screen appears muse EE TouchPro Patient Monitor The M se Start Screen The M se software or the TouchPro software can now be launched and the software can be used in the same fashion as on the Instructor Workstation OPTIONAL From your web browser a bookmark can be created on the TouchPro or Wireless Remote 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 BabySIM network for the Wireless Remote or TouchPro computers to be able to operate 52 CAE Healthcare Using Muse USING MUSE The Muse
179. t settings for the Ryan Summers and Rose Jackson patients as well as the ranges if available for all patients M1 Appendix A M se Parameter Descriptions BabySIM A 2 Neurological The BabySIM can simulate a variety of neurological clinical indicators such as secretions and reactive eyes Neurological Parameters Eyes Blink Speed Temperature Body Temperature Blood Eyes Blink Speed In Auto mode the eyelids are normally blinking under the following conditions Minute Ventilation is greater than 1500 mL SpO is greater than 70 and neuromuscular blockade NMB is less than 30 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 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 50 0 mmHg Neuromuscular Blockade NMB CAE Healthcare Appendix A M se Parameter Descriptions The pharmacokinetic and pharmacodynamic models based on the neuromuscular blocking agent
180. tem is comprised of three basic components The Mannequin The PCU The Instructor Workstation Basic setup requires connecting these three components as well as the air gas and electrical supplies Setting up the BabySIM system the first time should take approximately 30 minutes but setup time is reduced with practice The table below outlines the steps required for configuring the BabySIM system Setup Steps Set Up the TDCK Set Up the Wireless Microphone Configure the TouchPro and or Wireless Remote Computers 31 Getting Started BabySIM Before Beginning Proper operation of the BabySIM requires correct configuration Before setting up the system keep in mind these basic guidelines Understand the Cautions Warnings information section of this User Guide Follow the sequence of steps carefully Complete all steps in order Do not power on any components until instructed in the text and Do not attach air gas supplies until instructed in the text KEEP all original shipping materials including the BOXES warranty and repair items must be return shipped to CAE Healthcare in their original packaging If unpacking the BabySIM system for the first time careful use of a box cutter protects both the packaging and the product Because shipping materials should be stored and retained ensure all protective packing materials and unused ancillary computer parts are secured as well Additional tools required for setup includ
181. ters available are shown in the table below None Additional Parameters Respiratory Rate Tidal Volume Tidal Volume Factor pH Shift PEEP O Consumption CO Production Factor PaCO Set point to E Ratio 1 X PetCO PaCO Factor Respiratory Gain Factor Respiratory Quotient Volume Rate Control Factor Chest Wall Compliance Factor Functional Residual Capacity Lung Compliance Factor Left Lung Compliance Factor Right Venous CO Shift Bronchial Resistance Factor Left Bronchial Resistance Factor Right Baroreceptor Maximum None None Pressure Baroreceptor Minimum Pressure Left Ventricle Contractility Factor Right Ventricle Contractility Factor Systemic Vascular Resistance Factor Venous Capacity Factor Systemic Arteries Compliance Factor Pulmonary Arteries Compliance Factor Pulmonary Vasculature Resistance Factor Venous Return Resistance Factor Baroreceptor Gain Overall Factor Baroreceptor Gain Cardiac Factor Baroreceptor Gain Peripheral Factor Chest Compression Efficacy Aortic Valve Resistance Factor Mitral Valve Resistance Factor Pulmonic Valve Resistance Factor 169 Using the System BabySIM Neurological System The BabySIM can simulate a variety of neurological clinical indicators such as blinking eyes head secretions and a bulging fontanel The Neurological View Neurological System and Clinical Signs Softw atro Man
182. 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 one of the Quick Links The condition is applied and affects the patient s physiology The Conditions button m Conditions Apnea BP Hypertension Quick Links BP Hypotension Heart Rate Bradycardila Heart Rate Tachycardia Patient Stability The Conditions Palette NOTE Quick Links can only be added while creating or editing an SCE 75 Using M se BabySIM 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 Q 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
183. ti 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 the 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 147 Using M se BabySIM 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 Poisoning 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 appe
184. tion can be found on the clinical patient monitor if one is connected to the simulator 152 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 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 153 Using TouchPro BabySIM 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
185. tive tools are accessed via the Administrative Tools buttons located on the Home page The History button The System Administration button The Account Profile 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 simulation 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 SCE Patient Simulation Events Physiological Data 2013 06 10 12 35 20 Increased Intracranial Pressure Ethan Walker 2013 06 10 10 23 41 Healthy Female Infant Rose Jackson 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 126
186. to identify its presence or absence 2 Asthe learner places the stethoscope in his ears disable the left brachial pulse on the Cardiovascular view See page 178 3 Allow the learner to auscultate the blood pressure hearing the beginning of sounds at the systolic pressure and the absence of sounds indicating the diastolic pressure 4 Next enable the left brachial pulse See page 178 Chest Compression The patient mannequin supports normal finger placement and standard compression techniques Set the mannequin on a safe and sturdy work surface when administering chest compressions 186 3 CAE Healthcare Using the System Defibrillation The BabySIM is designed to safely absorb the energy discharged from manual defibrillators 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 use of defibrillators must be followed as if the mannequin were a patient Consult the defibrillator s User Manual for further information The following cautions should be observed Defibrillation should be performed on the defibrillation electrodes only If defibrillation is performed over any ECG or pacing electrode high voltage may be present on the remaining connectors during the shock This may also damage ECG and pacing circuitry To prevent overheating do NOT provide more than three 3 defibrillator discharges
187. to the group 3 On the User Accounts tab create or edit the desired users placing each user in the Content Only group 141 Using M se BabySIM 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 i User Accounts System Settings Th e System Settings System Configuration b utton Disk Space 217 16 GB available 73 free System Time Tue Apr 16 11 34 00 GMT 0400 2013 Data Management Back Up Data Restore Data Product Licensing The System License Manager Settings Error Log panel 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 142 CAE Healthcare Using Muse 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 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 ap
188. 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 set 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 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 400 mL M7 Appendix A M se Parameter Descriptions BabySIM A 8 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
189. tor as well as Zoll biphasic defibrillators The use of other defibrillators should be certified by CAE Healthcare prior to use e Always have the Power and Communications Unit PCU power switch turned off and unplugged when replacing fuses e Always use the supplied power cords Do not substitute e Do not overdrive the Auxiliary Power Input circuit Always use DC power sources rated at 12 13 5VDC 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 g Europe e Do not spill fluids of any kind in or on any piece of BabySIM equipment e Compliance with CSA 22 2 No 1010 1 1992 and UL 61010A 1 requires the BabySIM to be used indoors e Do not attempt to disassemble the PCU or service any of the electrical components other than the changing of fuses xiii Cautions and Warnings BabySIM Fuse Replacement The recommended source for replacement fuses is Littlelfuse Replace fuses in the Power Entry Module with a 250V T 2A slow blow fuse Recommended replacement Littelfuse 218 002 series e Replace F1 with a 250V T 10A slow blow fuse Recommended replacement Littelfuse 218 010 series e Replace F2 with a 250V F 5A fast blow fuse Recommended replacement Littelfuse 217 005 series e Replace F3 with a 250V T 1A slow blow fuse Recommended replacement Littelfuse 218 001 series
190. tored via the defibrillator contacts paddles or pads Also transcutaneous pacemakers can be applied The instructor is able to adjust the levels at which electrical capture and mechanical capture occur 25 26 Clinical Features BabySIM Metabolic System Arterial blood gases ABGs including pH PaCO and PaO and venous blood gas values PvCO PvO are physiologically modeled within the system so that the results are made available on the Instructor Workstation and on the optional Wireless Remote Control The data displayed corresponds accurately and dynamically to the alveolar concentration of CO and O Metabolic acidosis and alkalosis are simulated under instructor adjustment of the pH level thus facilitating simulation of patients with diabetic ketoacidosis Bowel sounds are able to be auscultated to the left and right of the umbilicus Genitourinary System The mannequin is provided with both male and female genitalia The genitourinary system provides for excretion of urine with a flow rate that is controlled by the instructor CAE Healthcare Clinical Features Pharmacology System The BabySIM Pharmacology System facilitates the administration of IV drugs Pharmacology System Features The pharmacology module contains pre programmed pharmacokinetic and pharmacodynamic param eters for six intravenous medications Atropine Epinephrine Dopamine Fentanyl Morphine Succinylcholine The patient mannequin
191. ts agents and representatives 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
192. tton accelerates the SCE time at a 4 1 ratio 85 Using M se BabySIM 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 F Bookmark QD The SCE Time Controls To return to a bookmarked time in the SCE 1 Click the orange 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 86 CAE Healthcare Using Muse 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 The Event Recorder Button The Event Recorder appears displaying all events that have occurred since the start of the SCE Tee Event Recorder Whole Blood Infusion 17 mL hr Events Bag Valve Mask 73 FiO2 The Edit button The Save State button SaveState dit dear 7 The Clear button The Event Recorder WARNING The Clear b
193. tus Display TouchPro software or physiological monitor To change the cardiac rhythm click 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 For cardiac rhythms without a number the Heart Rate Factor parameter can be used to independently control the heart rate Default Sinus Options Asystole Atrial Fibrillation Atrial Fibrillation HR 80 Atrial Fibrillation HR 120 Atrial Flutter Atrial Flutter HR 150 Bundle Branch Block Left Bundle Branch Block Left with PVCs Bundle Branch Block Right Mobitz Type I Wenckebach Mobitz Type II Myocardial Ischemia Mild Myocardial Ischemia Moderate Myocardial Ischemia Moderate with PVCs Myocardial Ischemia Severe Normal Junctional Normal Junctional HR 50 Paroxysmal Junctional Tachycardia Paroxysmal Junctional Tachycardia HR 130 PEA Pulseless Electrical Activity Sinus Sinus Tachycardia Sinus Tachycardia HR 120 Sinus Bradycardia Sinus Bradycardia HR 40 Sinus with PAC Sinus with PVCs 1096 Sinus with PVCs 2596 ST Elevation with Chest Pain Third Degree AV Block Ventricular Fibrillation Coarse Ventricular Fibrillation Fine Ventricular Tachycardia Ventricular Tachycardia HR 151 Ventricular Tachycardia Pulseless Ventricular Tachycardia Pulseless HR 151 A 18 CAE Healthcare Appendix A M se Parameter Descriptions Arterial Cathet
194. ual adjustments for normal 3 5 mm blown 8 mm and Eye Signs Blink trol pinpoint 2 mm set vray tings See Eyes None required See Secretions Secretions l 170 9 CAE Healthcare Using the System Eyes Each pupil of the BabySIM can be set independently to a fixed diameter of 2 3 5 or 8 mm pinpoint normal or blown by carefully lifting the eyelid and rotating the eye from left to right or right to left until the proper size appears Carefully pull back the eyelid and rotate the eye Adjusting the Eyes Additionally eyelids can be programmed to open and close spontaneously or can be fixed in the closed position When closed a learner can manually open the eyelids for clinical inspection The settings for Blink Control are located on the Neurological view Auta Auta Blinking Blinking Closed 1 Closed Blink Speed Controls Choosing the Auto setting which is also the default setting sets the eyes in a blinking mode but allows the simulator to react to physiological changes that cause the eyes to close such as unresponsiveness or a comatose condition Click Blinking to force the eyes to be open and blinking regardless of patient consciousness When set in the Closed position the eyelids can remain closed but still be manually opened for clinical inspection Additionally eyelids can be programmed in scenarios to open and close spontaneously or can be fixed in th
195. uced Apnea Isabella Williams i Shock Brody Hall Vomiting Ryan Summers Page arrows Page 1 2 gt The Open Library button fe New SCE The New SCE button ik Open Library The SCE Selection Panel The SCE Selection panel has four tabs that access SCEs Running Now Recent Favorites and All 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 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 57 Using M se BabySIM To search for an installed SCE enter part of the name of an SCE in the Search field and click the Search button 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
196. uch as tension pneumothorax This capability can be accomplished automatically without intervention of the instructor The mannequin s upper chest rises and falls synchronously with the inflationary state of the underly ing lungs This movement is synchronized with inspiration and expiration of spontaneous manual and automatic ventilation of the lungs and combinations thereof The depth of chest excursion cor relates to the physiologic tidal volume displayed on the user interface The simulated patient generates both normal and abnormal breath sounds bilateral and unilateral which are appropriately synchronized with the respective phases of respiration Breath sounds are audible over the apex of each lung with the use of a standard stethoscope In the case of esophageal intubation breath sounds chest excursion and carbon dioxide output are automatically absent but the stomach distends with positive pressure ventilation attempts Pulse oximetry is fully supported The reported oxyhemoglobin saturation correlates correctly and dynamically with the alveolar oxygen concentration the patient s intrapulmonary shunt fraction and the temperature and pH of the arterial blood The saturation value can be displayed on the Instructor Workstation or on the optional Wireless Remote Control The pulmonary response to administered medications is automatic and dose dependent The physiological mathematical models continuously calculate the patient s a
197. ue slide clamp and the light blue roller clamp are in the closed position to close off the flow before filling and hanging the bag GU Source Bag Hang the bag on the IV pole Connect to the mannequin by attaching the end of the IV solution set to the orange hose in the Umbilical Assembly Open the clamp and allow fluid to flow into the mannequin There is a reservoir inside the mannequin that serves as a bladder and fills up with the fluid When the fluid begins to flow from the mannequin adjust the clamp to control the flow Measurement of urinary output can be made by weighing the simulated patient s diaper NOTE Cleanup is very important when using simulated fluids See the Care Maintenance section of this User Guide for cleanup instructions 191 192 Using the System BabySIM Pharmacology System and Fluids The BabySIM supports pharmacological interventions through pre programmed pharmacokinetic and pharmacodynamic parameters that are established for six intravenous medications A permanent access catheter is located in the left femoral vein Medications and fluids are administered through the permanent access catheter located at the left femoral vein Before using the access catheter attach an empty bag to the blue hose labeled IV drain to collect those fluids introduced through the catheter The Fluids View CAE Healthcare Using the System Anatomy Physiology M Control an
198. uously when selected from the Vocal Sounds drop down menu To stop playing a selected vocal sound select None from the list A 33 Appendix A M se Parameter Descriptions BabySIM A 34 Wireless Voice Capability A wireless microphone is available to provide phonation or a voice from the patient To use the wireless microphone attach the transmitter to a belt or pocket and snap the microphone to a lapel or shirt pocket Wireless Microphone Verify that the two antennas located on the front of the wireless receiver on the PCU are extended and that the transmitter has been set to the same channel as the receiver on the PCU the default setting Switch the receiver and the microphone to the ON position There are two ways to adjust the Wireless Microphone volume Adjust the volume using the volume setting on the receiver on the PCU or with the Vocal Sounds volume on the software For more information on the Vocal Sounds menu please see page A 33 The receiver and transmitter are factory configured to the same channel However if they need to be reset e g when multiple simulators are in use adjust the frequencies using the Group and Channel settings on the microphone and receiver with a small screwdriver These settings must be identical Detailed instructions are shipped with the microphone The wireless microphone transmits over user selectable frequencies of between 790 and 806 MHz at 10 mW a range legally appropriate f
199. ures the complexities of human physiology with heart and breath sounds palpable pulses and a myriad of other features that mirror a true and accurate representation of the human body The intuitive design of the BabySIM and the realistic physiological models make it easy for instructors as well as learners to use the system The educational value of the BabySIM is summed up in the fact that critical care interventions such as infant CPR airway management medication administration and defibrillation to name a few can be applied to the simulator better preparing healthcare professionals for critical events involving infants With the flexibility of using preprogrammed or user initiated Simulated Clinical Experiences or SCEs instructors can create real life drama to help hone and perfect the skills of their learners Introduction BabySIM Equipment Overview The BabySIM has been designed to be used in any learning environment The BabySIM s standard features are easily integrated into a laboratory setting where the BabySIM can be operated using controlled central air gas supply sources and regular AC power However because the portability of the BabySIM allows for its use in offsite locations an optional Air Compressor and an optional Auxiliary Power Supply are available for those areas that do not have a central air gas supply or an electrical power source Components Inventory The BabySIM comes with all the necessary equipment for est
200. ustomer 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 Phone 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 CAE Healthcare Care Maintenance 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 remedi
201. ut adjustable VIEW Respiratory PARAMETERS Multiple VIEW Respiratory PARAMETER S Bronchial Occlusion None required The instructor must adjust the amount of physiologic intrapleural fluid present VIEW Respiratory PARAMETER S Intrapleural Volume The presence or absence of exhaled CO can be None required CO source required measured Closes vocal cords and prevents intubation and ventilation Decompression of a pneumothorax can be per formed by inserting a needle at the midclavicular line of the second intercostal space on the right Oxyhemoglobin saturation SpO automatically correlates with the oxygen concentration in the lungs and the intrapulmonary shunt fraction Direct laryngoscopy oral and nasal intubation and specialty airway devices e g endotracheal tubes combitubes and oropharyngeal airways Normal tidal breathing and pathophysiological conditions such as atelectasis pneumothorax and asthma Tracheal pathophysiologic conditions such as pneumothorax PvO and PvCO are continuously calculated and displayed on the Patient Status Display and the TouchPro software Esophageal intubation results in gastric disten tion and the absence of breath sounds chest excursion and CO output VIEW Respiratory PARAMETER S Laryngospasm The instructor must adjust the amount of physiologic intrapleural air present VIEW Respiratory PARAMETER S Needle Decompression See Needle D
202. utton deletes all recorded events This action cannot be undone 87 Using M se BabySIM 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 T Event Recorder Whole Blood d 17 ind Event Delete buttons Bag Valve Mask 73 FiO2 The Done ESSE RI The Save State button h Save State Done The Event Recorder 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 Mew State Marne 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 123 88 CAE Healthcare Using Muse 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
203. uttons 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 109 Using M se BabySIM Scenario Designer 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 110 CAE Healthcare Using M se Click the Line Item view button to utilize the Line Item view The Expand Collapse arrow An expanded state M 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 111 Using M se BabySIM Adding Scenario States When beginning to create a new scenario the canvas is blank
204. yed 104 CAE Healthcare Using Muse Adding a Scenario from the SCE Editor SCEs incorporate scenarios that contain preprogrammed 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 107 105 Using M se BabySIM Developing Scenarios
205. ys dongles or other devices 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

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