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Pediatric HAL User Guide

1. A hr min sec Precise oF of of hi p Approximate very quick lt 5m 3 Type the name of the new medication e g Generic Name Brand Name and enter the medication s description and the dosage information az Add New Medication 1 New Medication Naloxone Narcan i 2 Description L Used as a narcotic antagonist for opioid effect Ay reversal Note Second dose may be administered 5 minutes later 4 Y ug El ug kg C mg kg C g C g kg 4 Route TV Push IV Infusion IM SubQ Topical Per Oral Inhalation 5 Half Life hr sec 74 Pediatric HAL S3004 User Guide 5 Enter the drug s Half Life and Peak time ESE LJ Te Von ET Mmaa 5 Half Life hr min sec 6 Peak Time hr min sec Precise Pinar ail AAA 6 Enter half maximal effective concentration EC50 0001 mg dl m Concentration that produces 50 of the maximum effect Available Palettes Apply Items Threshold ug X rca nl 7 Select the standard dose SD effect palette created earlier and then click the applicable dosage button to assign it to the threshold Repeat this step to assign the over dose OD effect palette to the Over Dose threshold Ecso 0001 mg dl Concentration that produces 50 of the maximum effect Available Pa
2. an ea darian Wait indefinitely for ween and high doce pressor infusion to treat Epinephrine hypotension Pediatric HAL S3005 User Guide 157 Pediatric HAL One Year Cardiac Scenario Gaumard eee Sinus Tachycardia and Hypertension yz LY OETA TNT Methamphetamine Ingestion ee A young mother brings her baby to the ED She says her baby was crawling on the floor and af something in his mouth and swallowed it about an hour ago You notice the mother is thin jittery with open sores on her face and arms You consider the ingestion may be a stimulate No cooling blanket fluids or Diazepam Cooling blanket Perform actions fluids or Diazepam Treat hypertensive urgency with IV Enalaprilat Vasotec and wait 15 minutes Wait 15 minutes for BP to drop further 158 Pediatric HAL S3004 User Guide Pediatric HAL One Year Cardiac Scenario Gaumard Simulators for Health Care Education Congenital Heart Failure A one year old boy is transferred to your facility with a history of weakness and seizures despite therapeutic levels of anticonvulsants Normal CT Scan spinal fluid and electrolytes 30 second wait e dads Sulfate Pediatric HAL S3005 User Guide 159 Gaumard Pediatric HAL One Year Systemic Scenario Simul
3. CIRCULATION Temperature 99 5 F x ae CIRCULATION 99 5 F UTERUS HEM Hemorrhage 2 o ee A Uterine Pressure Temperature Sn 7 UA FHR Contraction Frequency f Contraction Duration E UTERUS HEM A off i Uterine Pressure 0 Bj In cor Hemorrhage Contraction Frequency 5 Contraction Duration 40 Contraction Intensity 40 FHR Baseline 140 Variability minimal Periodic Changes none Variable Changes none Pediatric HAL S3005 User Guide 21 In the List View the vital signs controls are divided into separate categories Click through the categories to view the controls available for the current simulator configuration Lung Sounds vol Right Left Enable the instant apply option and click the control to change the vital sign to a new value Vital signs undergoing change blink yellow CEPHALIC LA aoe 22 Pediatric HAL S3004 User Guide The Body View mode displays an interactive model of the simulator The model is a representation of the simulator and its internal organs The floating control boxes are used to monitor and change the vital signs just like in the List View mode STATUS DETAILS UTERUS HEM Hemorrhage List View Use the Body View
4. No changes are made to manikin 04 00 wheezing difficulty exhaling tongue edema respiratory allergy Closed airway 00 00 all difficult airway actuators on Wait Indefinitely ae drug therapy expected Healthy Resting 02 00 normal vitals Wait palette items Progress indicator During the scenario each vital signs palette updates the patient s vital signs The palette s transition time trends the increase or decrease of numerical parameters e g Heart rate blood pressure over seconds or minutes In the figure below for example the vital signs palette Healthy Resting is programmed with a transition time of 2 minutes When the scenario reaches Healthy Resting it will take 2 minutes for the vital signs to trend from the previous state to the values programmed within the palette Name Transition Description Wait 00 20 No changes are made to manikin respiratory alleray 04 00 wheezing difficulty exhaling tongue edema Closed airway 00 00 all difficult airway actuators on Wait Indefinitely oa drug therapy expected Healthy Resting 02 00 normal vitals Wait palettes do not update or change vital signs Instead wait palettes give the participant time to perform an action this may be treatment in response to a complication or performing a standard assessment Pediatric HAL S3005 User Guide 39 Scenarios are controlled using the playback buttons at the bottom of the tab Intui
5. Mox Add Palette Item Transition min sec 0El oF 59 59 Max Item Description Initial condition all vital signs are specifi cD dy View The first palette is now added Click Add Palette to Scenario button again to add more vital sign palettes and wait palette items Print n ri Add Ite Scena n to 10 42 Pediatric HAL S3004 User Guide A Wait item maintains vital signs values steady for the transition time allotted Insert a wait item to give the provider time to perform an action or an assessment For example auscultating blood pressure or gathering general information about the patient Alternatively add Wait Indefinitely to hold the vital signs until the next item button is clicked from the playback controls Transition min sec Ae 0 WS 08 y 59 59 Max No changes are made to manikin gt initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin Deteriorating 00 30 Vital signs deteriorate 20 over 30 seconds Add Item to Scenario SELECTED ITEM eo Initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin O Send Lab Lab 1 00 00 l Move Deteriorating 00 30 Vital signs deteriorate 20
6. Airway cleared Yes successfully Holding state for secondary treatment options No changes to vitals 2 min timeout Secondary Treatment Tracheostomy Options Racemic Epi IV or lO Epi O2 delivery 132 Pediatric HAL S3004 User Guide O m _ Gaumard Pediatric HAL Five Year Respiratory Scenario Simudatora foe Healih Care Education Epiglottitis y i 2 A five year old girl was recently adopted from another country Her immunization status is in question and her parents had planned to have her immunized soon Two weeks after her arrival in the United States she developed a high fever of 40 Deg C and has difficulty in swallowing Her voice became weak and she had coarse stridor with every breath Her parents tried treating her for croup with some cool mist as they had their other children but she showed no improvement Her parents then brought her to the E D Intubation with 02 Intubation or cryco Fluid bolus Dopamine drip Antibiotics IV Antibiotics Corticosteroids Yes Yes Pediatric HAL S3005 User Guide 133 m Gaunrard Pediatric HAL Five Year Trauma Scenario smulators for Health Care Education Chest Injury A five year old boy was racing his BMX bike over a dirt hill in his back yard He had his helmet on but
7. Edit Delete Preview Send to monitor h 3 An exclamation icon notifies the provider a file is ready for access on the Gaumard Monitors Instruct the participant to click the patient menu drop down and select the lab report Noelle db hal Ask for 58 Pediatric HAL S3004 User Guide 4 The lab report opens using the system s default application E l a t l ese Home View Lab 01 Report Time Description Above normal range Cholesterol LDL Cholesterol Variable Normal Range HDL Cholesterol mg dL 35 00 85 00 Cholesterold HDL Ratio 0 00 4 40 5 10 Care required Variable Normal Range HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Variable Normal Range Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 Triglycerides mg dL 30 00 200 00 5 The letter Y represents a shared document Click the Stop Sharing button on the right panel to remove the lab report items from the Gaumard Monitors menu Create New L Report An editable copy of the lab report is stored inside the Gaumard_Ul folder on the computer s home screen Go to page 109 for information on how to access other files from the Gaumard Monitor screen Pediatric HAL S3005 User Guide 59 Build new lab templates to supplement new scenarios To create a new laboratory test template 1 Navigate to the bottom of the tab and click New Template
8. New Template The Edit Lab Results Template window is displayed a Edit Lab Results Template TES 2 Enter a name for the new template followed by a description as Edit Lab Results Template Name Lipid Panel Description Cholesterol HDL LDL redeem IV AA Delete I 3 Create categories to group a series of tests in a lab report Click Add to create a new category Cholesterol HDL LDL Triglycerides Category Single Entry Description 4 Enter the name of the category and click OK EAS Oe se a AA a Category Name Lipid Panel Female 60 Pediatric HAL S3004 User Guide 5 Click add on the Single Entry menu to create a new test under the current category Single Entry a posea prea af Jrs A A 6 Enter the name of the test the unit and decimal precision f Add Insert Entry Name HDL Cholesterol Unit mg dL Precision MA NORMAL RANGE i im AAA 7 Enter a Normal Range the provider to reference The normal range is visible on the lab report The Allowed Range restricts the minimum and maximum value that can be entered a test result Click OK to add the new test j Add Insert Entry Name HDL Cholesterol Unit mg dL Precision NORMAL RANGE Minimum 35 00 Maximum 85
9. Ventilation rate in real time e PIP approx Peak Inspiratory Pressure e Ti Time Inspiration e l E Inspiratory Expiratory Ratio e PEEP approx Positive end expiratory pressure e LV Last Ventilation Time elapsed since the last ventilation performed The CPR trainer reference boxes generate a visual prompt of the compression to ventilation ratio programmed in the CPR Options menu Click the Trainer button to start The V ventilations and C compressions box borders blink to indicate the correct reference CPR rate By default the CPR trainer is configured to blink the reference borders ata 30 2 compression to ventilation ratio To change the ratio navigate to the menu bar and click the CPR dropdown and CPR Options Options Hal Add Ons Add Ons CPR Options Pacing shock Tolerances Log Other a ventilations and Compressions Environment General CA Pulses 100 Compressions per minute Compression Ventilation Ratio 30 2 Only Ventilations 12 Ventilations per minute Compressions are too shallow Waveforms mostly do not reach the green zone Compression indicator is yellow Compressions are too deep Waveforms mostly exceed the green zone Compression indicator Is red Compressions are performed correctly Waveform peaks are mostly inside the green zone Ventilations are too shallow Waveform peaks do not reach the green zon
10. _ IMPROVE adequate oxygen perfusion breathing R ii gt DETERIORATE compromised oxygen perfusion apnea Oxygen EE 3 fmin Epinephrine 0 1 mg Add TTT Model rate 3 x hi Hehi a estat Cronos covere Conocio Reset 4 es ain H ERE eee VENTILATION ss LOW Approx 3 CIRCULATION BP 45 25mmHg x HYPOXIA MODEL Oxygen turned off Temperature 37 5 C HYPOXIA MODEL Oxygen 1 L min HYPOXIA MODEL Oxygen 2 L min HYPOXIA MODEL Oxygen 3 L min ae 1 List View The hypoxia model options improve or deteriorate the cardiac and respiratory vital signs gradually e Pause Model will pause at the current state e Improve Trend the vital signs to a healthy state e Deteriorate Trend the vital signs to a severe cyanotic state Ventilations are detected when the respiratory rate is at 0 Select the cyanosis level to move to any of the following states immediately e Healthy Pedi is pink with adequate oxygenation e Mild Cyanosis Pedi is slightly blue and the vital signs are starting to deteriorate e Severe Cyanosis Pedi is blue apneic and vital signs are rapidly worsening The modeled therapy menu provides additional intervention options e Improve Gain Adjust the slider to increase or decrease the cyanotic response to ventilations e Oxygen
11. feature and the entes virtual shock panel Options The environment tab is used to configure the Noelle Features CPR Options Pacing Shock connectivity options Select the GENERIC Tolerances Log Other option to scan and connect to the nearest Environment Noelle Add Ons simulator Alternatively select the FIXED option and enter the simulator s serial number gt to connect to a specific simulator only The Enable Log Auto Save FIXED mode is required to enter activation Auto save every code for upgrade features Session Timer Reset session timer once scenario is started Electrical therapy Panel Pediatric Features CPR Options Padng Sshock Tolerances Log Other Show defibrillation cardioversion pacer panel General Pediatric Add Ons Stand by warning Warn the first time trying to apply settings when system is on Stand By mode International System SI Imperial a GENERIC Find and establish a connection with Pediatric Please switch to FIXED once connected FIXED The software will enable controls for features available on your simulator FIXED Pediatric Setup Enter the Serial Number from the Pediatric simulator that THIS computer will control SN on RF Module P 8505004 Can t find Serial Number i Click the lightning icon to open the PAA PAG aa a T C Check noise in channel as Shock Pace Panel Virtual Shock MA 102 Pediatric HAL S3004 Use
12. 1 Place the all in one PC within line of sight of the controlling computer 2 Connect the power supply to the PC and to the wall outlet 3 Connect the USB keyboard and mouse receiver to the PC 4 Turn on the computer VIRTUAL MONITOR WIRELESS CONNECTIVITY The control PC and the all in one virtual monitor PC establish a wireless link at startup automatically The wireless connection allows the Gaumard control software to transmit the vital signs information to the Gaumard Monitors software To verify the wireless link between the two computers click the wireless icon located on the task tray The wireless network name is configured at the factory and may differ from the one seen below To troubleshoot connection issues between the virtual monitor computer and the controlling tablet please go to page 162 Currently connected to Ez Unidentified network No Internet access Wireless Network Connection 2 A Connected A h gaumard ki GaumardNet Other Network al Open Network and Sharing Center eto Go a 4 254 PM After the wireless connection is established double click or tap the Gaumard Monitors icon to start the vital signs software The Gaumard Monitors software is now ready to receive the vital signs information generated by the GIGA control software 12 10 29 For more information about the Gaumard Monitors software please refer to the Gaumard Monitors user guide Pediatric H
13. REC Output Gain DESCRIPTION ARA i 66 Pediatric HAL S3004 User Guide Medication Auto Mode The Medication tab is exclusive to the automatic operating mode Use the medication controls to simulate the physiological effects and reactions of medications administered to the patient model To simulate the effects of a medication the GIGA software processes the drug s properties dosage and interactions and then adjusts the patient vital signs accordingly The Meds Profile includes a library of preprogrammed drugs The built in drug editor allows facilitators to stay current with new medications or make changes to the properties of the existing drugs All of the preprogrammed drugs included in the Med Profile library are found in the 2008 Handbook of Emergency Cardiovascular Care published by the American Heart Association MEDICATION Dug o Dose Units Route Rate mg Alteplase Activase tPA mg DVinfusion gt p Drug Properties Description Half Life 00 25 00 Peak Time 00 08 00 ECS50 0 031mg dl Manages acute coronary syndrome and reduces the incidence Standard Dose Alteplase 5D 40mg of congestive heart failure It can also be used to treat massive _ Over Dose Alteplase OD 150mg Stop Infusion Remove from list Change Dose and or Rate Rate l Fluids 4 Gas Saline Volume ml Rate ml min t Start IV Oxygen Cannula Concentration Rate L min Start 02 5 VIRTUAL FETAL M
14. User Guide Pediatric HAL Five Year Cardiac Scenario Gaumard Cardiac Ischemia o Carbon Monoxide Poisoning la During the ride home from a family camping trip a five year old boy falls asleep in the back of his parents truck camper The night was cold so the heater in the cab was turned on When they returned home he seemed confused couldn t walk and complained of a headache and vomited His parents bring him to the ED and are worried about meningitis 100 O2 delivered via non rebreather mask Yes y Wait 15 minutes Pediatric HAL S3005 User Guide 141 Pediatric HAL Five Year Cardiac Scenario Gaumard Cardiac Tamponade ES Obstructive Shock Pulseless Arrest A five year old boy has a gunshot wound to his chest The family has called 911 but has not begun CPR You are the first responder with your emergency team The boy is unresponsive with an entry wound near his heart The family said he was crying a few minutes ago 142 Pediatric HAL S3004 User Guide i Pediatric HAL Five Year Cardiac Scenario Gaumard f Simulators for Health Care Education Supraventricular Tachycardia A previously healthy boy is brought to the ED According to his dad he has been acting tired and passed out today He said he feels dizzy and his heart jumps O2 Delivered Holding state for ini
15. peed since yesterday Last week he had some bloody diarrhea and has been vomiting for two days but they were on vacation so they didn t see a doctor Calcium Chloride IV 20mg kg 138 Pediatric HAL S3004 User Guide r Or i f Gaumard Pediatric HAL Five Year Cardiac Scenario Simulators for Health Care Education Soccer Boy with SVT A previously healthy boy is brought to the ED because his mother says he has been acting tired and passed out while playing soccer today He said his chest hurts and his heart jumps Administer O2 adenosine rapid bolus IV and perform vagal maneuvers Adenosine given No adenosine Pediatric HAL S3005 User Guide 139 i i O m i i Cammnard Pediatric HAL Five Year Cardiac Scenario Simulators for Health Care Education Cardiac Arrest While watching a baseball game a five year old boy was hit by a high velocity foul ball in the chest He immediately falls to the ground and cries I m hurt As you approach he becomes unresponsive You access the ABC s and find him to be pulse less and not breathing You call for an EMT and report a cardiac arrest Yes Shock effective oo Wait indefinitely for additional shock Wait indefinitely for Epi via ET Tube 140 Pediatric HAL S3004
16. On the GIGA menu bar click Monitors gt Configuration The HAL Virtual Monitor Setup window is displayed Set the adapter to Wireless network connection and click Connect to begin transmitting the vital signs information Write down the controller IP and Port number Start the Gaumard Monitors software on the virtual monitor PC Click the V menu near the top left corner and then select Comm Setup The TCP Comm Setup window is displayed Enter the Controller IP and Port number displayed on the GIGA Virtual Monitor Setup window Click Connect to accept the incoming connection Pediatric HAL S3005 User Guide 167 Spare Parts List Contact Gaumard Scientific for a complete list of consumables and replacement parts and their prices S3005 001 A C Virtual Monitor A A C Powered 17 Touch Screen monitor and desktop S3005 002 D C Virtual Monitor D C Powered 12 Touch Screen Mobile Monitor with stylus ssroson Banery Crerar A 100240 V AC batery otargerwaim iaoe CN ewro a o 3005 053L D Upper LEFT Arm M Dark color upper left arm assembly with tethered BP with adaptor S3005 053R L Upper RIGHT Arm M Light color upper right arm assembly with tethered BP with adaptor S3005 081 Silicone Oil Oil based silicone lubricant S3005 200 Audio amp Video A Recording System S3005 206 RF Module Roo Radio Frequency Module with USB connector S3005 2
17. Please reference the troubleshooting guide for information on how to resolve battery issues USING THE POWER SUPPLY HAL 1 YEAR The power supply adapter allows the simulator to operate through long simulations sessions by drawing power from the wall outlet and not battery reserve Use the power supply for simulation sessions lasting 2 hours or more If simulation sessions are shorter than 2 hours using the simulator s battery reserve is recommended The power supply adapter will not re charge the battery Avoid using the power supply adapter if the simulator s battery is completely depleted To operate the simulator from wall power using the power adapter 1 Fully recharge the simulator s battery using the Battery Charger adapter 2 Disconnect the Charger and connect the Power Supply adapter 3 Activate the GIGA software The GIGA battery icon will display a lightning icon while the power supply is connected Please contact Gaumard for information on the power supply upgrade for earlier Pediatric HAL models HAL 5 year is equipped with an internal battery that allows the simulator to operate while untethered To charge the battery connect the HAL 5 year charger adapter to the battery port located on the simulator s right side The HAL 5 year charger can recharge the battery while the simulator is operating Battery charge time is approximat
18. Select Auto change to channel or an RF radiator number from 1 11 GaumardUl has set the The battery on the manikin is Plug charger for all others including power mode to STAND depleted BY automatically RF module not connected Connect the RF module to any USB port RF module nat identified by the Close the software and try disconnecting the computer RF module for at least five seconds then plug it back in and restart the software RF module not found message is displayed when GaumardUl is started Chest compressions are not properly detected or not detected at all Is the communication indicator See solution above in section making panel consistently yellow reference to blinking communication indicator is consistently yellow Is the respiratory rate set to 0 Set respiration rate to zero min Chest compressions are only detected when the respiratory rate is set to O per minute 0 min Otherwise they are ignored All others See Calibration Wizard section inside User s Manual Artificial ventilations are not properly detected or not detected at all Is the communication indicator See solution above in section making panel consistently yellow reference to blinking communication indicator is consistently yellow All others See Calibration Wizard section inside User s Manual Simulator not running In some simulators the trachea is disconnected from the lungs wh
19. So weak 64 Pediatric HAL S3004 User Guide Voice clarity can be affected by several factors To improve audio for the listen and talk options please review the following information e Connect the headset to the computer before activating the Gaumard control software e Connect to the simulator using the strongest channel Assign separate channels to each simulator if working with multiple simulators at a time e Adjust the physical mic control attached to the headset cable e Adjust the streaming voice Output Gain To raise the output gain in increments tap and hold the control then slide to the desired level Higher gain levels increase the talk volume but degrade the audio quality e Fine tune the Windows microphone settings Create a library of custom recordings to play back as the simulator s voice using the Prerecorded Speech feature Prerecorded Speech PRERECORDED Ayudame por favor COMPLAINT CONFUSION DESCRIPTION EFFECT I love this hospital To record a new custom phrase 1 Click the Rec button and speak into the microphone OPTIONS 2 Press Stop to finish recording gt Voice Recorder US Pediatric HAL S3005 User Guide 65 3 Entera name and click OK Enter Audio Name Thank you simulation team 4 Voice Recorder simulation team hs
20. The GIGA control elements and scenario programming procedures are consistent throughout the Gaumard family of high fidelity simulators Some software controls and features covered in this guide may be hidden depending on the simulator s hardware configuration and optional upgrades aa GIGA Noelle 574 575 576 Q8505004 DEFAULT PROFILE For use only in North South America VIRTUAL MONITOR E CEPHALIC A Eye State dosed E BREATHING owe UTERUS HEM ML RR 13bpm x Hemorrhage Off CARDIAC 4 7 n ui pl 3 Eke Sinus Cont cd req HR 70bpm Con e aci n i Dur ais a de Contraction Intensity 40 FHR Baseline S y CIRCULATION A 10 16 57 i Variability minimal e ay 02 09 2013 eriodic Changes none m D Temperature aa ae VIRTUAL MONITOR a E OME Terie A MN MES cor ME Tol E vores Variable Changes Ail 00 00 47 P Connection Status The communication indicator displays the status of the radio link between the tablets USB RF module and the simulator Full bars indicate excellent communication i e normal operation Battery Indicator The battery indicator displays the battery charge information An exclamation sign is shown when there is no communication with the simulator and battery information cannot be retrieved co ca The simulator is set to STAND BY mode automatically when the battery is depleted The simulator wi
21. Upon receiving authorization from Gaumard send the Gaumard product along with copies of 1 the original bill of sale or receipt and 2 this limited warranty document to Gaumard at 14700 SW 136 Street Miami FL 33196 5691 USA 3 Ifthe necessary repairs to the Gaumard product are covered by this limited warranty then the first purchaser will pay only the incidental expenses associated with the repair including any shipping handling and related costs for sending the product to Gaumard and for sending the product back to the first purchaser However if the repairs are not covered by this limited warranty then the first purchaser will be liable for all repair costs in addition to costs of shipping and handling In addition to the standard one year of coverage the following support plans are available e Two Year Extension covers second and third years Call for pricing USA only 170 Pediatric HAL S3004 User Guide Contact On the web www Gaumard com Technical Support support gaumard com Sales and Customer Service sales gaumard com Phone Toll free in the USA 800 882 6655 Worldwide 01 305 971 3790 Fax 305 667 6085 Before contacting Tech Support you must 1 Have the simulator s Serial Number located in the left leg under the IM site 2 Be next to the simulator if troubleshooting is needed Gaumard Scientific 14700 SW 136 Street Miami FL 33196 5691 USA Office hours Monday Friday 8 30am 4 30pm E
22. f beating a Right chest rise On E 15 6 gl Left chest rise On Pneumothorax Off Pneumo Right Off Pneumo Left Off ade Luna Camninnen o Anl 82 Pediatric HAL S3004 User Guide Enter notes into the add to log field to record notes manually The information is categorized in the log as NOTE eo eo E e e Eno NE PROVIDER ACTIONS Log 00 01 01 NOTE The team is ready to start Additional providers joined e Team o N 990 The log event time stamps reference the GIGA session clock At the start of a new simulation exercise click File gt New Session to reset the session clock 00 00 00 reset any vital parameters settings and clear all the event entries Profile Setup Reset Session Clock Monitors View Help Save Report Print Report Import Export Exit The log information is recorded in a rich text format Export the log information to save a detailed history of the events that occurred during the session To save the session log report as a text file 1 Click FILE gt Save report 2 Entera name for the report 3 Select the desired name and path and click Save Pediatric HAL S3005 User Guide 83 Provider Actions Use the Provider Actions tab to track actions performed by the provider manually Each option on the Provider menu generates a time stamped entry in the text log below PROWIDER ACTIONS PROVIDERS 12 j Brea
23. page range For example 5 12 It is recommended that documents be first saved as XPS files before being printed into hard copies 92 Pediatric HAL S3004 User Guide Create new evaluation templates for new scenarios using the edit mode To enter the edit mode toggle the Go To button located on the top right of the evaluation form window Enter a name for the new evaluation template in the Evaluation Name field as Evaluation Form Loadtemplate Save Clear Delete Evaluation Name Shoulder Dystocial I On Site Reviewer F Add dl lortemoverl liinsert al lo A vw J lada al kepelet liethser Click Add on the Category menu Evaluation Name Shoulder Dystocial On Site Reviewer Select the category type and enter the category title Click OK to save Category Options 1 Select Category Type Question with answer region Multiple choice Yes No Multiple choice Disagree Neither Agree or Disagree Agree Multiple choice Unacceptable Poor Average Good Perfect The new category is now created Un Site Reviewer Multiple Choice Entry 1 Yes No N A Pediatric HAL S3005 User Guide 93 Highlight the new category and then click Add on the Multiple Choice Entry menu SN Multiple Choice Entry 1 non Delete Insert ran DA Yes No N A Type the evaluation statement in the new multiple choice
24. x S IO c Irritability L CIRCULATION ows Temperature PH Level 7 39 A a UTERUS HEM A e 4 Increase the Rate factor to speed up the effect of a medication on the patient model pndjorrate Rate 65 E je ag a z ml min t Start IV 1 z L min i Start 024 Administer Oug kg 0 00 sd 1 01 36 24 Unselect Current Effect EC ETA Effect Off Over Dose Select from the following options e Unselect Unselect a highlighted drug e Current Effects View the effect on the patient s vital signs e All effects View all the available programmed drug effects for this medication e Drug effect toggle Turn the drug effects on the patient model on or off 70 Pediatric HAL S3004 User Guide Drugs cannot be removed from the list during the administration process with the exception of IV infusions To stop an IV infusion before it is finished highlight the medication from the list and click stop Remove from list Change Dose and or Ri Fluids amp Saline Volume ml Rate After the dose administration is complete select the drug and click Remove from list Restart il Change Dose and or Rate Rate 80 Fluids amp Gas Saline y Volume ml Rate o ml min To remove all the medications from the list and reset the effects on the pa
25. 00 ALLOWED RANGE Minimum Maximum Pediatric HAL S3005 User Guide 61 8 Repeat the process to add more tests and categories Click Save to create the new lab template as Edit Lab Results Template Name Lipid Panel Description Cholesterol HDL LDL Triglycerides on P asa gf remove prenane fonr A EA aea poe e p Aa E T Lipid Panel Female Variable Normal Range HDL Cholesterol mg dL 35 00 85 00 Cholesterold HDL Ratio 0 00 4 40 Normal Range HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Lipid Panel Both Variable Normal Range Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 Triglycerides mg dL 30 00 200 00 Allowed value range is displayed in Value column It won t be visible when entering data The new template is listed on the Lab Template section at the bottom of the Lab tab Use the buttons on the left panel to edit or delete lab templates Lab Template New Template ssessment of patient s conscious state 3 15 Edit Blood Test Male red blood cell white blood cell coagulation Cholesterol HDL LDL Ti ap ii Anion Gap Albumin Alkaline Phos Calcium Choride 62 Pediatric HAL S3004 User Guide Select the Speech tab to command the simulator to speak aloud The collection of speech and other sounds covers a wide r
26. 85 degrees Fahrenheit 29 Celsius will cause the simulator to soften and slowly warp It is acceptable to operate NOELLE at an ambient temperature of 95 degrees Fahrenheit 35 Celsius Do not store the simulator with a discharged battery Re charge the backup battery at the end of every simulation session In addition recharge the battery at least once every 30 days even if the simulator is not in use otherwise permanent loss of capacity might occur because of self discharge Do not allow any objects to rest on the face or chest skin or store the simulator face down Pressure points on the face and chest skin may warp or damage the skin Clean the simulator with a cloth dampened with diluted liquid dishwashing soap If medical adhesives remain on the skin clean with alcohol wipes Do not use citric acid cleaners anywhere on the simulator Doing so will cause pitting of the various materials comprising your simulator The simulator is splash proof but not waterproof Do not submerge or allow water to enter the interior of the simulator Do not expose the tablet computer to water or excessive dust Always purge and drain the internal fluid reservoirs and vein reservoirs at the end of the simulation session Doing so will prevent molding or clogging Defibrillation ECG Defibrillation is allowed only on the large sternum and apex sites Do not deliver a shock to ECG electrode sites on the shoulders or waist Fo
27. Actions Vv OK 4 feCancel m 3 Enter the name of the action and select the type of action aa Airway Custom Log Button 1 Action Ventilate 2 Action type Descriptive Action Responsive Action 3 Descriptive Actions Pediatric HAL S3005 User Guide 87 4 Enter a description for the possible action and click to add Repeat the process to add several actions as Airway Custom Log Button 1 Action Ventilate 5 Click OK to save Breathing transport ventilator mechanical ventilator Use correct hand CPAP BIPAP 88 Pediatric HAL S3004 User Guide Evaluation Form The evaluation tool assists facilitators in reporting and assessing provider interaction using a questionnaire form A completed evaluation form can then be stored as a digital document or printed for distribution ass Evaluation Form Load template Breech Vaginal Delivery Clear Print Go To Edit Mode Evaluation Name Breech Vaginal Delivery On site Reviewer James Date 01 30 2013 Providers nurse or doctor request pediatrics Providers nurse or doctor suggest moving to OR www El l X Provider allows breech to deliver to umbilicus with maternal pushing and does not pull Several preprogrammed evaluation templates included in the GIGA software E
28. Adjust the slider to administer oxygen to the fetus in liters per minute e Epinephrine Administer epinephrine to the model Set the epinephrine dose and then click add Administering epinephrine increases the heart rate e Reset Click Reset to clear the oxygen flow and the epinephrine dose onboard 54 Pediatric HAL S3004 User Guide Lab Use the Lab tab to create mock laboratory tests results to aid the participants during simulation In addition create new laboratory templates to supplement different types of scenarios Once a laboratory report is created send the file to the virtual monitor screen for the provider access during the exercise LAB Lab Report Edit Delete Preview Send to monitor Lab Template Platelets Differential assessment of patient s conscious state 3 15 Blood Test Male red blood cell white blood cell coagulation Cholesterol HDL LDL Triglycerides Anion Gap Albumin Alkaline Phos Calcium Choride To create a new lab report with mock test results 1 Click Create a New Lab Report on the right panel Create New Lab Report Sort by Color The Edit Lab Report window is displayed Edit Lab Report Lab Template CBC Differential y Clear Save 4 Cancel Pediatric HAL S3005 User Guide 55 2 Selecta Lab Template from the drop down menu Edit Lab Re
29. PALETTE SCENARIO BRANCH LABOR AB Y PROVIDE Pediatric HAL S3005 User Guide 67 Follow this guide to administer a medication directly from the medication tab If the simulator is equipped with a Drug Recognition Arm reference the directions for use guide for information on how to administer medications using the tagged syringes To administer a medication from the Medication tab 1 Select the medication from the Drug drop down menu MEDICATION Drug Calcium Gluconate a Captopril Capoten Carboprost hemabate Clopidogrel Plavix Dexamethasone Decadron Diazepam Valium Digoxin Lanoxin Digitek Digoxin ImmuneFab Digibind Diltiazem Cardizem Dinoprostone Prostaglandin E2 PGE Dobutamine Dobutrex Dopamine Intropin Enalapril Enalaprilat Enalapril Vasotec Ephedrine Epinephrine Primatene Adrenalin Eptifibatide Integrilin Esmolol Brevibloc Flumazenil i Furosemide Lasix Glucagon Glucagen Heparin LMW Enoxaparin Lovenox Heparin UFH Hydralazine Apresoline m Change Dose and or Rate A brief description is displayed at the top of the window The half life peak time and drug concentration values are listed in addition to the standard and over dose dosage MEDICATION Drug Dose Furosemide Lasix y mg IVPush m Administer Drug Properties Description Half Life 00 30 00 Peak Time 00 45 00 EC50 2 64mg dl Diuret
30. Restart the computer 2 Select the Wireless Network Adapter LS ee ee E If the wireless adapter is not listed first enable the adapter using the Windows network menu and then return to this window Description GAUMARD MONITORS NETWORK Controller Create Ad Hoc Wireless Network CO N E G U R ATIO N After the GIGA control computer is 1 Select Wireless Network Adapter 2 configured complete the next steps using the Create an ad hoc network tool included Wireless Network Adapter in Gaumard Monitors software 1 On the virtual monitor computer click the Gaumard Monitors icon to start the vital signs software 2 Wireless Network Name lp GaumardNet o 2 Click the V menu near the top left corner 3 Controller IP 2 and select Create Ad Hoc Network 10 711 1 ct 1 1200 Apply Wireless Network Settings 4 Pediatric HAL S3005 User Guide 165 Monitor Selection Comm setup Performance Keyboard Toggle Cursor Remote Access V a Network Check for Updates Help About Exit The Virtual Monitor Create ad hoc Wireless Network window is displayed 3 Select Wireless Network Adapter If the wireless adapter is not listed first enable the adapter using the Windows network menu and then return to this window 3 mmj Virtual Monitor Create Ad Hoc Wire ess Network x l Create Ad Hoc Wirele
31. Writer t Status Print to file Location Comment Find Printer Page Range Al Number of copies 1 H Selection Curent Page Pages Collate ia Aa 90 Pediatric HAL S3004 User Guide Enter a name for the evaluation and click Save e gt d Documents Evaluations v Search Evaluations p Organize v New folder Fr Favorites Documents library Arrange by Folder Evaluations A Libraries Documents al Music E Pictures F Videos r Eclamptic Seizure Session 3 xps k Computer vr En AS Filename Eclamptic Seizure Session 3 xps O tide Folin Gay eee If the PC is connected to a printer select and open the evaluation document saved in the previous step e do Libraries Documents Evaluations Organize v Open y Share with w Print E mail Burn New YX Favorites Documents library Evaluations a Tien a Eclamptic Seizure Session 3 xps Documents XPS Document a Music 150 KB E Pictures E Videos Pediatric HAL S3005 User Guide 91 Navigate to the XPS Viewer file menu and select Print Alt Enter Alt Fa pic Pregnancy On Site Reviewer Jane Date 01 18 2013 _ 1 History Select the printer device from the list box and click print T Add Printer fig Canon ik CAOBO CA580 PCLSC Page Range Al Selection Current Page Pages 13 Enter either a single page number or a single
32. an empty syringe when simulating drug administration via endotracheal tube Passing liquids into the trachea or esophagus may cause internal damage Mouth to mouth resuscitation without a barrier device is not recommended as it will contaminate the airway Treat the simulator with the same precautions that would be used with a real patient Vein tubes contain latex which may cause allergic reactions Users allergic or sensitive to latex should avoid contact Discontinue use of this product and seek medical attention if an allergic reaction occurs Use only simulated blood provided by Gaumard Any other simulated blood brand containing sugar or any additive may cause blockage and or interruption of the vasculature system The use of needles larger than 22 gauge will reduce the lifetime of the lower arms skin and veins 8 Pediatric HAL S3004 User Guide When the arm veins require replacement contact Gaumard to arrange for a lower arm exchange For a small fee we will deliver reconditioned and warrantied lower arm assemblies to your facility Upon receiving the replacement arms use the same box and the enclosed shipping label to return the old arms to Gaumard For international and express service additional fees may be charged Refer to the Consumables and Replacement Parts section of this guide and contact customer service for more information Store the simulator in a cool dry place extended storage above
33. and click connect The Non Scenario Automatic Response feature allows the facilitator to set preprogrammed responses to electrical therapy events When the electrical therapy is detected auto responses can automatically load a specific palette item or prompt the facilitator before making preprogrammed changes to the simulator s vital signs Non scenario response settings detect electrical therapy administered when a scenario is not in progress For information on how to configure auto responses for use during a scenario go to page 46 To activate the virtual shock panel for administering electrical therapy virtually go to page 102 Non scenario automatic responses settings p Era po degrade to 120 80 fortation Cancel The behavior of each auto response option is explained below e Off The software does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the facilitator before applying the changes configured in the Settings section e Auto The software automatically detects the electrical therapy and compares it to a threshold selected by the provider If the threshold is met the vitals will automatically change to the parameters specified on the Settings section Each type of electrical therapy has a unique set of default parameters For example the default response to a defibrillation Shock applies the following vital sign paramet
34. convulsing to simulate mild or severe seizures Use the software controls to enable the seizure behavior Pediatric HAL S3005 User Guide 123 The simulator features ventilation and o compression sensors for monitoring CPR URINARY CATHETERIZATION performance The CPR window detects HAL features an internal bladder for ventilations when the respiratory rate is set to catheterization exercises zero or apneic and compressions when the heart rhythm is in an unhealthy state Simulator Maximum Catheter Model Infusion size Volume mL Complete the ventilation and compression calibration process before using the CPR window for the first time S3004 48 SFr ooo o SITES s3005 10 Fr AN ES Intramuscular injection sites are located on both deltoids and quadriceps for injection To fill the bladder with fluid to perform a technique and placement exercises catheterization exercise 1 Place the simulator face down and locate eee the bladder fill port HAL can exhibit gastric distension if ventilated a excessively To relieve the gastric distension press down on the stomach gently Use the streaming voice to speak as the simulator s voice and engage the provider in a realistic conversation Ensure that the headset and microphone is connected to the PC before starting the GIGA software The headset minimizes echo and environmental noise to improve audio quality 2 Fill the kit syringe with water 3 Connect the fill kit
35. gt Flash Drive p 695 OSearchiflash Drive p i a ee ca E sone Stage3 immediate postpartum bleeding is heavy and a gt Sir Favorites ype contains clots uterine fundus displaced L Chris scz SCZ File gt Sy Libraries gt 2 Homegroup gt i Computer l E ERIR Close The Save As window is displayed JJ Documents GIA Bacup 49 Filename helen04 plt a Save as type Palette Items plt Browse Folders The scenario file is copied to the GIGA scenario library automatically 4 Browse to the location where the file will be saved and click Save EXPORT Sen it gn pe eee gt lo Documents GIGA Backup 4 Search GIGABackup o Use the Export feature to backup palettes scenarios branched or linear and model patients files File name helen04 plt a Save as type Palette Items plt i e Y Browse Folders To export an item and save it to a location on the computer Click File gt Exit to close the GIGA software and turn the simulator off Alternatively click the power bottom and click the X icon near the top corner of the screen 1 Click File gt Export to open the Export menu 2 Select the file type from the Export File Type drop down menu Pediatric HAL S3005 User Guide 99 Set up Calibration Monitors Options View Remote Access Via Network Help Auto Response Set Med Id Scan RF Chann
36. has been advised of the possibilities of such damages Some jurisdictions do not allow disclaimers of implied warranties or the exclusion or limitation of consequential damages so the above disclaimers and exclusions may not apply and the first purchaser may have other legal rights This limited warranty applies only to the first purchaser of the product and is not transferable Any subsequent purchasers or users of the product acquire the product as is and this limited warranty does not apply This limited warranty applies only to the products manufactured and produced by Gaumard This limited warranty does not apply to any products provided along with the Gaumard product that are manufactured by third parties For example third party products such as computers desktop laptop tablet or handheld and monitors standard or touch screen are not covered by this limited warranty Gaumard does not provide any warranty express or implied with respect to any third party products Defects in third party products are covered exclusively by the warranty if any provided by the third party Any waiver or amendment of this warranty must be in writing and signed by an officer of Gaumard In the event of a perceived defect in material or workmanship of the Gaumard product the first purchaser must 1 Contact Gaumard and request authorization to return the Gaumard product Do NOT return the Gaumard product to Gaumard without prior authorization 2
37. in service training and installation Pediatric HAL S3005 User Guide 169 Warranty EXCLUSIVE ONE YEAR LIMITED WARRANTY Gaumard warrants that if the accompanying Gaumard product proves to be defective in material or workmanship within one year from the date on which the product is shipped from Gaumard to the customer Gaumard will at Gaumard s option repair or replace the Gaumard product This limited warranty covers all defects in material and workmanship in the Gaumard product except 1 Damage resulting from accident misuse abuse neglect or unintended use of the Gaumard product 2 Damage resulting from failure to properly maintain the Gaumard product in accordance with Gaumard product instructions including failure to property clean the Gaumard product and 3 Damage resulting from a repair or attempted repair of the Gaumard product by anyone other than Gaumard or a Gaumard representative This one year limited warranty is the sole and exclusive warranty provided by Gaumard for the accompanying Gaumard product and Gaumard hereby explicitly disclaims the implied warranties of merchantability satisfactory quality and fitness for a particular purpose Except for the limited obligations specifically set forth in this one year limited warranty Gaumard will not be liable for any direct indirect special incidental or consequential damages whether based on contract tort or any other legal theory regardless of whether Gaumard
38. not his chest protector His mother was watching and said he became airborne and the handle bar of the bike landed on his chest when he hit the ground He is crying my chest hurts and I can t breathe He was not unconscious and his extremities and abdomen appear normal You suspect fractured ribs a lung contusion or a tension pneumothorax Decompression No performed successfully 2 min timeout Wait 20 seconds for CPR _ Wait 30 seconds for Epi via ET Tube and continue CPR 134 Pediatric HAL S3004 User Guide Yes Pediatric HAL Five Year Trauma Scenario Gaumard Sirulators for Health Care Education Hypothermia nia y A five year old boy wandered away from his parent s farm house in freezing temperatures He was found by a passing motorist curled in a snow drift He was dressed only in pajamas and his exposure time was at least four hours The motorist wrapped him up and drove him to the hospital External and internal warming Both External only 2 min time out Pediatric HAL S3005 User Guide 135 Pediatric HAL Five Year Trauma Scenario A Gaumard Alcohol Ingestion le Simulators for Health Care Education i Bradycardia and Hypoglycemia A five year old boy wakes up early and is thirsty His parents had
39. numbers Resp Monitor The files on this list will be accessible from the patient menu on the vital sign monitor The Context Name will be the name displayed Thermometer Configuration NIBP Cuff hy ABP cannula Available Files ELA m n e Layout Capnography CV catheter gt LIA b Some sensors such as NIBP and Thermometer feature a STAT control that will allow the facilitator to activate readings on the virtual monitors from the controller software Pediatric HAL S3005 User Guide 109 The files used for sharing are stored in the control PC Before the simulation begins add mock image jpg omp or text files txt into the Gaumard_UI folder located on the home screen of the control computer Setup Auto Mode Sensors Custom numbers View Configuration The list of files stored on the Gaumard_ UI folder available for sharing is displayed on the left panel To share a file select the file from the left panel and click Ada File Sharing Setup The files on this list will be accessible from 1 Name will be the name displayed Available Files Refresh Ba Delete a 7 Enter a context name on the pop up menu and click OK to share 110 Pediatric HAL S3004 User Guide Enter Context Name Pelvis X ray OK Cancel Files currently shared ar
40. o e 100 ee i 2 Shocks Shocks ss nated aati advance to next advance to next advance to next el scenario item only scenario item only scenario item only when at WAIT when at WAIT when at WAIT OK Cancel The three response options are defined below e Off The scenario does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the user for approval before advancing to the next palette O Auto Advances to the next palette automatically only if the electrical therapy meets the threshold specified 46 Pediatric HAL S3004 User Guide Branching Scenarios Unlike linear scenarios which move from one palette to the next the trajectory of a branching scenario can change in response to the participant s actions Click the Branching scenario tab to access the branching scenario window BRANCH SCENARIO Auto Responses Bo ADD NODE LAB SPEECH PROVIDER ACTIONS Use the panel buttons to clear load and save new scenarios or to switch from branching to linear scenarios Click Load Scenario to access the preprogrammed branched scenarios in the current profile BRANCH SCENARIO Auto Responses Bo ADD NODE The process of creating a new branching scenario is the following e Add nodes e Add palettes or scenarios to each node e Add paths to nodes that require provider action e Create ke
41. over 30 seconds O Wait Indefinitely ae Hold vital signs Click Next Palette to continue Improvement 00 45 Vital signs improve 30 percent over 45 seconds Edit Palette VIRTUAL MONITOR PALETTE BRANCH SCENARIO LAB SPEECH PROVIDER ACTIONS Pediatric HAL S3005 User Guide 43 Click Save Scenario to store the scenario in the current profile for later use Add Item to Name Transition Description gt initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin Send Lab Lab 1 00 00 Move Deteriorating 00 30 Vital signs deteriorate 20 over 30 seconds A Type in a name and a description for the new scenario and click Save Save Scenario Scenario Name Allergic Reaction Scenario Description Simulation Session 1 Incorporate the following features into a scenario for added realism e Auto responses move onto the next palette item automatically when virtual electric therapy is detected e File sharing and lab reports Send lab reports to the virtual monitor computer e Speech add phrases or custom speech 44 Pediatric HAL S3004 User Guide The scenario can also automate the distribution of shared files and labs Click Add to scenario and then use the File and Lab tabs to select from available documents For more information making files available for file sharing go t
42. real time feedback on the provider s compression and ventilation performance 5 Gaumard Scientific CPR Evaluator 0 10 30 Compression Data 26 Ventilation Data Rate Ct LC Rate PIP Ti 0 0 2 00 00 0 133 2 4 I E PEEP LV 1 0 6 14 12 Too Many Compressions 242 Too Many Ventilations 9 L 9 OK 129 H 104 L 0 OK 0 H 9 The provider performance indicator boxes are located on the right The V ventilation and C compression box fill color changes between the following states e Grey No intervention was detected e Yellow Compression was too shallow Ventilation was too weak 96 Pediatric HAL S3004 User Guide e Green Compression ventilation was performed correctly e Red Compression was too deep Ventilation was too strong Compression and ventilation data is displayed at the bottom of the window as CPR is performed by the provider 0 10 20 30 40 Compression Data 306 Ventilation Data Rate ct LC Rate PIP Ti 96 0 3 00 00 0 0 0 5 IE PEEP LV 0 08 57 Too Many Compressions 42 Too Many Ventilations 8 L 0 OK 0 H 8 L 3 OK 11 H 28 Compression Data e Rate Rate of compressions in real time e Ct Compression time Average length of each compression in seconds e LC Last Compression Time elapsed since the last compression performed Ventilation Data e Rate
43. syringe to the bladder fill port 4 Inject fluid into the bladder Do not exceed the maximum infusion volume Catheterize the simulator using the appropriately sized catheter lubricated with silicone oil At the end of the exercise drain the fluid from the bladder reservoir to prevent mold 124 Pediatric HAL S3004 User Guide Click the talk icon and speak in to the 2 Remove the tibia insert headset to talk as the simulator s voice Streaming Audio Talk To listen to the provider s response click Listen __ ele 3 Remove the bone s reservoir cap and use the fill kit syringe to fill the bone reservoir with fluid 4 Replace tibia bone in the leg and the skin cover INSTRUCTIONS FOR USE Streaming Audio Intraosseous access is only supported on the hollow tibia insert To view a list of replacement parts including leg skin covers and tibia bones go to page 168 Listen Reference the GIGA software User Guide for information on additional streaming voice features and functions HAL features replaceable tibia bones on the left leg for intraosseous access The hollow bones allow for the aspiration and infusion of fluid using real medical devices To fill the tibia bones with fluid 1 Remove the skin cover from the right leg Pediatric HAL S3005 User Guide 125 Appendix 126 Pediat
44. 04 User Guide By default the NIBP parameter does not update automatically Click the NIBP menu and select Stat to refresh the reading Alternatively set a refresh interval to automate the stat process periodically Pediatric HAL S3005 User Guide 37 Palette Use the Palette tab to sort manage and edit the palette items in the current profile Each profile stores an independent library of palette items To modify the vital sign parameters programmed into a palette select a palette and click the Edit button After the changes are made using the Details tab click the Save as Palette Item button See the Tips on Palette ltem and Scenario Creation section of the appendix for more information on customizing palettes Select a palette item from the list and click an a Apply button to update the vital signs to the values stored in the palette item Descpription Wr Edit ug Delete Fi Properties VIRTUAL MONITOR FETAL MONITOR PALETTE SCENARIO BRANCHSCENARIO LABOR LAB SPEECH PROVIDER ACTIONS 38 Pediatric HAL S3004 User Guide Linear Scenarios Scenarios automate the vital sign changes responses and software actions required to carry out a complete simulation exercise GIGA includes several preprogrammed scenario based simulation exercises in the Quick Start Profile To use a preprogrammed scenario go to the Scenario tab and click Load Scenario
45. 2 R 10 sec 30 sec imin 2min 5min 10min On Apply Clear and Close Details Window A palette item stores one or more vital sign settings into a single loadable object Use a palette item to update a set of vital signs quickly For example one palette item can be created to update all the cardiac parameters to a healthy state To create a new palette item set the values for the desired vital signs parameters using the details controls and click Save m l EKG Sinus Heart rate 74 bpm Heart Sound normal Heart sound volume 3 llOn Apply Clear and Close Details Window Pediatric HAL S3005 User Guide 27 Enter a name for the palette a description and choose color code Click Save to create the new palette ltem Palette items are stored in the active profile Save as Palette Item Palette Item Name Color e Healthy Care Required Select the palette item from the Load Palette Item menu and click Load A PALCI IC Load Palette Item Sinus 74 bpm Heart Sound Normal 28 Pediatric HAL S3004 User Guide Click the apply option to submit the changes P pas ree as Details x Healthy Heart Sinus 74 bpm Heart Sound Normal Cardiac EKG Sinus Heart rate 74 bpm Heart Sound normal Heart sound volume 3 While operating in the Automatic Mode GIGA adjusts the pat
46. 23L L Lower Left Arm M Lower left IV arm reveining light color Reveining S 3005 223R L Lower Right Arm M Lower right IV arm reveining light color Reveining S3005 300 Wireless Streaming A Wireless streaming audio feature Audio S3005 300 U Wireless Streaming U Audio Upgrade S3005 DEMO Adult PEDIATRIC 5YO Demo Unit S3005 EXW Two Year Extended A Extended warranty for years Two AND Three Warranty S3005 INST In Service Training Day of in service training and installation 168 Pediatric HAL S3004 User Guide S3004 001 A C Virtual Monitor A C Powered 17 Touch Screen monitor and desktop S3004 002 D C Virtual Monitor D C Powered 12 Touch Screen Mobile Monitor with stylus S3004 053L D Upper LEFT Arm M Dark color upper left arm assembly with tethered BP with adaptor S3004 053R L Upper RIGHT Arm M Light color upper right arm assembly with tethered BP with adaptor S3004 081 Silicone Oil C Oil based silicone lubricant S3004 200 Audio amp Video A Recording System S3004 206 RF Module Radio Frequency Module with USB connector S3004 223L L Lower Left Arm M Lower left IV arm reveining light color Reveining S3004 223R L Lower Right Arm M Lower right IV arm reveining light color Reveining S3004 300 Wireless Streaming A Wireless streaming audio feature Audio S3004 300 U Wireless Streaming U Audio Upgrade S3004 EXW Two Year Extended A Extended warranty for years Two AND Warranty Three S3004 INST In Service Training Day of
47. AL S3005 User Guide 15 Working with GIGA 16 Pediatric HAL S3004 User Guide Initializing the Simulator After reading the simulator s direction for use guide press the power button to turn on the Tablet PC The GIGA software initializes the simulator Double click the GIGA icon on the tablet s home screen to open the GIGA software ow We os Campus eltio amine Wi e wi The simulator selection menu is shown Select the simulator and click Start as GIGA 2 15 16 0 Simulators for Health Care Education Please select one simulator 1 PEDIATRIC HAL FIVE YEAR a PEDIATRIC HAL ONE YEAR The wireless link between GIGA and the simulator is established within 1 minute Profiles and Operating Modes After the startup screen the profile and operating mode selection menu is displayed Pediatric HAL Five Year Profiles PROFILES DESCRIPTION eraut Quick Start Pediatric 5 Rename ii Delete Pediatric HALO Five Year New Profile The GIGA control software has two modes of operation Manual and Automatic Each mode includes a Quick Start profile with preprogrammed scenarios exercises created in conjunction with experienced healthcare instructors and working medical professionals Continue to the next section to learn more about the each operating mode and the profiles included After selecting an operating mode and profile clic
48. AO Gen Details m A Clear E Save E Load Naloxone SD Breathing Respiration rate Auto Inspiration Percentage Auto OSat Auto Etco Auto Cardiac Cardiac irritability slight improve 4 Circulation Blood pressure Hold to change 25 25 via Vascular_ Properties A UA_FHR none Operating mode Auto e nong FHR Baseline Auto B Variability Auto Accel Decel Intensity Auto a Fetal Movement in 10min Auto a Fetal 02 Level 2 gt CO t On Apply Clear and Close Details Window 2 After dose effect palettes are created using the Details controls go to the drug tab and click the Manage Drug List button rRate Rate o ml min Start IV L min Start 025 SPEECH Pediatric HAL S3005 User Guide 73 The Add New Medication window is displayed aa Add New Medication 7 Medication Response I EC50 mg dl EX ceca that procs 50 be maximum effect Available Palettes y Apply Items Threshold SD 15 oD 3 la Properties j Edit i jp Clear 1 E Properties ug mg g 8 Drug Effect Tester J Eug E ug kg E ma E mg kg E g E g kg Test object weight 8 85 00 kg Update Graph EXT l 4 Route El NV Push N Infusion 7 M El SubQ E Topical Per Oral Y Inhalation
49. ATION USB MODULE The controlling computer transmits the startup and control commands to simulator through the USB RF communication module Connect the RF communication module to an available USB port on the tablet 14 Pediatric HAL 53004 User Guide Secure the RF communication module to the tablet or PRO computer using the Velcro patch The tablet is now ready to communicate with the simulator wirelessly For information about the signal strength indicator go to page 19 The computer system includes a headset that allows the facilitator to soeak as HAL s voice and listen to the participants reply Connect the headset MIC and Speaker connectors to the designated ports on the side of the tablet PC Go to page 63 for more information about the streaming voice feature Always connect the streaming audio headset before starting the GIGA software Virtual Monitor The Gaumard Monitors software displays HAL s simulated vital signs in real time The interactive monitoring software is preloaded in to the virtual monitors PC The virtual monitor PC also allows the facilitator to play back the session recordings stored in the PRO PC for debriefing 10 25 08 Refer to the manufacturer s documentation included with the virtual monitor system components for important safety installation and start up information before turning on the PC for the first time To setup the virtual monitor PC
50. Disconnect the syringe tube from the arm port while maintaining suction The port will seal and the veins will remain collapsed Clean and dry the forearm vasculature at the end of the simulation session to prevent mold or clogs To clean and dry the IV arm 1 Fill the filling syringe with distilled water 2 Connect the fill syringe and the drain tube to arm 3 Flush the vasculature with distilled water If the IV arm is not going to be used fora week or more purge the system with 70 isopropyl alcohol solution 4 Fill the filling syringe with air and purge the clean water to dry the vasculature 5 Disconnect the drain tube and filling syringe Warning Do not store the simulator with fluids in the veins Doing so may lead to molding and damage to the internal electronics Complete the vasculature cleaning procedure at the end of the simulation sessions Connect the modified blood pressure line to the port on the simulator s left shoulder Before using the blood pressure feature for the first time place the blood pressure cuff on the arm and calibrate the blood pressure feature using the blood pressure calibration wizard 122 Pediatric HAL S3004 User Guide BLOOD PRESSURE CALIBRATION WIZARD Before starting the calibration process place the blood pressure cuff on the simulator as it would be placed on a real human patient To calibrate the blood pressure feature 1 Click Setup gt Calibrat
51. Electrode gel on the skin between any two electrode targets can become a pathway for electrical current just as in real life If this occurs the simulator s skin can be burned Do not allow defibrillation pads to overlap ECG sites Doing so will may damage the simulator and cause arcing Should dark traces appear on the conductive patches due to gel residue or previous arcing use a pencil eraser to remove the traces and then clean with alcohol DO NOT SCRATCH the conductive patches with abrasive objects doing so will cause irreversible damage to the conductive sites and subsequently cause arcing Pediatric HAL S3005 User Guide 9 Terminology Facilitator the person conducting the simulation an instructor or lab staff member GUI the Gaumard User Interface is the software application used to control the simulator and evaluate care providers Palette a collection of Palette Items Each profile has its own palette Palette ltem Any full or partial set of physiological parameters that have been grouped and saved together under a single name Profile a unique NOELLE software configuration including custom Palette Scenarios and options Each Profile acts as a separate program in that changes made to one profile have no effect on the others Provider a person participating in the simulation as a healthcare provider Scenario a saved sequence of physiological states like a playlist Scenario
52. Flow SH Dead Space 155ml Pediatric HAL S3005 User Guide 31 In the automatic mode a tidal volume of 450 m L to 500 m L is considered the normal level for an adult of average build The auto mode does not restore the respiratory rate if it is set to zero Always remember to specify a new respiratory rate STATUS DETAILS Lung Sounds wol Right Left Each cardiac rhythm has a specific effect on the blood pressure waveforms The pressure waveforms include ABP CVP PAWP and Pulse The blood pressure values are affected when any of the following parameters are changed e Vascular profiles vessel diameter and vessel stiffness e Heart Rate e LV Contractility e Total Blood Volume 32 Pediatric HAL S3004 User Guide Set the patient status to Excited after exercise to increases heart rate temperature respiratory rate tidal volume O2 CO2 diffusion capacity metabolic rate and CO2 formation rate Set the status to resting for a normal state STATUS DETAILS HI K Sounds Pulse Radial Temperature Patient State Vessel Diameter Vessel Stiffness The Bleed and Wound size options simulate blood loss virtually To start the virtual bleeding click the Bleed button and then adjust the bleeding rate using the Wound Size control Once the bleeding function is activated the Auto Mode will adjust the vital signs in response to the blood loss If the provider does no
53. N Infusion 7 IM E SubQ Topical Per Oral Inhalation hr min sec Precise of of of Approximate very quick lt 5m min sec Precise 041 of appraat very quick lt 5m Drug Interactions i Clear All ib Add if Cancel Edit Medj Delete Med Select a medication from the Medication List and click edit to view the medication s properties 72 Pediatric HAL S3004 User Guide Each medication is programmed with two palette items One palette item is programmed with the vital signs adjustments to simulate the effects of a standard dose SD and the other palette item is programmed with the effects of an over dose OD Additional information such as half life peak time and route is also programmed into the medication properties When the medication is administered to the patient the software applies the palette item associated with the dose threshold The Auto Mode adjusts the vital signs changed by the palette item gradually to simulate the medication s effect on the patient To create a new medication 1 Create a palette item using details page for the effects of a standard dose SD Then repeat the process to create a palette item for the effects of an over dose OD For general information on how to create palette items please go to page 27 T TaOxXo0ne 0 LINE l Name Descpription E O SI
54. Pediatric HAL 93004 S3005 Gaumard Simulators for Health Care Education Pediatric HAL is an interactive educational system developed to assist a certified instructor lt is not a substitute for a comprehensive understanding of the subject matter and not intended for clinical decision making User Guide G13 6 1 Gaumard Scientific Company 2013 All Rights Reserved www Gaumard com Contents COMO MS aro at 3 INTOdUCIO intro 5 End User License Agreement iii did 6 General Care Maintenance and Warnings ccccoccccccccccnccocnconnnnnnncnnnnnnaninonoss 8 DefibrillatOny EC Gi oia 9 HTM ONO peaked A E cab aiid satel uhaer te tmelcaaet 10 Genting Staite dina 11 SIMAO SD o dad 12 COTO aC adi da 14 IMA MONO 15 WV OFKING WHA GIO Accra A a 16 mMitializng the Simulation pois 17 Profiles and Operating MOdO Sist a es cu abe 17 Manual MOS r AE 17 AUTO Mato MOda sionn tii a a E a E aN 18 CGT Age hits els eee ere een Rt a Rae a a Rn Tae mR ea eR eae mT Renee 19 COMIC CHO Stats anidar 19 Barely WICC AON anti a A eae A 19 SA AA o meo PP tahoe at Eo a a a 20 P werstand isso ada 20 status Details CONTO Said 21 Virtual O 39 Palin cada 38 Linear ScenanOS anida 39 BANGING o Cenan aja in id al 47 A CO 54 E Jae EAE E EAEE A PET EN PEENE en A E EEA E E PEE E 99 Pe ius e ile A 63 Medication AUTO MOGE e Eo OS 67 Pediatric HAL S3005 User Guide 3 A A a e S e man ere tone ert men mre tne rete tt 82 Provider ACUONS see set
55. S FOR ANY PARTICULAR PURPOSE NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY GAUMARD ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES SHALL CREATE A WARRANTY OR IN ANY WAY INCREASE THE SCOPE OF THIS WARRANTY AND YOU MAY NOT RELY ON ANY SUCH INFORMATION OR ADVICE GAUMARD DOES NOT WARRANT GUARANTEE OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF USE OF THE SOFTWARE OR WRITTEN MATERIALS IN TERMS OF CORRECTNESS ACCURACY RELIABILITY CURRENTNESS OR OTHERWISE AND THE ENTIRE RISK AS TO THE RESULTS AND PERFORMANCE OF THE SOFTWARE IS ASSUMED BY YOU IF THE SOFTWARE OR WRITTEN MATERIALS ARE DEFECTIVE YOU AND NOT GAUMARD OR ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES ASSUME THE ENTIRE COST OF ALL NECESSARY SERVICING REPAIR OR CORRECTION OTHER THAN EXPRESSLY DESCRIBED ABOVE 6 Pediatric HAL S3004 User Guide C NEITHER GAUMARD NOR ANYONE ELSE WHO HAS BEEN INVOLVED IN THE CREATION PRODUCTION OR DELIVERY OF THIS PRODUCT SHALL BE LIABLE FOR ANY DIRECT INDIRECT CONSEQUENTIAL OR INCIDENTAL DAMAGES INCLUDING DAMAGES FOR LOSS OF BUSINESS PROFITS BUSINESS INTERRUPTION LOSS OF BUSINESS INFORMATION AND THE LIKE ARISING OUT OF THE USE OR INABILITY TO USE SUCH PRODUCT OR RELATED TO THIS AGREEMENT EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES GAUMARD SHALL NOT BE LIABLE TO YOU FOR ANY INDIRECT SPECIAL INCIDENTAL OR CONSEQUENTIAL DAMAGES OR LOST PROFITS ARISING OUT OF OR RELATED TO THIS AGREEMENT OR YOUR
56. ST GMT 5 4 Summer Time Always dispose of this product and its components in compliance with local laws and regulations C The HAL simulation system is protected by US patent other Patents Pending Gaumard HAL GIGA are trademarks of Gaumard Scientific Company Inc Gaumard Scientific Company 2013 Made in U S A All rights reserved Pediatric HAL S3005 User Guide 171
57. USE OF THE SOFTWARE AND OR THE RELATED DOCUMENTATION EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES IN NO EVENT SHALL GAUMARD S LIABILITY HERE UNDER IF ANY EXCEED THE PURCHASE PRICE PAID BY YOU FOR THE SOFTWARE ALL RIGHTS NOT EXPRESSLY GRANTED IN THIS LICENSE AGREEMENT ARE RESERVED BY GAUMARD ACKNOWLEDGMENT BY INSTALLATION OF THIS SOFTWARE YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THE FOREGOING AND THAT YOU AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS YOU ALSO AGREE THAT THIS AGREEMENT IS THE COMPLETE AND EXCLUSIVE STATEMENT OF AGREEMENT BETWEEN THE PARTIES AND SUPERSEDES ALL PROPOSED OR PRIOR AGREEMENTS ORAL OR WRITTEN AND ANY OTHER COMMUNICATIONS BETWEEN THE PARTIES RELATING TO THE LICENSE DESCRIBED HEREIN Pediatric HAL S3005 User Guide 7 General Care Maintenance and Warnings The Gaumard warranty does not cover damage caused by misuse It is critical to understand and comply with the following guidelines to prevent injury to the user and damage to the simulator Do not attempt to intubate without lubricating the airway adjunct with silicone lubricant provided Intubating the simulator without lubrication may result in damage to the airway Avoid using surgical tools to cut the neck skin The precut opening allows the insertion of most medical devices Always lubricate the medical adjunct before insertion Do not introduce flammable gases into the airway Providers must use
58. a Note for this scenario to function as intended the 7 O al Start Bradycardia O w Palette Scenario Path v 00 01 gt bradycardia 00 00 RR 10 HR 45 2nd deg AVB Type II Speechi 00 01 complaint Feel dizzy 2 Deteriorate o Palette Scenario Path c ooaj O gt wait 02 00 No changes are made to manikin Speechi 00 01 confusion What happened Cardio Drop 01 00 HR 15 BP 10 OSat 5 KEY EVENTS Key events activate alternate paths in a node The alternate paths are used to change the trajectory of the scenario depending the participant s actions To add a key event to a node first add the additional paths 2 Deteriorate O Y Palette Scenario Path 00 01 gt z O gt wait 02 00 No changes are made to manikin x p Speech1 00 01 confusion What happened ap End Cardio Drop 01 00 HR 15 BP 10 OSat 5 a x BH End x BH End 4 Click the Edit path icon to program key events for the node 50 Pediatric HAL S3004 User Guide A key event is the action expected by the participant Type a name for the action and then click Add Key events f Rename 1 h Delete a Action 5 Linked Action Edit Path After the action is added to the Key Events list assign the node that this action will move the scenari
59. a party the night before and left glasses half full of mixed alcoholic drinks around the living room When the parents get up two hours later they find him asleep on the floor and smelling of alcohol They cannot wake him up so they call 911 Deliver 02 Chin lift and deliver O2 20cc kg normal saline bolus Treat glucose deficiency Deliver O2 and correct hypotension Bolus of D10W and hypotension Infusion of IV fluids with glucose ES e CD Intubation Or 2 Min Timeout 136 Pediatric HAL S3004 User Guide Gaumard imulators tor Health Care lucation Pediatric HAL Five Year Trauma Scenario Organophosphate Poisoning OP Poisoning A five year old immigrant boy wandered in a field that was recently sprayed with pesticides Organophosphate His parents took off his cloths and washed him off with water but a few minutes later he began vomiting and became limp They drove him to the ED that was thirty minutes away Atropine 0 01 epeat Atropine a higher dose and add 2PAM YES mg kg IV Pediatric HAL S3005 User Guide 137 Pediatric HAL Five Year Trauma Scenario Gaumard i Simulators for Health Care Education Renal Failure and Hyperkalemia A five year old boy presents to the ED with some tiny red dots on his arms and legs and his mother says he hasn t
60. ach template includes a set of multiple choice questions fill in the blank and true or false questions for a variety of scenarios Select an evaluation template from the Load template drop down to begin ass Evaluation Form Load template gt Breech Vaginal Delivery Evaluation Na Forceps Delivery a Postpartum Hemorrhage On Site Revie der Dystocia Umbilical Cord Prolapse Vacuum Delivery Enter the name of the facilitator administering the evaluation in On Site Reviewer field as Evaluation Form Load template Eclamptic Seizure Print Evaluation Name Eclamptic Seizure On Site Reviewer Date 0 Pediatric HAL S3005 User Guide 89 Complete the form by answering each question Evaluation Name EClampuc Seizure On Site Reviewer Date 01 30 2013 None a m Yes No N A Calls for additional help Nursing or Physician 6 Calls for anesthesia 86 Providers turn or assist in turning patient to side during seizure e Inserts tongue blade into mouth e 0 Click Print at the top right corner of the screen once the evaluation is completed tic Seizure cl Seizure ames Dat 01 30 2013 a Select the Microsoft XPS Document writer to save the finished evaluation as digital document Click Print to save the digital copy in the system Select Printer Microsoft XPS Document
61. ange scenarios In addition use the streaming voice option to speak as the simulator s voice and listen to the student responses I 1 TYPE OPTIONS g i 3 R i g TEIE i I d E g i a f Voice Activation Language i ggg Hi i FETAL MONITOR PALETTE SCENARIO BRANCH SCENARIO LABOR LAB sp ECH PROVIDER ACTIONS Click the phrase button to have the simulator speak the phrase aloud Alternatively program the phrases into a scenario to have the simulator speak automatically page 63 SPEECH COMPLAINT COMPLAINT CONFUSION Pediatric HAL S3005 User Guide 63 Use the streaming voice to speak as the simulator s voice and engage the provider in a realistic conversation In addition record and save custom phrases to be played back during scenarios automatically Ensure that the headset and microphone is connected to the PC before starting the GIGA software The headset minimizes echo and environmental noise to improve audio quality Enable the Voice Activation feature to switch to the talk mode when voice input is detected automatically Adjust the mic threshold to set the voice activation sensitivity The higher the threshold the less sensitive the microphone is and vice versa For instance if the threshold is set to high the voice input volume must be high to trigger the voice activation ee feels different ly water broke a
62. apture footage of the simulation and interlace it with the event information generated by the simulator control software To enable the fetal Neo link menu option go to Set Up gt Options gt Other and checkmark Use AV System Monitors Auto Mode v Stop AV F M Link Help Click Setup AV to configure the software connection to the AV system Enter a port number for the connection and click Connect to establish a link Please contact the AV administrator for information on how to accept incoming connections from the GIGA software A V Link Information x AV SOLUTIONS not connected Adapter Local Area Connection H lt refresh al Controller IP 192 168 50 123 Port 8001 find avail 9 Connected to Return to the A V menu and click Start AV to initialize the recorder Some third party A V solutions may not recognize the Start command generated by the log event If the recorder does not start remotely please start the new video manually using the third party controls The log event does not command the recording to stop at the end of the scenario automatically Click Stop A V from the menu to end the recording Pediatric HAL S3005 User Guide 113 3 Run the GIGA update file to update the Help software Es Do not change the wireless network settings Doing so will disconnect the Setup virtual monitor computer and the Gaumard Monit
63. ators for Health Care Education Bee Sting You are called to a home where a one year old boy was bitten multiple times by angry Yellow Jackets thirty minutes ago When you arrive you see areas of hives around the bites his lips and eyes are swollen and he has audible stridor Wait indefinitely for Oxygen Epinephrine Nebulized Albuterol Favorable response No gt Steroids Benadryl Wait indefinitely for Additional Epinephrine IV Wait indefinitely for anti hypertensive infusion 160 Pediatric HAL S3004 User Guide Pediatric HAL One Year Systemic Scenario Hypovolemic Shock Hyponatremic Seizures Gaumard mlators for Health Care Education A one year old boy presents to the ED with a three day history of vomiting and watery diarrhea with out blood or mucous He attends daycare and a note was sent home about two other children with rotovirus diarrhea He was given Pedialyte the first day and his vomiting and diarrhea decreased on the second day Today however his diarrhea is constant and he has refused to drink His urine output is unclear because of the diarrhea in the diapers During your assessment he has a thirty second period of tremors Wait indefinitely for two boluses of Ringer s Lactate Wait indefinitely for switching IV fluid to Normal Saline Wai
64. battery charge is displayed on the software panel after the connection with the simulator is established Total runtime is dependent on the breathing rate volumes seizures and muscle tone WARNING Do not store the simulator with a discharged battery Recharge the battery at the end of every simulation session l the simulator will not be used for an extended period re charge the battery at least once every 30 days Doing so will prevent damaging the battery due to discharging The Pediatric HAL 1 Year battery can only be recharged using the Pediatric HAL 1 year Charger while the simulator is off or in standby Neither the battery charger nor the power supply adapter recharge the battery while the simulator is in use 12 Pediatric HAL S3004 User Guide Turn the simulator off and connect the battery charger to recharge the battery To charge the battery 1 Close the GIGA software to turn the simulator off 2 Connect the adapter labeled Pediatric 1 Year HAL Charger to the battery port located on the simulator s right side 3 Allow the simulator to charge for 2 3 hours or until the charger displays a green light The charger indicator light will show red during the charge period and green once the process is complete 4 After the charger indicator light turns green disconnect the charger The simulator is ready for use Avoid using the simulator while the battery charger is connected
65. ber that only the settings you specify will cause a change in HAL and all other settings will remain constant So by starting with a complete state HAL s condition will always be the same when the scenario starts regardless of what he was doing previously Likewise the transition duration of the first step in the scenario should be zero indicating that changes are applied immediately There is one point that can cause confusion and warrants further explanation It is an extension of the above discussion of partial states The issue is best illustrated through the following example Suppose that you are creating a Palette Item to start your scenario In this case you have decided that the patient will be apneic The question is How should the lung sounds be set Most people s first inclination is to set the lung sounds to none This is incorrect despite apnea Obviously no lung sounds should be heard during apnea but since you have already set respiratory rate to zero none will be Sounds are synchronized to the breathing cycle What you are really setting here when you choose a lung sound is the condition of the lungs given respiratory drive That is if the patient s respiratory rate were changed from zero what sound would be heard Assuming that the lungs themselves are normal in this scenario you would choose normal for the lung sound setting Then as the scenario progresses if the patient starts breathing there
66. by Internet delivery by installation of the Software you acknowledge that you have read and understand this license agreement and agree to be bound by its terms and conditions 5 Term of Agreement The term of this Agreement and the license granted to you pursuant hereto shall commence upon installation of this Software This Agreement and the license granted herein may otherwise be terminated by Gaumard in the event that you are in breach of any provision of this Agreement In the event of termination you agree to immediately return this Software accompanying items and any copies thereof to Gaumard 6 LIMITED WARRANTY A THE CD ROM MEDIA THE MEDIA WHICH CONTAINS THIS SOFTWARE IS WARRANTED FOR A PERIOD OF 30 DAYS FROM THE DATE OF PURCHASE TO BE FREE FROM DEFECTS IN MATERIAL AND WORKMANSHIP ELECTRONIC TRANSMISSION IS WARRANTED TO BE FREE FROM DEFECTS AT THE MOMENT OF TRANSMISSION YOUR SOLE AND EXCLUSIVE REMEDY AND GAUMARD S SOLE LIABILITY IS TO REPLACE THE DEFECTIVE MEDIA OR TO REPEAT THE ELECTRONIC TRANSMISSION PROVIDED THAT YOU NOTIFY GAUMARD IN WRITING OF SUCH DEFECT OR DEFECTIVE TRANSMISSION AND RETURN THE DEFECTIVE MEDIA IF ANY DURING THE 30 DAY WARRANTY PERIOD B EXCEPT AND TO THE EXTENT EXPRESSLY PROVIDED IN PARAGRAPH A THE SOFTWARE AND ACCOMPANYING WRITTEN MATERIALS ARE PROVIDED ON AN AS IS BASIS WITHOUT ANY WARRANTIES OF ANY KIND INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNES
67. ck on him Her boyfriend said he was probably just sleepy because he had cried a lot the night before She knows something is wrong and takes him to the ED Elevate head 30 degrees Intubation and IV access draw appropriate labs Request emergency CT of the head and a l neurosurgical consult Incorrect action IV fluids with normal saline and low dose mannitol to help reduce intracranial pressure Correct action Pediatric HAL S3005 User Guide 155 Pediatric HAL One Year Trauma Scenario Gaumard Simulators for Health Care Education Drowning Boy A one year old boy falls into the pool and is found floating a couple of minutes later paramedics arrive the child is not breathing has severe cyanosis and he is in asystole When the Wait indefinitely for ABCs CPR Meds Wait 20 seconds for Epinephrine 156 Pediatric HAL S3004 User Guide Pediatric HAL One Year Cardiac Scenario Gaumard En Second Degree Heart Block A Mobitz Type Wenkebach A one year old child was visiting his grandmother and was found playing in her purse She noticed her long acting propranolol bottle was opened and he may have ingested at least four pills about one hour ago She contacted poison control who told her to bring him to the hospital Glucagon 05 15mg kg bolus followed by an infusion
68. controls to rotate zoom and re center the model Click the transparency button to view the model s internal organs JS DETAILS Pediatric HAL S3005 User Guide 23 The floating controls are used to monitor and change the vital signs The default layout displays commonly used vital signs controls Click the button to add controls to the floating window CEPHALIC HM show all clear all Respiratory Pattern Inspire EtCO 2 Enable the instant apply option and click the control to change the vital sign to a new value Vital signs undergoing change blink yellow STATUS DETAILS Lung Sounds vol Right normal 2 Left normal 2 x 24 Pediatric HAL S3004 User Guide The expanded details view is used to tabulate a list of vital sign changes before applying them all at once In addition the Details list is used for creating palette items a set of vital signs parameters stored in a single loadable item Click the edit button to open the expanded Details list Lung Sounds vol Right normal 2 Left normal 2 The vital signs controls are divided into categories Click through the categories to view the controls available for the current simulator configuration as Details Sound Col gt go to Cardiac e Respiratory Pattern Currently on sim normal ooo O e Respiration Rate Currently on sim 10 e Inspiration Percentage Curr
69. d medications Quick Start Modeling includes preprogrammed scenarios to simulate a variety of preprogrammed exercises 18 Pediatric HAL S3004 User Guide Profiles store palette scenario and option settings independently changes made to one profile have no effect on the others Below are some examples on how profiles are used e Assign one profile to each user of your Gaumard simulator system e Use profiles to organize and protect palettes and scenarios e Create a profile dedicated to a specific academic course taught by multiple instructors e Devote an entire profile to one particular subject area or even one particular scenario To create a new profile click New Profile ro SAREE Rename i Delete Enter a name for the new profile followed by a description Create New Profile Profile Name Winter Session PIN ble PIN Ena a Profile Description a Enter PIN Re Enter PIN Include contents of Default Profile Include contents of Quick Start Pediatric HAL OR Copy current profile Enable the PIN protection to prevent unauthorized users from accessing or making changes to this profile Lastly click Create to save the new profile GIGA Interface The GIGA software is used control the simulator monitor the vital signs and evaluate the provider s performance The simulation technician or instructor carrying out the simulation operates the GIGA software
70. e Ventilations are too strong Waveform peaks exceed the green zone Ventilation was performed correctly Waveform peak is inside the green zone Pediatric HAL S3005 User Guide 97 New Session Setup Reset Session Clock Monitors Save Report View b Print Report Help Import Export Exit Click the Profile menu option to open the Profiles menu To switch to a different profile select the operating mode and the new profile and click Load Clicking New Session in the file menu will e Clear any loaded playing scenario e Clear any loaded playing palette e Reset vital signs to normal values e Clear out log page e Restart the session clock The session clock is located at the bottom of the dialog box MIE The shortcut key for staring a new session s Ctrl N 98 Pediatric HAL S3004 User Guide Clicking on Reset Session Clock resets the clock back to zero It does not have any effect on the transition time remaining on a scenario it does not reset the vital signs or clear out loaded scenarios The facilitator can also reset the session clock by clicking on the Session button next to the session time s ist View This option allows you to save all the information recorded in the log page as a text file Clicking on it brings up the Save As dialog box eo Save As GOR gt te y erg y ll Search Reports Organize v New folder a gt Y Favorites Name Da
71. e listed on the Shared Files list accessible from the patient menu on the vital sign monitor The Context played File Context Name Pelvis X ay jpg Pelvis X ray Remove Remove All Close A yellow notification icon is displayed on the patient menu at the top left of the virtual monitor screen The icon notifies the provider that a file is available for viewing Click the patient menu and select the file open it Noelle i ASK for Ww The x ray file is now open on the virtual monitor computer To unshared the file select the file from the file sharing menu and click remove ccessible from the patient menu on the vital sign monitor The Context layed Leitner ici File Context Name Pelvis X ray jpg Pelvis X ray gt Remove All To troubleshoot file sharing access errors please reference the Gaumard Monitors user guide Use the custom numbers feature to add custom numerical parameters to the Gaumard Monitors screen For example glucose levels or platelets count On the GIGA menu bar click Monitors gt Custom Numbers to open the Custom Numerical Parameters on Monitor menu Click the Add button to create a new parameter Custom Numerical Parameters on Monitor s Type the name and units of the new parameter and then click OK Custom Numerical Parameters on Monitor s Name Units Hematocrit Cancel Th
72. e provides an airtight seal to prevent air leaks Pediatric HAL S3005 User Guide 117 Breathing Bilateral chest rise and fall is automatic Use the software controls to enable or disable the lungs independently and to adjust the breathing rate and the inspiratory percentage The simulator is generates anterior left and right lung sounds Use the software controls to select between the available respiratory sounds and to adjust the volume of each lung independently The respiratory sounds include normal wheezing inspiratory squeaks crackles and rales Set the respiratory rate to O and ventilate the simulator using a standard bag valve mask Open the CPR window to monitor the provider s ventilation performance in real time Complete the ventilation calibration process before using the ventilation feature for the first time The ventilation calibration wizard records the performance average of five ventilations as the benchmark for correct ventilation Perform the actions requested by the calibration wizard following the most current CPR guidelines The CPR window evaluates provider performance based on the benchmark recorded during the calibration process 118 Pediatric HAL S3004 User Guide To calibrate the ventilation performance benchmark 1 Click Setup gt Calibration gt Ventilations and click Next The wizard prompts to perform ventilation 1 2 Perform the first ven
73. e scalar parameter is now created Enter a value for the parameter and click Update Custom Numerical Parameters on Monitor s Save Load Add Remove e On off Hematocrit 52 eo On Off Glucose 83 mg dl update On the virtual monitor screen click on a scalar s menu and select Close to make the entry available for the custom parameter The scalar entry is now a blank field Click on the empty scalar menu and select Other from the list of available scalar parameters Select the name of the custom parameter m F NIBP O Sat FCO Temp ABP Time G u E a x E Glucose Pediatric HAL S3005 User Guide 111 The figure below shows two new values Glucose level and hematocrit levels Return to the custom parameter menu on the GIGA software to update the values when necessary On the GIGA menu bar click Monitors gt Configuration to open the Virtual Monitor Setup window Use the setup window to verify the connection between the GIGA software and the Gaumard Monitors vital signs software re configure the communication ports and view the controller IP address To troubleshoot connectivity issues between the two computers please reference the Gaumard Monitors user Guide 112 Pediatric HAL S3004 User Guide A V Audio amp Video GIGA is capable of interfacing with a number of third party A V recording systems Generally A V solutions c
74. ecords a time stamped entry of events that occur during the simulation session lt addition every individual entry records a snapshot of the vital signs parameters at the time the event occurred The text log records the following events 01 24 33 01 24 33 01 24 34 01 24 36 Vital sign changes applied manually or made by scenario Events detected by onboard sensors e g intubation sensor defibrillation sites Preprogrammed speech phrases Satisfactory or unsatisfactory evaluation Facilitator notes APPLIED TO NOELLE Reset the Model APPLIED TO NOELLE Reset the Model MODEL TO NOELLE 00 00 MODEL TO NOELLE 00 00 EtCO2 33 FHRAccel t dramatic J uli 00 03 12 00 03 15 00 04 36 00 04 59 4 APPLIED 00 00 alice01 HR 75 RR 21 Temp APPLIED 00 00 alice02 ContractionFreg 4 APPLIED 00 00 alice03 RR 23 OSat 97 m Select patient vital signs options to view a snapshot of the vital signs values when the event occurred E USC VINY WE INVIEL FVU ANANIRA as Properties i 00 03 12 Cephalic Seizures none 7 Eye state closed DE L Pupil dilation time 0 5 sec 3 Right pupil reaction On LL Left pupil reaction On Es t Right pupil dilation 5 1 __ Left pupil dilation 5 qa Airway F 5 Tongue Edema off Pharyngeal Swelling off dl Upper Airway Sound normal 9 Upper Airway Sound volume 2 11
75. ection Sort lab reports by name template description or color tag LAB Lab Report W Name Template Description Sent Create New Lab Report lew Sort by Color Selected Item i 6 Click Preview to review the final lab report Create New Lab Report The preview window displays the test results how the provider will see them on the virtual monitor screen lf the computer is connected to a printer click PRINT to create a hard copy DEFA T DDOETI E Enr nca anh in Marth Cnrnth Amarirat Lab Preview Lab 01 Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable Normal Range Value Comment HDL Cholesterol mg dL 35 00 85 00 85 00 Cholesterold HDL Ratio 0 00 4 40 5 10 Care required HDL Cholesterol mg dL 29 00 71 00 35 00 Cholesterol HDL Ratio Ratio 0 00 4 90 4 00 Lipid Panel Both Variable Normal Range Value Comment Cholesterol mg dL 0 00 199 00 190 00 0 00 129 00 135 00 30 00 200 00 Pediatric HAL S3005 User Guide 57 Send the completed lab report to the virtual monitor screen to assist the care provider To transfer the lab report to the virtual monitor screen 1 First select the report from the lab reports list W Name Template Description Sent Create New Lab Report Sort by Color Edit 2 Click Send to Monitor button to transfer the lab report to the virtual monitor Create New Lab
76. ed as a team or individually Click the provider s name to set the provider as active and track the actions individually Session Title Simulation 1 ES Emergency pm Click the appropriate option to track the action For example if the provider assesses the patient s responsiveness by requesting them to open their eyes click the Assess responsiveness button and select Open your eyes MI Options responsiveness DC open your eyes open your eyes if you can feel me touching you Log Evaluation of Lisa ACTION Intubation Check ACTION Intubation Check ACTION Extubate ACTION Extubate Lisa ACTION Assess responsiveness open your eyes 00 54 57 Lisa ACTION Assess responsiveness open your eyes if you can feel me touching you ADD TO LOG Click the Team button to deactivate the active provider and return to general logging Right click the provider button to delete or rename a provider Session Title Simulation 1 PROVIDERS Emergency Mission a h Shoulder ri dystocia 86 Pediatric HAL S3004 User Guide Create new clickable provider action buttons to expand the library of actions To add a new action to an existing category 1 Click the button on the category 2 The category menu is displayed Breall g Uirculatio a Circulation Custom Log ion 2 Action type 9 Descriptive Action Responsive Action 3 Descriptive
77. ed in the scenario punctuated by Wait Indefinitely items In other cases the simulation will require more direct control by the facilitator via either the Palette or Details page 4 Choose auto response settings based on the scenario content and the objectives As you ve seen auto responses can be used to free the facilitators attention They also enhance realism by presenting instant reactions to the care providers On the other hand sometimes it is not possible or desirable to determine the responses before the simulation begins Different environments and applications call for different settings Some teaching practices are best done with the auto response settings in Prompt mode Responses must be triggered by a vigilant facilitator Though it is slower and requires more attention the benefit of Prompt over other modes is that the simulation can be allowed to go in any direction and it will be possible to choose the response on a case by case basis Other learning exercises require a higher degree of automation For such applications most facilitators choose Auto mode for the auto response settings The key issue is standardized timing of symptom presentation A consistent repeatable simulation is essential for fair assessment of that care provider in relation to others and for the broader interpretation of results in the context of training validation studies When in doubt it is best to choose Prompt mode in which the facilitator
78. els Use the Calibration menu to calibrate the simulator s features and to reset the sensors back to default settings Reference the simulator s directions for use guide to determine which feature calibrations apply Calibration Calibration Wizard Welcome to the Manikin s calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate a Pupil Sensitivity A Chest Compressions Artificial Ventilation Blood Pressure Cuff Settings Factory Chest rise will stop when the Calibration menu is active e Chest compressions e Artificial Ventilations e Blood Pressure Cuff The chest compression calibration wizard records the average depth as pressure of 5 chest compressions GIGA evaluates provider performance using the information recorded during the calibration as the correct benchmark To calibrate the compression performance benchmark 100 Pediatric HAL S3004 User Guide 1 Click Setup gt Calibration gt Chest Compressions and click Next The wizard prompts to perform compression 1 2 Perform one chest compression correctly A green filled oval indicates that the chest compression was recorded successfully 3 Perform chest compression 2 as prompted by the wizard A green filled oval indicates that the chest compression was recorded successfully 4 Co
79. ely 2 hours The AC adapter s status indicator light displays red when the battery is charging and green when the process is complete To display the battery level the GIGA software must first establish a connection with the HAL WARNING Do not store the simulator with a discharged battery Recharge the battery at the end of every simulation session lf the simulator will not be used for an extended period re charge the battery at least once every 30 days Doing so will prevent damaging the battery due to discharging Pediatric HAL S3005 User Guide 13 Control Tablet PC The tablet PC is preloaded with the GIGA control software used by the facilitator to initialize the simulator and control the vital signs Before turning on the computer for the first time please review the documentation included with the product for important care and warning information The tablet s stylus is a pen shaped input used to interact with files and programs e Left click tap the screen with the pointer Tap twice rapidly to double click e Right click tap and hold a highlighted item or hold the button near the pointer and tap the item or text As part of the initial setup process calibrate the stylus using the Tablet and Pen calibration tool in the Windows control panel Complete the calibration process while holding the pen in a natural writing position for greater accuracy during normal use WIRELESS COMMUNIC
80. en they are not on Simulator s chest does not rise with artificial ventilation e g BVM Disable lung s Enable the lungs from Detail page on the GaumardUl software Low chest rise or no Wrong settings or disabled lungs chest rise at all while breathing Make sure lungs are enabled and both respiration rate and inspiration percent are different than 0 Try changing the respiration rate to a different value and if still nothing happens try turning the manikin off and restarting everything to make sure the internal air compressor gets its initial settings Loss of brachial pulse Brachial pulses disabled Make sure to enable brachial pulse on Details tab page Pediatric HAL S3005 User Guide 163 Pre built scenarios don t Select Quick Start Scenarios when starting show up the software Should user forget to do so there s no need to shut down the software and open it again in order to load the pre built scenarios Go to File Profile menu and then select Modeled Scenarios A sound is absent or is Volume not set to user s criterion Every sound has a volume control Play with not heard at desired the volume control to get it to the desired volume level level 164 Pediatric HAL S3004 User Guide 3 Enter a wireless network name case WI reless Netwo rk sensitive Use the same wireless network name to configure the Gaumard GIGA generates the vital signs infor
81. ently on sim ET e OSat Currently on sim jsp e EtCO2 Currently on sim AA NOW 10sec 3Osec 1min 2min 5min 10 min On Apply Clear and Close Details Window Pediatric HAL S3005 User Guide 25 Change vital sign value or state to add it to the Details list e Respiration rate 30 bpm OSat 96 EtCO2 39 mmHg as Details gt Vital Controls Sound Controls jo Respiratory Pattern A Currently on sim SO Inspiration Percentage Currently on sim ES El OSat 4 Currently on sim Change To 98 H96 jo EtCO2 4 Currently on sim Change To 39 fo 2 aw Click the sound controls tab to change the sound types for audible features e g heart rate and volume level as Details Breathing Respiration rate Sync ALL Lung Sounds ee jo Lung Sounds Right 4 EtCO2 rmal wheezing Lung Sounds Lung sounds volume ri Lung sounds Lung sounds volume 26 Pediatric HAL S3004 User Guide After the list of changes is created click NOW to update the vital signs instantly Alternatively click a trending timer to update numerical vital sign parameters e g heart rate blood pressure gradually ax Details Vital Controls Breathing Respiration rate Sync ALL Lung Sounds Cts e Lung Sounds Right EtCO2 i Lung Sounds Lung sounds volume right Lung sounds left Lung sounds volume left one
82. er changes NSR 75 bpm BP 120 80 Click the palette button to program a specific palette item as an auto response Defibrillation Shock off A Prompt Ei En Auto E setting SE at Joules 5 Shocks convert to NSR vie 70 bpm BP Ik 120 80 Pediatric HAL S3005 User Guide 105 Select the desired palette from the Load Palette Item window and click Load Load Palette Item Palette Healthy Vitals Q francine02 E gloria01 oe Healthy Vital Signs The defibrillation shock auto response is now configured apply the Healthy Resting palette if a virtual defibrillation shock of 200 Joules or greater is detected The programmed response palette is listed in the settings panel Defibrillation Shock off of Prompt Pri 5 Auto Au setti Setti at etting Joules 1 O Shocks Healthy Vitals 106 Pediatric HAL S3004 User Guide AUTOMATIC MODE NON SCENARIO AUTOMATIC RESPONSES The Automatic Mode non scenario Automatic Responses are unique to the automatic mode Link All Auto Response to Cardiac Irritability Auto responses will work only if the cardiac irritability option on the details page matches the selection on this window enario automatic responses settin
83. es Disclaimer The section below describes all possible features in the HAL simulator The content of this table is subject to change without prior notice Please contact Gaumard Scientific for the most current information Y Yes included O Optional O ro O E EA S3005 S3004 CAS E LA ES CA CA EEC EN EA CS CA EA A 2 lt lt lt lt lt lt lt lt lt lt lt lt CTO CA LA CS CAM LA ETS LAA LA E LA 2000 es A E 2000000 20000 Bilateral Pulses Carotid Brachial Radial Femoral Radial CI CA A CS CA CA DO L LR CS CA A E A LA EE CA A CS CA A aC CC CC lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt lt 116 Pediatric HAL S3004 User Guide Sensors in the airway detect the placement of the endotracheal tube If the endotracheal tube is inserted too deep the left lung is automatically disabled demonstrating right mainstem intubation Correcting the tube position enables the left lung chest rise Use the software controls to enable the airway complications and make intubation more difficult HAL can display tongue edema The simulator can produce airway sounds Use the software controls to change the sound type and adjust the volume Auscultate using a standard stethoscope Intubate HAL s airway via the
84. esi aii ieante aes ate A A 84 EV AIA NOn EON tan teot manna aoielnnaaneaemeteontse 89 SP EE PO UE E ER shears andthe 96 A ete nee te nen Pree Enc Een er nn Ree er et ree neh er ee Ee tr eee eee rene eee 98 AT 98 SOU uri aa aa a diesel ico 100 AUTO Mode Upgrade ua laica 107 MORI Sa AAA A 109 ANV AUdIO O an 118 O AEE EE EA EE moose ET aaa 114 WOFKINO WIN IRA Loca 115 BELTS NU 2 bo ame rere gouge et E OE EE Se ere Se DE EA et CSU ENS oct ane are pore nO Seg 116 AIN A cer A tierce tus ced A A A E S 117 A A A eee ear 118 Gadid arina e a A O OAA 119 SINCUIATIOMNN mearra aa A A E E AAE 121 Neurologie aan a a a a a ermine 123 MET AET E AN A E N E E E E TA 124 PADD CII inci cbiieduentbocindeansbevermsorimectwenewt 126 Scenario Frequently Asked Questions FAQS ccccceecesseeesseeeeeeeeeseeeesees 127 CENA OO Sai 129 A eet Ee eed te Slee eet Satan 162 MA orriari areln a ecemse Sect mehoeemeetcdac en heaces 165 Spa e Panini 168 WA AY eae A A A A anes 170 GO A E a E 171 4 Pediatric HAL S3004 User Guide Introduction Pediatric HAL S3005 User Guide 5 End User License Agreement This is a legal agreement between you the end user and Gaumard Scientific Company Inc Gaumard This software is protected by copyright laws and remains the sole property of Gaumard By installing the GIGA the Software media you agree to be bound by the terms of this agreement If you do not agree to the terms of this agreement promptl
85. ested by the calibration wizard following the most current CPR guidelines The CPR window evaluates provider performance based on the benchmark recorded during the calibration process To calibrate the compression performance benchmark 1 Click Setup gt Calibration gt Compressions and click Next The wizard prompts to perform compression H1 2 Perform the first compression A green filled oval indicates that the compression was recorded successfully 3 Perform compression 2 as prompted by the wizard A green filled oval indicates that the compression was recorded successfully 4 Continue through the calibration wizard to record a total of five compressions 120 Pediatric HAL S3004 User Guide Circulation The simulator s palpable pulses are blood pressure dependent Use the software controls to disable the radial pulses to simulate severe hypotension IV ARM The simulator is equipped with an IV arm that 3 Insert water in the system until fluids exits allows for bolus or intravenous infusions as through the drainage tube into the well as for drawing fluids container and all air bubbles are purged WARNING Do not attempt to fill IV system without the drain connector in place Always leave the drain port connected when injecting fluids into the system Use only Gaumard s artificial blood concentrate or clean water to fill the vasculature Any other simulated blood brand containing suga
86. eveloped chills and his temperature is still 40 Deg C despite fever reducers He takes folic acid and penicillin daily His immunizations are up to date Pediatric HAL S3005 User Guide 147 Caurmard Pediatric HAL Five Year Systemic Scenario Simulators for Health Care Education Diabetic Ketoacidosis A five year old boy presents to the ED with a history of vomiting for one day His mother says he has vomited at least ten times since the night before and he can t keep anything down He has a low grade fever and has not had diarrhea but he has been wetting the bed He appears pale with sunken eyes and breathing very rapidly BE Perform Actions Excessive fluids Perform S Yes actions No Yes 148 Pediatric HAL S3004 User Guide PEDIATRIC HAL 1 YEAR SCENARIOS Category Scenario Respiratory 1 Bronchiolitis 2 Upper Airway Obstruction Toy Aspiration 3 Croup 4 Pneumonia 5 Pneumonia with Septic Shock Trauma 1 Shaken Baby Syndrome 2 Drowning Boy Cardiac 1 Second Degree Block 2 Sinus Tachycardia and Hypertension 3 Congenital Heart Failure Systemic 1 Bee Sting 2 Hypovolemic Shock Automatic Adenosine OD Adenosine SD Adenosine UD Pediatric HAL S3005 User Guide 149 e 7 Gauna Pediatric HAL One Year Respiratory Scenario Simulators for Health Ca
87. field CVGIUGLUUIE Name On Site Reviewer Multiple Choice Entry 1 Eae dfe pa ETa E Ea ET Yes No N A Repeat the previous steps to add more categories questions and multiple choice options es Evaluation Form Load template lear Delete S0 To Eaton ode Evaluation Name Shoulder Dystocia On Site Reviewer O Category Multiple Choice Entry 1 ped frero jpe pa E a oee ree a T 1 Provider Tasks and Performance gt gt Yes No N A Calls for additional help Nursing or Physician Calls for pediatrics Applies gentle traction to attempt delivery Utilizes McRobert s maneuver Utilizes Suprapubic pressure Attempts oblique maneuver Woodscrew or Rubin Performs Episiotomy After the evaluation template design is complete click Save at the top of the window ass Evaluation Form Load templat saye ear Evaluation Name Shoulder Dystocia On Site Reviewer 94 Pediatric HAL S3004 User Guide The evaluation form is now available for use Load template Clear Print 4 Go To Edit Mode rs o _Yes No N A Calls for additional help Nursing or Physician A Pediatric HAL S3005 User Guide 95 CPR GIGA features a CPR performance evaluator and trainer Click the CPR icon on the vertical menu bar to open the CPR window The CPR evaluator feature provides
88. gel adhesive or use expired pads e Do not attempt to repair or modify any electrical connections or conductive sites Discontinue use if wires are exposed wire insulation is damaged or if any conductive sites are damaged e Electrode gel can become a pathway for electrical current Do not allow defibrillation pads to overlap ECG sites or gel to carry a current to the ECG sites Applying an electrical current to the ECG sites will result in damage to the simulator s internal components e Some electrical therapy devices may be sensitive enough to detect the simulator s electrical current for operation If the interference is displayed on the ECG reading please disconnect simulator s charger and operate the simulator on battery power only Pediatric HAL S3005 User Guide 119 CHEST COMPRESSIONS At the end of the calibration process the son A e wizard reports the average peak pressure Set the heart rhythm to asystole and instruct and duration values for the procedure Click the provider to perform chest compressions Save to store the calibration settings Monitor the depth and frequency of chest compressions from the CPR trainer window Before using the chest compression feature for the first time please calibrate the chest compression feature The compression calibration wizard records the performance average of five compressions as the benchmark for a correct compression Perform the actions requ
89. gs Link All Auto Response to Cardiac Irritability Modeling off none E pt 9 Onif Cardiac Irritability is scale jom a Defibrillation Shock An event prompt is displayed if electrical therapy is detected and the cardiac irritability set does not match the selection on the responses window Drug Model Effect Configure the auto response behavior for drug administration e Auto Apply the drug effects based on medication s programmed properties and dosage e Prompt Display a confirm prompt before applying the drug s effects Use the Scan RF Channel tool to search for the strongest RF communication channel available Click the Scan RF Channels option in the setup menu to start the scan Please wait while the system completes the process The tallest bar represents the strongest channel Double click the bar to connect to the simulator using the channel selected To load an already existing patient go to Auto Mode Upgrade Modeling Modeling Patient Load Patient The Modeling drop down menu in the top left corner of the GIGA contains four options Select Last Modified Modeling Patient Reset Model Import Se ws eee Between Pati ents and Auto Log Setti Ng 08 31 2012 11 28 40 Her companion s name is Bill husband Her OB 08 31 2012 11 28 40 history shows a gravida of 0 a term of 0 a 08 31 2012 11 28 40 preterm of 0 and that she is cu
90. hing scenarios from other patient profiles into the current active one Enter the name of the patient age gender height weight and or additional notes Then To import an item another patient in to the click Save active patient 1 Click Auto Mode gt Import Patient to open the Import menu 2 Select the item category to import Pediatric HAL S3005 User Guide 107 Import Between Patients Importing Select Scenarios Branching Scenarios Alyssa 2 Alvssa 3 Becca 3 Select the patient name that contains the items to be imported into the active patient Importing Palettes Angela 1 1 Angela 1 Angela 2 Angela 3 Angela 4 Eleanor Frin 4 Select the items to import from the list and click Import Angela Early Labor Properties 108 Pediatric HAL S3004 User Guide The palettes are now copied into the active patient This menu option is used to specify various vitals to be logged automatically after reaching a specific threshold as Auto Log Setting v Auto Log Log Vitals when Heart Rate changes more than Systolic BP changes more than Diastolic BP changes more than Resp Rate changes more than Insp Percentage changes more than EtCO2 changes more than Sp 02 changes more than Temperature changes more than Monitors eee eee The sensor control window is a floating
91. iatric HAL S3004 User Guide Set the Go to node from the drop down and click OK to save the changes Edit Path sto Res D K Key events Move yy H Rename Delete Defibrillation Shock Cardioversion Shock Non Sync Shock External Pacing Goto End I OK 1 i p 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine m 6 Dopamine r Pace Previous gt l m End The key event is now programmed to move the scenario to node 8 if pacing is detected 1 OSat 5 Scenario E Epinephrine Al Epinephrine E The Linked Action model medication tab is exclusive to the automatic mode Program the medication linked action to trigger an alternate path when the system detects that the specific medication has been administered to the simulator e Linked Action Electrical Therapy Medication Atropine Pediatric HAL S3005 User Guide 53 Use the Hypoxia tab to evaluate the effectiveness of provider intervention on an apneic patient The model adjusts the cardiac oxygen saturation and cyanosis dynamically in response to effective ventilations The model also responds to the administration of epinephrine and oxygen as GIGA Newborn HALO B8505004 S T A B L E NEWBORN STATUS DETAILS x HYPOXIA PAUSE hypoxia modeling Improve Gain Y
92. ibed Clear Load Save Bradycardia Note for this scenario to function as intended the E 1 Start Bradycardia O w Palette Scenario Path v i gt Bradycardia 00 00 RR 10 HR 45 2nd deg AVB Type II Speechi 00 01 complaint Feel dizzy 2 Deteriorate o w Palette Scenario Path v O wait 02 00 No changes are made to manikin Speechi 00 01 confusion What happened Cardio Drop 01 00 HR 15 BP 10 OSat 5 3 Interventions 0 w Palette Scenario Path gt wait Indefinitely Wait for intervention 4 Atropine w Palette Scenario Path gt Atropine 01 00 HR 10 BP 7 5 Epinephrine v Palette Scenario Path gt Epiinfusion 01 00 HR 5 BP 8 A path refers to the trajectory from one node to another after the last palette in the node expires The scenario will move on to the node indicated by the arrow Click on the Time Limit icon to modify the Go To point for the default path H Scenario Path v Pediatric HAL S3005 User Guide 49 In this example the first node must move to Node 2 Deteriorate after the time limit expires Click OK to save the changes PaTELEE OCEAN Pao Set Time Limit min SEC 59 59 Max Go to 2 Deteriorate h bp Cancel Fl Epinephrine Node 1 is now configured to proceed to Node 2 as indicated by the arrow Bradycardi
93. ic drug used to treat hypertension Standard Dose Furosemide SD 40mg Over Dose Furosemide OD 120mg 2 Enter the dose units route and rate if applicable and click Administer MEDICATION Drug Furosemide Lasix Drug Properties Description Half Life 00 30 00 Peak Time 00 45 00 EC50 2 64mg dl Diuretic drug used to treat hypertension a Standard Dose Furosemide SD 40mg Dene Maras Dirnsansida Ms Mess 68 Pediatric HAL S3004 User Guide 3 The Proceed Drug window prompts to confirm the dosage effects before applying them Adjust the peak effect percentage and or the dosage effect and then click Yes to apply the effects Proceed Drug 50 0mg of Furosemide Lasix through IV_Push has just been Administered This dose will be treated as Dose Do you want this drug to take the following peak effect pe View Effect Reverse effect when the drug s level begins to drop To turn off the Proceed Drug prompt click Setup gt Auto Responses and change the Drug Model Effect settings to Auto The administered drug panel displays information on dosage rate does administered and total time of administration Administer Pediatric HAL S3005 User Guide 69 The Auto mode adjusts the patient s vital signs to simulate the effects of the drug automatically a CIRCULATION TEA Temperature 37 0 C Vessel Stiffness 103 PH Level 7 40
94. icate that the maximum interaction effect 82 39 occurs at 00 46 51 The alpha at that point is 1 01 and the drug effect for each drug is reduced by 0 90 Fine tune the Max Alpha control and retest if the drug interaction effect is not realistic I Update Graph Results At time 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 i Compared to Additive individ drug effect reduced by 0 90 A time effect graph is generated from the test results Tap and hold to draw a zoom area Time Effect Graph 80 Pediatric HAL S3004 User Guide 3 Right click anywhere on the graph access the zoon and print options Time Effect Graph Page Setup Print Show Point Values Un oom 4 Isobologram plasma concentration 5 Review all the properties of the new medication in the Add New Medication window and click Add to save the new changes hr min sec Precise 0 184 308 Approximate very quick lt 5m Clear All In the example below two drugs preprogrammed to interact have been administered The interaction information is listed in the Interaction Status panel ww bl Naloxone Narcan 0 ug IV Push 4 29ug kg 98 63 sd 00 10 17 Captopril Capoten 0 mg Per Oral 6 20ug kg 3 36 sd 00 09 57 More Potent Eff Change Less Potent Eff Change Max Alpha Current Alpha Pediatric HAL S3005 User Guide 81 Event Log The event log r
95. ient s vital signs automatically in response to caregiver participation instructor input and pharmacologic intervention For example if the heart rate is increased GIGA will calculate a realistic response to the event and adjust the blood pressure values automatically To enable the Automatic Mode as an option in the profiles menu go to page 103 Click Auto Mode to pause the automatic changes To return the patient to the initial state click Reset iL Body View all Oo Auto Mode On Pediatric HAL S3005 User Guide 29 Patient files store general information such as weight height and age The automatic mode factors the patient s weight as it adjusts related physiological parameters GIGA includes several preprogrammed patients in the Quick Start Modeling profile For more information on the each patient profile go to page 106 A default patient is loaded when the Quick Start Modeling Profile is selected and it is an ideal candidate for most simulations Click the patient information bar to view the patient s profile Patient Noelle F 27 y 165 0 cm 85 0 kg Her companion s name is hal Her OB history shows a gravida of L term of 0 a preterm of Patient s Info Her companion s name is hal Her OB history shows a gravida of 1 a term of 0 a preterm of 0 and that she is currently 40 weeks pregnant Name Noelle she has had 0 spontaneous abortions 0 elective abortions and 0 living Gestio
96. imulator caused by applying an electrical charge to the ECG sites For exercises that incorporate real electrical therapy of any kind always follow the safety guidelines and operating procedures outlined in the medical device manufacturer documentation ECG AND DEFIBRILLATION WARNINGS e Always follow the standard medical guidelines and precautions for handling electrical therapy devices Improper use of a real electrical therapy device may result in personal injury e Operate simulator in a well ventilated area free of flammable gases e Ensure the simulator is fully assembled fully operational dry and undamaged before administering electrical therapy Never apply electrical therapy if the simulator is in contact with a conductive surface or substance e Do not leave electrodes or pads attached to the conductive sites when the simulator Is not in use e Use hard paddles or wet gel pads preferably Avoid using solid gel pads as they increase the risk of burning the simulator s skin if arcing occurs When using gel patches make sure not to leave air gaps or bubbles between the pads and the conductive area on the simulator s skin to avoid arcing e Clean the conductive sites at the end of the simulation Refer to the care section for more information on approved cleaning products Gel residue adhesive residue or dirt can increase the risk of arcing during defibrillation e Do not reused
97. ion gt Blood pressure and click Next 2 Set the pressure on the BP cuff to 0 i e cuff valve open as prompted by the calibration wizard 3 Click the OK button to record the current cuff pressure for the interval A green filled oval indicates the pressure interval was recorded successfully 4 Set the pressure on the BP cuff to 20 mmHg as prompted by the wizard and then Click OK to record 5 Continue increasing the BP cuff pressure as indicated by the prompt and recording the pressure intervals At the end of the calibration wizard click Finish to close the calibration wizard Use the software controls to adjust the cyanosis intensity Neurological The simulator is equipped with programmable blinking eyes and pupils that dilate Use the software controls to change the blinking rate and to enable or disable pupil reaction The eye reaction is factory calibrated Use the Pupil Sensitivity controls to recalibrate the pupil reaction for the current room lighting only if needed To calibrate the pupil dilation 1 From the File menu go to Setup gt Options gt Tolerances 2 Click Set ambient light to recalibrate the pupil diameter to the current ambient light 3 Cover both eyes from most incoming light and click Set Dilation Light to set the low light pupil diameter 4 Click increase or decrease to adjust the pupil s sensitivity to light The simulator is capable of
98. k Load to continue Manual Mode In the Manual operating mode the facilitator fully controls the vital signs and physiologic responses Pediatric HAL Five Year Profiles Manual PROFILES DESCRIPTION Default Profile factory preset scenarios Quick Start Pediatric 5 Rename i Delete Pediatric HAL a Vear i New Profile Pediatric HAL S3005 User Guide 17 The Manual mode includes the following profiles Default Profile includes one preprogrammed palette with healthy vital signs Quick Start Profile includes basic preprogrammed scenarios Automatic Mode The Automatic mode assists the facilitator by automatically adjusting vital signs in response to caregiver participation pharmacologic intervention and manual input For example when facilitator increases the heart rate the Auto mode will calculate the response and adjust the blood pressure automatically To activate the operating mode as an upgrade option go to page 103 For more information about controlling the simulator using the Auto Mode go to page 29 Pediatric HAL Five Year Profiles PROFILES DESCRIPTION Default Modeling factory preset scenarios e Pediatric HAL AAA Five Year New Profile The Automatic mode includes the following built in profiles Default Modeling includes one preprogrammed palette with healthy vital signs Meds Profile includes a library of pre programme
99. lettes Apply tems Threshold an Eees ES 8 Select the threshold unit and set the dosage amount that will trigger the programmed palette effect bduces 50 of the maximum effect F Apply Items Threshold mg e m Properties F Eat p clear 4 Betame Pediatric HAL S3005 User Guide 75 9 Click Add to save the new medication to the Medication List library E ESSE bale ll hr sec ecise proximate very quick lt 5m lear All After configuring the drug properties using the Add New Medication menu click the Update Graph button to generate the effect plasma concentration results Continue to the next section to program interactors for this drug Properties Properties Edit Clear 8 Drug Effect Tester g C g kg Effect Plasma Concentration log Graph subQ il 4 g 2 Plasma Concentration mg dL Drug Interactions i l 76 Pediatric HAL S3004 User Guide Use the Interaction Editor window to program drug interactions When two or more medications preprogrammed to interact are administered the physiologic model will adj
100. ll not initialize until the power adapter is reconnected or the battery is recharged Refer to the directions for use guide for charging information specific to the simulator model Pediatric HAL S3005 User Guide 19 Session Clock The session timer displays the duration of the current session Click the timer to reset the clock or to start a new session Event entries in the text log are synchronized with the session timer ction Duration 40 x AL Body view 00 12 15 Reset Session Clock Power Stand by The power button is located at the bottom right corner of the GIGA software Toggle the power button to set the simulator to stand by mode and then again to resume 20 Pediatric HAL S3004 User Guide Status Details Controls The Status Details panel is used to monitor and control the simulator s vital signs The individual parameter controls displayed on the details tab provide the simplest method for controlling the simulator s vital signs sounds and features There are two viewing modes The List view displays the vital signs controls in a list format while the Body view displays the interactive patient model with floating control boxes Toggle the view buttons to switch between the two modes CEPHALIC Eye State CEPHALIC A Eye State closed x lt Tongue Edema Pharyngeal Swelling BREATHING D e 13bpm
101. mation Monitors PG GaumardNet is the displayed on the virtual monitor PC The required name for Windows 7 information is transmitted through a wireless computers ad hoc connection between the two computers in real time The wireless settings are configured at the ee E pa factory so no additional configuration is GaumardNet required Please reference the 3 Controller 1P 2 troubleshooting section to resolve common Be connectivity issue before attempting to reconfigure the network 4 Set the Controller IP On each control PC and virtual monitor PC enter the same values for the first three IP fields and a set unique value for the last field The suggested address is for the Controller IP is 10 1 1 200 Use the Create an ad hoc Wireless network tool to configure the wireless ad hoc link between the two computers Then configure the connection between GIGA and the Gaumard Monitors software GIGA NETWORK CONFIGURATION odua UINEL 3 Controller IP p gt 10 1 E 1 lt 1 200 Complete the next steps using the Apply Wireless Network Settings Controller Create Ad Hoc Wireless en Network tool built in to GIGA software 1 From the menu bar go to Help gt Create ad hoc Wireless Network The Controller Create Ad hoc Wireless Network window is displayed 5 Click Apply Wireless Network Settings to save the settings 6
102. n fl anowin Diniteki Information about the interactor drug is displayed in the Interactor Data window Naloxone Narcan Half Life 01 00 00 Peak Time 00 01 30 SD 400ug OD 2000ug EC50 0 0001mg dL gt Ma o Interactors 2 Remove B B Remove Alh i Edit E Drug List Captopril Capoten Captopril Capoten mg dL g B Interactor Data 8 Half Life 01 54 00 Peak Time 01 00 00 E SD 25mg OD 75mg EC50 0 0240mg dL 2 The drug is included into the interactors list Repeat the process to add more drugs to the interactors list if necessary SD 400ug OD 2000ug ECHN 0 0001mg dL Interactors Nitroprusside Nitropress Re All Edit Drug List Add 78 Pediatric HAL S3004 User Guide 3 Select the interactor and click Edit Et FU LL FS Captopril Capoten Drug List j Add 4 Adjust the Max Alpha to modify the type of interactivity effect Monitor the graph for a visual model of the plasma concentration e Alpha 1 Additive e Alpha lt 1 Synergistic Induction e Alpha gt 1 Antagonistic Inhibition Cancel A Max Apna 0 75 1 30 S S e ug Isobologram plasma concentrat ___ move y emove a Os move All E n TEST 7 NEL A Use the test panel to simulate the interaction between the drugs based on dosage and time of administrati
103. n treatment with albuterol and atrovent 130 Pediatric HAL S3004 User Guide a g i Gaumard Pediatric HAL Five Year Respiratory Scenario Sinadslors Scr Heth ire Bilicalion Foreign Body Aspiration US A five year old boy was visiting his grandmother who had a bowl full of peanuts on the table He and his older brother were throwing the peanuts in each others mouths and laughing The five year old began choking and gasping for air He could still say a few words between coughing but then he collapsed to the floor His grandmother ran into the room and his older brother explained he had choked on a peanut His grandmother saw he was turning blue She told her grandson to call 911 Wait indefinitely for five abdominal thrusts Wait indefinitely for intubation Pediatric HAL S3005 User Guide 131 Pediatric HAL Five Year Respiratory Scenario Gaumard Upper Airway Obstruction a gt iii Toy Balloon 5yr LD DY You are at a birthday party where you see a five year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins gasping for breath He is turning cyanotic and cannot cry You assess his airway is obstructed and the obstruction must be removed You try simple measures as back blows and chest thrusts and activate EMS Unsuccessful or 1 min timeout
104. nal Age 40 w children Age 27 y A Height 165 0 cm Weight 85 0 kg In the automatic mode the Details panel includes additional vital sign parameters and control options not available in the Manual mode STATUS DETAILS CARDIAC Regurgitation tricuspid pulmonary mitral aortic Valve Resistance tricuspid pulmonary mitral 100 Auto 100 Auto 100 Auto 100 Auto 30 Pediatric HAL 3004 User Guide The Hold and Auto options are unique to the automatic mode The Auto Mode adjusts vital sign controls with an auto suffix automatically Checkmark Hold to prevent the Auto Mode from adjusting the value Then change the vital sign to the new static value The automatic mode will not change values set to hold The Auto Mode will adjust all other controls set to auto STATUS DETAILS MEDICATION CARDIAC Regurgitation tricuspid Off pulmonary Off mitral aortic Valve Resistance tricuspid 135 pulmonary 135 mitral Some changes are gradual and even if submitted for immediate change The delay results from using a closed loop model that adjusts to the target values over time rather than displaying a unique value that is unrelated to other parameters The lung condition parameter adjusts the shunt flow dead space airway resistance and respiratory pattern automatically STATUS DETAILS Shunt
105. nasal or oral route using an endotracheal tube or an LMA Providers can perform a cricothyrotomy through the precut opening on the neck skin The airway itself features an opening covered with tape that simulates the soft cricothyroid membrane Avoid using surgical tools to cut the neck skin The precut opening allows the insertion of most medical devices Always lubricate the medical adjunct before insertion WARNING Always lubricate the endotracheal tube and the medical device using silicone oil before intubating Do not introduce liquids into the airway Doing so can permanently damage the system AAA _ 3005 ni REPLACING THE CRICOTHYROID Intubation Miller 2 or Miller 1 TAPE Blade size MAC 3 A eee cement Size 2 2 5 Size 1 5 2 Nasal 10 Frcatheter 10 Fr catheter Intubation Lubricated ETT 3 5 no cuff 8 Fr suction catheter Oral Lubricated ETT 5 0 or 5 5 no cuff 10 Fr suction catheter Nasogastric 10 Fr catheter 10 Fr catheter Tube Intubation To replace the cricothyroid membrane tape 1 Turn off the simulator and place it on a clean flat surface 2 Unscrew the bolts located at either side of the midsection 3 Gently slide the skin off each bolt and life the chest skin over the face to expose the airway 4 Remove the punctured cricoid tape from the airway and any glue residue 5 Wrap a new piece of tape around the airway to cover the cricoid opening Ensure that the tap
106. ntinue the calibration process to record a total of 5 compressions as prompted by the wizard At the end of the calibrating session the wizard reports the average peak pressure and duration values for the procedure Click Save to store the settings Please test the compressions calibration using the CPR trainer Go to page 96 learn more about the CPR trainer and the feedback graphic The ventilation calibration wizard records the average pressure of 5 ventilations GIGA evaluates provider performance using the information recorded during the calibration as the correct benchmark To calibrate the ventilation performance benchmark 1 Click Setup gt Calibration gt Ventilations and click Next The wizard prompts to perform ventilation 1 2 Perform one ventilation correctly A green filled oval indicates that the chest ventilation was recorded successfully 3 Perform ventilation 2 as prompted by the wizard A green filled oval indicates that the ventilation was recorded successfully 4 Continue the calibration process to record a total of 5 ventilations as prompted by the wizard At the end of the calibration process the wizard reports the average peak pressure and duration values for the procedure Click Save to store the settings Please test the ventilation calibration using the CPR trainer Go to page 96 learn more about the CPR trainer and the feedback graphic Calibra
107. o page 109 To create a new lab report go to page 54 Transition min sec ok oF 59 59 Max 59 59 Max Item Description Item Description Wait Wait Indefinitely Add realism to a scenario by integrating automated speech phrases Click the Add to scenario button and select Speech Then select the type of speech and phrase using the drop down menus Add Palette Item Transition min sec 08 o gt 59 59 Max Item Description VIRTUAL MONITOR PALETTE LOG 00 09 06 APPLIED 00 00 Pediatric HAL S3005 User Guide 45 The scenario auto response settings move the scenario to the next palette when electrical therapy is detected Electrical therapy can be applied by the facilitator via Virtual Shock panel or by the care provider using real medical equipment if the simulator supports it Auto responses advance to the next palette if the virtual shock is applied while a wait indefinitely palette is playing and the heart rhythm is shockable a Scenario automatic responses settings All Off All Prompt Display warning when non shockable jp All Auto y EKG is shocked Cardioversion Shock Prompt gt Prompt S Prompt Ca Prompt Ca Auto Y Auto Sy Auto Sy Auto SS setting Capture at t at a 40 Ema 205 i a
108. o to using the Go to menu Click OK to save changes Edit Path Le ses Key events Selected Atropine r A lo Move l Vea LU oo f Rename 1 i Delete j 9 Action Linked Action Electrical Therapy Drug Recognition Defibrillation Shock Joules Shocks Cardioversion Shock Joules Shocks Non Sync Shock O Joules Shocks External Pacing mA Add 1 3 Goto End li ox A fio Cancer MN 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine X 6 Dopamine HAB Pace Previous y End Pediatric HAL S3005 User Guide 51 In the figure below node 2 is configured with four alternate paths Once the provider performs any one of the actions listed as key events checkmark the key event to activate the alternate path a ro 2 Deteriorate a v Palette Scenario Path v T 00 01 gt 3 5 Wait 02 00 No changes are made to manikin Atropine x Speech 00 01 confusion What happened a A gt 4 l Cardio Drop 01 00 HR 15 BP 10 OSat 5 a i E Epinephrine x Om 5 Edf i Dopamine x ad A gt 6 ral Pace x mc ode rosene oeeo Start Node vital signs palettes simulate bradycardia Go to node 2 bradycardia Vital signs palette
109. ock O Ventilations and Compressions 1100 Compressions per minute Compression Ventilation Ratio 30 2 Only Ventilations 12 Ventilations per minute e Ventilations and compressions Set the trainer s ventilations to compressions ratio prompt e Ventilations only Set the trainer to prompt for ventilations only and set the rate per minute Use the Tolerances controls to adjust error margin allowed by the CPR intensity and rate The simulator s pupils react to light Use the Pupil Sensitivity controls to recalibrate the pupil reaction if dilation is erratic e Set ambient light Click Set ambient light to recalibrate the pupil diameter to the current ambient light e Set Dilation Light While covering both eyes from most incoming light click Set Dilation Light to set the low light pupil diameter e Increase Decrease Sensitivity Click increase or decrease to adjust the pupil s sensitivity to light e Reset to Default Reset the pupils ambient and dilation settings to the factory settings Pediatric HAL S3005 User Guide 103 Checkmark the Use A V to display the audio and video configuration menu on the menu Environment General Moele Add Ons bar Noelle Features CPR Options Pacing Shock Tolerances Log Other Options CPR Intensity Tolerances qx 22 oo y Environment General Noelle Add Ons Artificial ventilation intensi
110. on Test Panel Test object weight 68 kg Time Effect Graph Apply Naloxone Narcan z P i Dose 1 lug Attime 0 0 0 Apply Captopril Capoten Dose 2 mg Attime 0 0 0 M Update Graph 2 Results At time 01 45 00 Max Interaction Effect 3 88 Alpha 0 93 Compared to Additive individual drug effect increased by 6 87 Pediatric HAL S3005 User Guide 79 To simulate the medication interactivity using the test panel 1 Enter the patient s weight and the dose for each drug Y Test Panel Test object weight kg Apply Naloxone Narcan a o 7 Dose 2 lug Attime 9 05 0 Apply Captopril Capoten Dose 25 mg Attime 05 05 ok Update Graph Results At time 01 45 00 Max Interaction Effect 3 88 Alpha 0 93 Compared to Additive individual drug effect increased by 6 87 2 Enter the time of administration for each drug and click Update Graph Test object weight 75 kg Time Effect Graph Apply Naloxone Narcan RN TA areae A Dose 400 jug At time 0f 108 08 Captopril Capoten oni Apply Captopril Capoten Dose 25 mg At time 0f 458 o6 Update Graph Results At time 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 Compared to Additive individual drug effect reduced by 0 90 Effect Ya os 88 8 BAB BB The results ind
111. ors vital signs software Monitors Auto Mode View aN To update the GIGA software using an F N Link Ethernet connection 1 Connect an Ethernet cable to the laptop About GIGA Fx PC pt i 2 Click Check for Updates 3 Click Install to begin the update The download progress bar begins to auto fill as the setup file is downloaded Diagnostics Create Ad Hoc Network After the download is complete the update i l setup wizard is launched automatically Click the Instruction Manual option to open a Sa i digital copy of the latest User Guide 4 Click Next and follow the wizard to information complete the software download The diagnostics menu is used to test the status of electronic and mechanical components in the simulator Click Check all Modules to run a full systems check Active modules report blue Modules that are inactive or not installed report black Version 2 12 16 0 Armware 33 33 Copyright 2013 Gaumard Scientific Co www gaumard com OK Redistributable GIGA installer files are available for download at http www gaumard com software updates To update the GIGA software using a flash drive 1 Download the update file to a flash drive using a computer with internet access 2 Copy the setup file to the simulator s control computer 114 Pediatric HAL S3004 User Guide Working with HAL Pediatric HAL S3005 User Guide 115 Featur
112. ory of trauma He has been seizing for at least fifteen minutes Valium delivered over 5 minute followed by saline IV Yes Wait indefinitely For BVM Wait indefinitely for Lorazepam and Phenytoin Pediatric HAL S3005 User Guide 145 Pediatric HAL Five Year Systemic Scenario Gaumard Simulators for Health Care Educ n Fire Victim SS A five year old boy is rescued by his father from a house fire He was found in his bedroom asleep The room was engulfed with flames and smoke His pajamas are charred and his face is burned and covered with soot His pajamas are removed to reveal his arm and torso are burned He inhaled a large amount of smoke during the fire Wait indefinitely for intubation IV access and bolus of normal saline at 20 cc kg Wait indefinitely for second bolus of saline 146 Pediatric HAL S3004 User Guide Pediatric HAL Five Year Systemic Scenario Gaumard a Simulators for Health Care Education Se ptic Distri butive Shock A five year old boy with Sickle Cell Anemia is brought to the ED with what the mother thought were infected mosquito bites She treated them with antibiotic ointment Most of them improved except for one large area on his abdomen that now measures 3X4 cm with a localized abscess formation He developed fever yesterday of 40 Deg C Today he has d
113. ot charged properly Make sure that LED indicator on battery the time specified on the charger goes through the sequence manual described in its label usually red or orange after plugging it and then green when charge is completed If LED does not go through label s indications then Check plug connection making sure it is all the way in Make sure you are using the appropriate charger labeled with its simulator name Simulator doesn t The computer is properly If you have more than one manikin in your respond to any com communicating with a simulator facility make sure that your computer is mand even that blinking but not necessarily the one you properly set up to control the manikin that communication indicator intend to control you wish to control Go to Options on the is consistently green Setup pull down menu and check the Environment preferences 162 Pediatric HAL S3004 User Guide Commands are taking Distance between computer and Get simulator closer to computer or move longer than usual to take manikin is reaching its limit away from obstructions effect or simulator is not or reporting every action there are too many obstructions blinking communica between walls etc tion indicator is consis tently yellow There s too much RF interference Try changing the RF channel by going to the either from another Gaumard menu for Setup gt Options gt Environment tetherless simulator in the vicinity
114. out 30 second wait Pediatric HAL S3005 User Guide 151 e Camran Pediatric HAL One Year Respiratory Scenario Pm ulators for Health Care Education Croup SUQA You are called to a home at two a m because a one year old boy can t breathe His parents said he was fine when they put him to bed He has had no illness before and there is no history of asthma He woke up with a barking cough and then began to struggle for each breath They called their advice line that said to put him in some steam from the bathroom shower He did not improve so they called 911 Wait indefinitely for racemic epinephrine via inhaled nebulizer and face mask over 10 minutes Wait 15 minutes for hospital transport Real Time Wait 2 min Wait indefinitely for Racemic epinephrine O2 Corticosteroid 152 Pediatric HAL S3004 User Guide E i Gauna Pediatric HAL One Year Respiratory Scenario simulators for Health Care Education Pneumonia UL You are called to a home where a one year old child is gasping forbreath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 1 Deg C his nose has become more filled with yellow mucou
115. panel with on off toggle controls Click Monitors gt Sensors gt Window to open the floating sensor control panel Use the Monitors drop down menu to enable disable sensors on the virtual monitor screen share files program custom scalars and verify the connection between the GIGA and Gaumard Virtual Monitor software Sensors rica term of 0 a preterm of 0 and that she is currently File Setup Sensors File sharing Auto Mode Custom numbers View Configuration Layout If the Monitors drop down is not showing go to Setup gt Options gt Add ons and checkmark Use Virtual Vital Signs Monitor Single click the circular icon to enable or disable the sensors displayed on the virtual nnn monitor screen Click the circle dark to disable SENSORS the sensor and light blue to re enable it In the T adas example abovexall the sendors are onexceot p the thermometer any of the waveforms displayed in the vital signs monitor Select the waveform and click seee ON to display the readings on the virtual FILE SHARING moatra Taa a aaar Eo or reading click OFF The vital signs monitor sensors defaults to All On The file sharing menu allows the facilitator to send images audio and text files to the virtual monitor screen Use the file sharing feature to fulfill file requests by the provider during simulation SpO2 Probe ECG Leads File sharing Custom
116. port Lab Template CBC Differential CBC Differential Template Glasgow Coma Scale Description Hematology Lipid Panel Metabolic Panel Neonate Blood test OB Blood test 3 Enter a report name a report time and a description In addition select a color tag for the lab report on the right panel Color tags aid the sorting of lab reports on the report list window Edit Lab Report Lab Template Cholesterol HDL LDL Triglycerides Report Name Lab 01 Rel Description Above normal range Cholesterol LDL Cholesterol 1 Lipid Panel Female Variable 4 Enter the test results in the Value column Include any comments associated with the test performed O Description Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable Normal Range Comment HDL Cholesterol mg dL 35 00 85 00 A Cholesterold HDL Ratio 0 00 4 40 fererequired ooo Lipid Panel Male Variable Normal Range Comment HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Lipid Panel Both Variable Normal Range Comment Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 fo Triglycerides mg dL 30 00 200 00 O 5 Click Save to create the lab report AS O 56 Pediatric HAL S3004 User Guide The newly created lab report is now listed in the Lab Reports s
117. r Guide Customize the following simulator specific features e Fine tune the pulse intensity for normal blood pressure e Configure the systolic threshold for each pulse Activation codes enable upgrade and additional software features Activation codes are unique to the simulator s serial number Before entering a code to activate a feature go to the Environment tab set the connectivity mode to FIXED and enter the simulator s serial number e Virtual Monitor Enables the Monitors menu option to configure the virtual monitor connection e Automatic Mode Enter the Automatic Mode activation code to enable the automatic operating mode option in the profile menu GIGA can detect small variations in the heart rate and current during pacing Each variation could trigger a programmed auto response or create a new entry in the log event Adjust the threshold for each parameter so only the changes greater than the ones specified will be detected by the GIGA software Options Environment General Noelle Add Ons Tolerances Log Omer Noelle Features CPR Options Pacing Reporting Heart Rate dl 10 bpm Change Gf 0 f 0 A Th O y I Current jj Change i i f 6 m Detect Shock A Threshold erat A 5 Joules Configure the CPR trainer parameters to meet the most current CPR standards Options Environment General Noelle Add Ons Tolerances Log Other Noelle Features Padng Sh
118. r exercises that incorporate real electrical therapy of any kind always follow the safety guidelines and operating procedures outlined in the medical device s directions for use documentation Only deliver electrical therapy when the simulator is fully assembled dry and undamaged Make sure the defibrillation patches on the simulator are in good condition including removing all gel residue on the defibrillation patches from previous use s It is a good practice to remove gel residues after every use Failure to do so will leave behind a film of electrode gel that hardens Causing arcing and pitting Do not re use the gel adhesive pads Do not leave them on for next day use Use hard paddles or wet gel pads preferably Avoid using solid gel pads since they present higher risk of burning the simulator s skin Gel pads have a shelf life Make sure they are not expired to avoid arcing Make sure the simulator is not in contact with any electrically conductive surfaces Use the simulator only in a well ventilated area free of all flammable gases NEVER attempt to service or modify any of the electrical connections especially those between conductive skin sites and the internal electronics Discontinue use if any wires are found exposed with damaged insulation Real medical products especially electrodes sometimes use powerful adhesives that can be difficult to remove A gentle degreasing cleanser may be needed
119. r or any additive may cause blockage and or interruption of the vasculature system A The IV arm is now ready for use Always flush the IV system with distilled water at the end of every simulation To simulate a patient with no accessible peripheral IV sites connect only the syringe Pull the plunger to create suction which will collapse the veins Disconnect the syringe tube from the arm port while maintaining suction The port will seal and the veins will To prime the IV arm for an infusion exercise or remain collapsed eis A A A INSTRUCTIONS FOR USE HAL 1 1 Locate the fill syringe with tubing and the YEAR drain tube with pinch clamp EU ee syringe with the desired fluid water or To prime the IV arm for an infusion exercise or simulated blood to draw fluids 1 Locate the fill syringe kit and port adapters Fill the syringe with water or simulated blood 2 Using the kit adapters connect the syringe and drain tube to the vein ports located on the forearm 3 Push fluid into the vein port until it exits through the drain tube 4 Disconnect the fill syringe and drain tube The IV arm is now ready for use 2 Connect the syringe with tubing to one port and the drain tube with clamp to the other port as shown Pediatric HAL S3005 User Guide 121 To simulate a patient with no accessible peripheral IV sites connect only the syringe Pull the plunger to create suction which will collapse the veins
120. re Education Bronchiolitis WSA a A one year old child is brought to your ER with a one day history of a clear runny nose low grade temperature and a wet cough His mother states today that he is refusing to drink and appears to be breathing fast She claims his immunizations are up to date and he has been in good health Wait indefinitely for suction of nasal secretions and supplemental O2 Nebulized albuterol we treatment successful Yes 2 min timeout Wait indefinitely for racemic epinephrine via nebulizer every four hours Wait next day 150 Pediatric HAL S3004 User Guide S Pediatric HAL One Year Respiratory Scenario Gaumard Upper Airway Obstruction Simulators for Health Care Education E a Y X Toy Aspiration gt You are at a birthday party where you see a one year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins gasping for breath He is turning cyanotic and cannot cry You assess his airway is obstructed and the obstruction must be removed You try simple measures as back blows and chest thrusts and activate EMS Unsuccessful or 1 min timeout Airway cleared Yes successfully Intubation performed successfully Airway cleared successfully Unsuccessful or 1 min timeout Unsuccessful or 1 min time
121. ric HAL S3004 User Guide Scenario Frequently Asked Questions FAQs THINKING IN TERMS OF PALETTE ITEMS As described previously Palette items represent complete or partial groups of settings that have been stored as a single item We learned how applying partial states will hold constant all settings that are left unspecified Not only does it take time to customize the palette but a very large palette becomes difficult to navigate So it is desirable to minimize the number of Palette Items in each Profile To accomplish this an experienced facilitator tries to create items that are as generally applicable as possible and can thus be applied to a wide range of scenarios The key is to only include in your Palette Items the settings that are directly related to the physiological event represented by that Palette Item SMART SCENARIOS After reading the Details Palette and Scenarios sections of this guide it should be clear how to build a scenario You may have already tried building your own or modifying some of the factory presets The following four guidelines will refine your ability to build the best possible scenarios 1 How will the scenario begin The first thing to consider is the initial condition of the patient Create a Palette Item to describe this condition Make sure that this first step in the scenario is a complete state That is indicate some selection for each and every available setting on the Details page Remem
122. rrently 40 weeks pregnant she has had 0 spontaneous 08 31 2012 11 28 42 abortions 0 elective abortions and 0 living 08 31 2012 11 28 42 children 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 2 File Setup Monitors New Patient Import Between Patients Noelle Auto Log Settings Recent Patients Reset Model 1 Cancel 1 Delete Select the desired patient and click on Load Notice that the factory pre set patient cannot be deleted as opposed to any of the patients Sa _e es that you cre ate yours elf which Can b e d eleted This option allows you to create a new patient A o or load an already existing one Patient information is displayed on the right side and near the top of the Details tab New Patient Modeling Patients Auto Mode RESET MODEL Load Patient TT ip al la Auto Log Settings Clicking on Reset Model under the Modeling Recent Patients Reset Model drop down menu will restore all vitals and physiologic controls to normal state For instance if the ECG rhythm is currently on To create a new patient go to Modeling Ventricular Fibrillation clicking on reset model Modeling Patient new patient The following changes the ECG rhythm back to sinus dialog box is displayed aa New Patient Use the Import between patients menu to import palettes scenarios and branc
123. s and he has had little to drink He is not taking any antibiotics Wait indefinitely for O2 via nasal cannula Wait indefinitely for BVM and prepare for endotracheal intubation Pediatric HAL S3005 User Guide 153 G Pediatric HAL One Year Respiratory Scenario aumard i i Sinden fir Hielo Biijcaiion Pneumonia with Septic Shock De You are called to a home where a one year old child is gasping for breath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 Deg C his nose has become more filled with yellow mucous and he has had little to drink He is not taking any antibiotics Wait indefinitely for O2 via nasal cannula Wait indefinitely for intubation Wait indefinitely for Antipyretic Glucose Calcium and electrolytes Isotonic fluid bolus Antibiotic stat Wait indefinitely for bolus of isotonic fluid Wait indefinitely for dopamine or dopbutamine drip 154 Pediatric HAL S3004 User Guide Pediatric HAL One Year Trauma Scenario Gaumard Simulators for Health Care Education Shaken Baby Syndrome A young mother returned from her night shift to find her one year would not wake up when she went to che
124. s deteriorate the patient s condition by 15 Care provider has 4 options Each option key event moves the scenario to the node specified If no action is taken the scenario will move to node 3 at a A end of the time limit Deteriorate PS Keyevent S event Atropine Epinephrine Dopamine Node 4 Node 5 Node 6 Wait ee ee vital signs are on hold Provider is to intervene again again e event Intervention Atropine Epinephrine Dopamine Node 4 Node 5 Node 6 NUNES vital signs palettes simulate the response to atropine Time limit Go to node 3 after 1 minute eaineshane Node vital signs palettes simulate the response to epinephrine Time limit poe Go to node 8 after 1 minute A Node vital signs palettes simulate the response to dopamine Time limit p Go to node 3 after 1 minute Vital signs simulate the effect of pacing Scenario ends NOS A Linked Action key event triggers an alternate path when electrical therapy is detected Click the Linked Action radio button and select the available actions Then set the electrical therapy thresholds or number of shocks require to trigger the action Click add to create the key event Add Linked Action Electrical Therapy Drug Recognition Defibrillation Shock 200 Joules Shocks Cardioversion Shock 100 6 Joules Shocks Non Syne Shock 100 ioules Shocks External Pacing z a 52 Ped
125. s provide a level of automation that unburdens the facilitator and allows standardized presentation of symptoms Scenario Item a Palette Item that is part of a scenario Scenario Items may also represent a fixed delay period Wait or a pause Wait Indefinitely Stylus a special pointing device for the tablet computer The stylus is the fastest and easiest means of controlling the NOELLE software See the Equipment Set up section of this guide for more information on working with the stylus 10 Pediatric HAL S3004 User Guide Getting Started Pediatric HAL S3005 User Guide 11 Simulator Setup Prepare the simulation area prior to unboxing the simulator The simulator s designated area should have ample space for multiple participants to move about freely Remove the simulator from the blue case with the assistance of at least two persons Avoid lifting the simulator by the arms as it could damage the shoulder joints Rest the simulator on a patient bed capable of supporting the weight of a real patient It is recommended that HAL s head rest flat on the bed or on a thin pillow to prevent the face skin from shifting HAL 1 Year includes two separate power adapters labeled Pediatric 1 Year Charger and Pediatric 1 Year Power Supply Please review the use for each adapter before using the simulator for the first time Pediatric HAL 1 year has a maximum battery runtime of approximately 3 hrs The
126. scitation 00 11 21 Ap 02 00 Palette Anaphylaxix 4 Details HR 108 BP 105 65 RR 0 Inspire 0 OSat 91 EtCO2 30 Temp 37 6 Arterial Bleed OFF Venous OFF This option allows you to print a text file containing all the information in the log for the latest session Clicking on Print Report brings up the Print dialog box The shortcut key for this option is Ctrl P Export File Type Last Modified 08 31 2012 11 3 08 31 2012 11 33 Use the Import menu to import palettes EE Ea scenarios and modeling patients created on aliceO1 08 31 2012 11 2 another PC or stored in a backup location alice02 08 31 2012 11 2 To import an item into GIGA 3 Select the item to export from the list and click Export 1 Click File gt Import on the menu to access the Open menu 2 Set the type of file to import Export File Type rms a a e Program Files x86 1 7 20138 51AM F Py via DUO LT p Dat 1 14 2013 2 43PM F7 A C AA _ helen01 08 31 2012 11 28 40 A helend2 08 31 2012 11 28 40 Scenario Files scz helen03 08 31 2012 11 28 40 tes helenos 202 11 28 40 A Profiles pfz hii 08 31 2012 11 28 40 irene02 08 31 2012 11 28 40 irene03 08 31 2012 11 28 40 3 Browse to the location where the item is eae Poe irene04 08 31 2012 11 28 40 saved and click Open to import CARTED s E Open gO Ji
127. ss Network 1 Select Wireless Network Adapter 121 Wireless Network Adapter 1 2 Wireless Network Name GaumardNet l 3 Monitor IP f Apply Wireless Network Settings Enter a wireless network name case sensitive Use the same name entered in the controller computer GaumardNet is the required name for Windows 7 computers 2 Wireless Network Name GaumardNet 3 Monitor IP 166 Pediatric HAL S3004 User Guide 5 Set the Monitor IP On each control PC and virtual monitor PC enter the same values for the first three IP fields and a set unique value for the last field The suggested address is for the Monitor IP is 10 1 1 220 3 Monitor IP 1 2 1 2 220 lt 6 Click Apply Wireless Network Settings to save the settings 7 Restart the computer 3 Monitor IP 10 3 1 51 Y CONFIGURE THE VITAL SIGNS BROADCAST After the wireless ad hoc link is established between both computers complete next steps to configure the transmission of the vital signs information 1 Verify that both computers are connected to the GaumardNet network using Windows wireless connection menu If the computers are not connected select the GaumardNet network and click Connect manually Curremtly connected to Sep Unidentified network No Interret access EPM rte aff 4 Start the GIGA control software
128. t indefinitely for dopamine or dopbutamine drip Pediatric HAL S3005 User Guide 161 Troubleshooting Communication never Battery connectors in the manikin Make sure to connect red wire to red gets established or is lost are reversed terminal and black to black blinking communica Battery is discharged Make sure battery is charged tion indicator is con sistently red Computer is too far away from Get simulator closer to computer simulator Trying to communicate with a Make sure to select the right simulator when different simulator opening the software In a multiple simulator environment make sure to enter the right Serial Number Starting more than one simulator Select different channels for each of the with its own tablet simulators and then turn them on one ata time meaning Wait until a link has been established between the tablet and the simulator the yellow window goes away Only after that start running the GaumardUl software in the second tablet and so on for the rest of the simulators To do so go to menu Setup gt Options gt Environment gt Select Auto change to channel number from 1 11 All others Close the GaumardUl software and unplug the RF module for at least 5 seconds then plug it back in Disconnect one terminal from the battery and reconnect after 5 seconds Restart the software and wait for initialization Simulator doesn t run for Battery n
129. t intervene the vital signs will deteriorate and myocardial ischemia will occur For information on how to infuse blood to the model virtually go to page 71 Pediatric HAL S3005 User Guide 33 The Cardiac irritability control adjusts the cardiac rhythms indirectly Set the Cardiac Irritability to improve to move the current heart rhythm to normal sinus gradually Alternatively set the cardiac irritability to deteriorate to move the heart rhythm to ventricular fibrillation and eventually asystole pulmonary 135 mitral 135 aortic Contractility RA 100 Auto 100 Auto 100 Auto 100 Auto none slight random great random slight improve qreat improve Bleeding rate 584 oeste great deteriorate The progression of rhythms generally follows the pattern displayed in the figure below where X represents normal sinus rhythm multifocal atrial tachycardia atrial flutter atrial fibrillation junctional rhythm left or right bundle branch block or atrio ventricular block X rhythm i X with PACs X with unifocal P C s X with multifocal PVC s Unifacal Y tach Multifocal V tach Ventricular Fibrillation Asystole 34 Pediatric HAL S3004 User Guide Virtual Monitor The interactive virtual monitor tab VM displays the patient s vital signs information in real time The waveform and numerical parameters are interactive and the layout is full
130. te Sal A No items match your search gt 3 Libraries gt 8 Homegroup gt jE Computer D Cu Network 4 m r Filename Report1 Save as type Text files txt a Hide Folders Select the desired name and path and click Save The shortcut key for saving a report is Ctrl S For a sample report look at the figure below B Home View Gaumard Scientific GaumardUI 01 17 2013 08 37 25 ession Facilitator Providers Team 00 04 17 Action Sharing File Added Chloe Lab 1 rtf displayed as Chloe Lab 1 00 04 54 Provider File accessed Chloe Lab 1 00 10 32 Action Sharing File Removed Chloe Lab 1 rtf displayed as Chloe Lab 1 00 11 16 Applied 00 00 Palette Anaphylaxix 1 Details HR 74 BP 122 64 RR 0 EtCO2 30 Temp 37 6 Arterial Bleed ON Venous Bleed ON 00 11 18 Key Event Checked Competently incise and open abdominal wall 00 11 18 Key Event Checked Competently initiate removal of ovarian teratoma 00 11 18 Key Event Checked Identify anaphylaxis as threat to patient s life 00 11 19 Key Event Checked Call for help 00 11 19 Key Event Checked Identify and remove potential causative agents 00 11 19 Key Event Checked Increase FIO2 00 11 20 Key Event Checked Give epinephrine 00 11 20 Key Event Checked Provide supportive measures including increased IV fluids 00 11 20 Key Event Checked Terminate the procedure to focus on resu
131. te the Blood pressure cuff feature if the Korotkoff sounds do not match the systolic and diastolic values set using the GIGA controls Reference the simulator s directions for use section to calibrate this feature Use the Factory Settings menu to restore sensors settings back to the factory default values Resetting the sensors deletes all current calibration settings 0 40 0000 Dad EHER P07 3 20 Remove all adjuncts or peripherals that may alter the neutral state of a sensor prior to resetting it Click the sensor button to reset it to the factory setting Please reference the directions for use guide for troubleshooting information Calibration a Reset Left BP Sensor E F Reset Right BP Sensor 3 py Reset ET Tube Sensor Lc Reset Force Sensor n t Remove User Calibration 1 Pediatric HAL S3005 User Guide 101 Navigate through the Options menu to configure software settings and enable e Enable auto saving of the log additional features This tab allows the facilitator to e Save your current log report e Enable stand by warning e Select units SI or English Calibration Monitors e Enable electrical therapy shock panel Remote ccess Via Network a N The shock panel is a floating window used to Auto Response ate apply electrical therapy to the patient virtually eos Go to page 46 for more information on how to work with the auto responses
132. te the new palette STATUS DETAILS as Details AIRWAY a 9 Tongue Edema Off x Pharyngeal Swelling Off x Airway Tongue Edema normal 3 x Pharyngeal Swelling Off Laryngospasm Off Upper Airway Sound stridor inspiratory Upper Airway Sound vol Breathing Right chest rise Left chest rise The Save as Palette Item dialog box is displayed Type in the palette item name and a brief description assign a color tag and click Save Save as Palette Item Palette Item Name Initial State Palette Item Description Patient s initial state Color Healthy Care Required Create the next palette item with only those vital sign parameters that are relevant to the second stage in the patient s condition Repeat this process to create palettes for the third and final stage in the scenario Remember to program only the values that require change After all the individual vital sign palettes are created go to the Scenario tab and click Add to Scenario x Add Item to Scenario h Descrinti Move Edit Transition Pediatric HAL S3005 User Guide 41 The Add Palette item menu displayed Select the vital sign palette programmed to be first state in the scenario Enter 0 min 0 sec for the transition time so the initial vital signs are applied immediately Click Add to add the palette to the scenario
133. thing Circulation Assess i Attach eres tenting Call for se assistance ERE Elena VIRTUAL FETALM PALETTE SCENARIO BRANCH MEDICAT LABOR AB SPEECH LOG 01 24 33 APPLIED TO NOELLE Reset the Model D 01 24 33 APPLIED TO NOELLE Reset the Model 01 24 34 MODEL TO NOELLE 00 00 HR 85 BP 105 70 RR 19 EtCO 40 FHRVariability moderate FHRSpo 01 24 36 MODEL TO NOELLE 00 00 EtCO2 33 FHRAccel Decelint dramatic ADD TO LOG Enter the session tile information and the name of the facilitator at the start of the session The information is included in the final log report PROVIDER ACTIONS Session Title Simulation 1 SBS Assess 5 Determine PROVIDERS 84 Pediatric HAL S3004 User Guide The team logging feature is used to track the individual actions of up to six providers manually The feature records the name of the provider with the action as an event entry in the log To add a new provider to the Provider Actions window 1 Click Add button to add a new provider Session Title Simulation 1 Breathing 2 Enter the provider s name and select a color tag Click OK to save the provider Malnrecentanar Add Provider 3 The provider is now added to the log tab Repeat the steps to add up to six different providers Session Title Simulation 1 Facilitator c i Pediatric HAL S3005 User Guide 85 Provider actions can be track
134. tial treatment options No nitial treatment changes to vitals options Valsalva Speech Heart Jumping Cannula Action taken None 2 minute timeout 2 adenosine doses Cardioversion BVM Intubation vardioversion Yes No 2 minute timeout Pediatric HAL S3005 User Guide 143 Pediatric HAL Five Year Systemic Scenario Gaumard Gram Negative Sepsis i isa Perforated Viscous and Peritonitis A five year old boy with cerebral palsy is carried in to the ED by his foster father He is one of five foster children all with special needs He wears braces to walk and has speech and language delays He has been vomiting for three days and has been refusing to eat He has also been crying a lot He has no medications His foster father says he has to leave because his wife needs the car to go to work IV Fluids only Perform Action Fluids and Antibiotics Wait 45 seconds for IV fluids 144 Pediatric HAL S3004 User Guide Pediatric HAL Five Year Systemic Scenario Gaumard ulators for Health Care Education Status Epilepticus Mom calls 911 because as her son was falling asleep she noticed seizure activity of his arms and legs He had had short seizures with high fever when he was one and two This Time he had no fever and was well the entire day There has been no hist
135. tient model click File gt New Session Reset Session Clock Monitors Auto Mode Save Report View Print Report Help Import Export Exit FLUID amp GAS The automatic mode can process the administration of gas and or fluids to the patient model Fluids amp Gas Mal Saline Wolume ml Rate ml min Start IV 4 Blood Cannula Concentration Rate L min Start 02 VIRTUAL FETAL M PALETTE SCENARIO BRANCH LABOR LAB SPEECH MEI LAR Select from saline blood or oxygen and the volume concentration and rate Click on Start to administer Fluids amp Gas Saline Volume mi Rate ml min Start IV 4 Start IV 4 Oxygen Cannula Concentration 100 Rate 5 y3 Pediatric HAL S3005 User Guide 71 RANCH LABOR z g PROVIDE as Fr mr mM Aa rm Use the Add New Medication manager to add new medications edit medication properties update existing items and program medication interactions ass Add New Medication Medication List EC50 mg dl b Concentration that produces 50 of the maximum efect Available Palettes Apply Items Threshold Standard Dose sD E Over Dose 1 oD I Properties Properties J Edit i f Clear 4 Test object weight 85 00 kg k Update Graph 3 El M Push
136. tilation A green filled oval indicates that the ventilation was recorded successfully 3 Perform ventilation 2 as prompted by the wizard A green filled oval indicates that the ventilation was recorded successfully 4 Continue through the calibration wizard to record a total of five ventilations At the end of the calibration process the wizard reports the average peak pressure and duration values for the procedure Click Save to store the calibration settings Cardiac HAL generates audible heart sounds normal distant systolic murmur S3 and S4 tied to the heart rate and selectable rhythms Use the software controls to change the heart sound type and volume level ECG MONITORING AND ELECTRICAL THERAPY The simulator is equipped with conductive skin sites that allow the attachment of real electrodes and defibrillator pads This feature allows the provider to track cardiac rhythms using real medical equipment just like with a human patient The simulator s ECG and defibrillation sites generate waveforms detectable using real medical equipment and standard electrodes Real automated external defibrillators can detect the simulator s heart rhythm and treat shockable rhythms Defibrillation pacing and cardioversion is supported only on the large sternum and apex sites circled RED Do not deliver a shock to ECG electrode sites on the shoulders or waist marked GREEN The warranty does not cover damaged to the s
137. tively the click play stop pause or next as necessary during the scenario Click next to proceed to the next palette from a wait indefinitely palette Next palette Previous palette Use the scenario Quick Launch tab to start a scenario with a single click The Quick Launch tab displays all the scenarios saved in the active profile Scenario Scenario 1 Scenario Scenario 3 Scenario 4 Scenario 5 Branch Scenario Branching Branching Scenario 1 Scenario 2 The general process of creating a new linear scenario is the following e Create a vital sign palette item for each state in the scenario e Add the vital signs palettes and wait times to the scenario e Play the scenario e Modify and edit palettes e Save the scenario The first step is to create several vital sign palette items using the Details Status panel Each palette item represents a physiological state during the scenario Program the first palette item to be used as the scenario s starting point Set values for all the physiological parameters sound types and volumes This ensures that when the scenario begins no vital signs from a previous state will inadvertently carry into the scenario exercise 40 Pediatric HAL S3004 User Guide Using the list view controls select the vital signs parameters for the starting physiological state in the scenario Click the Save as Palette Item button to crea
138. ty evaluation tolerance TEE EE _ __ 10 aS ep Chest compression intensity evaluation tolerance Details Apply Clear and Close Details Window 2 10 Link Respiration sensor to EKG Leads sensors Artificial ventilation rate evaluation tolerance Use AV System Other than Kb Port e 10 Start AV Automatically on Scenario Start Chest compression rate evaluation tolerance j 10 Use single monitor for maternal vitals and fetal traces poet piston Increase fjeset ing EN dt Ea Berca Decrease Default Es The Remote Access via Network feature allows GIGA to communicate with the simulator remotely using the virtual monitor PC as the RF transmitter The alternate configuration may provide better connectivity in environments with numerous walls or Log event text entries are color coded Use the obstructions between the simulator and the log tab to customize the color of each log entry control PC type Options Environment General Noelle Add Ons Calibration Noelle Features CPR Options Pacing Sshock Options Monitors gt pS Other Remote Access Via Network View j Auto Response ME Appied Detais Said CN Tracheal Intubation Scan RF Channels I Defibrilation Cardioversion The USB RF module drivers must be installed on the virtual monitor PC E Compression CN Ventilation before the Remote Access via Network feature can be configured E Pacing CN BP cuff Go to ww
139. ust vital signs to simulate interaction effect Interaction Editor Naloxone Narcan Cancel Confirm Max Alpha 11 Half Life 01 00 00 Peak Time 00 01 30 SN SD 400ug OD 2000ug EC50 0 0001mg dL Isobologram plasma concentration DEl E TO Interactors Captopril Capoten Drug List Save Interactor Data Half Life 01 54 00 Peak Time 01 00 00 SD 25mg OD 75mg Captopril Capoten mg dL 100 150 200 EC50 0 0240mg dL Naloxone Narcan mg dL 10 6 Test Panel Test object weight kg Apply Naloxone Narcan Dose 400 ug At time Apply Captopril Capoten Dose 25 mg At time Results At time 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 Compared to Additive individual drug effect reduced by 0 90 Effect editor Pediatric HAL S3005 User Guide 77 To program one or more medications to interact with the current drug 1 Select the interactor from the drug list click Add Interaction Editor Naloxone Narcan Half Life 01 00 00 Peak Time 00 01 30 q SD 400ug OD 2000ug ECO 0 0001mg dL Remove l Remove All Edit add 4 Drug sia sd a fy Calcium Chloride Calcium Gluconate cd hemabat Clopidogrel Plavix Dexamethasone Decadron a iera Dinnwi
140. w Gaumard com to download MM Speech the latest USB RF module drivers using o PC with internet access Do not connect OTHER the Virtual Monitor PC to the internet AAA Transfer the USB RF module setup file Checkmark Once a Palette is applied load to to the virtual monitor PC using a USB Details Tab to show the value of each drive and complete the installation palette s vital signs parameter on the Details tab control fields l o To configure the Remote Access via Network Checkmark the Link respiration sensor to connection ECG leads sensors to generate artifacts with each compression 1 Connect the simulator s USB RF module an available USB port on the virtual monitor PC 104 Pediatric HAL S3004 User Guide 2 Verify that both computers are connected to the ad hoc network e g GaumardNet 3 Initialize GIGA on the tablet PC open the Remote Access via Network menu from the Setup menu 4 Select the Remote access via network radio button 5 Verify that Wireless Network Connection is selected from the adapter list 6 Click Find available to auto configure the port used for this connection 7 Write down the controller IP and port number then click Connect 8 Navigate to the V menu on the virtual monitor computer and select Remote access Via Network Please wait 30 seconds for the feature to initialize 9 Enter the controller IP and port number as shown on step 7
141. will be given direct control of the responses as events are detected 128 Pediatric HAL S3004 User Guide Scenario Flow Charts PEDIATRIC HAL 5 YEAR SCENARIOS Category Scenario Respiratory 1 Asthma 2 Foreign Body Aspiration 3 Upper Airway Obstruction Toy Balloon 4 Epiglottitis Trauma 1 Chest Injury 2 Hypothermia 3 Alcohol Ingestion 4 Organophosphate Poisoning 5 Renal Failure and Hyperkalemia Cardiac 1 Soccer boy with SVT 2 Cardiac Arrest 3 Cardiac Ischemia 4 Cardiac Tamponade 5 Supraventricular Tachycardia Systemic 1 Gram Negative Sepsis 2 Status Epilepticus 3 Fire Victim 4 Septic Distributive Shock 5 Diabetic Ketoacidosis Automatic Adenosine OD Adenosine SD Adenosine UD Pediatric HAL S3005 User Guide 12 9 i O rm Gaumard Pediatric HAL Five Year Respiratory Scenario Simulators for Health Care Education Asthma gt i A five year old known asthmatic began coughing and wheezing the previous day His parents had run out of his daily steroid inhaler two weeks ago He received two nebulized Albuterol the day before and slept through the night He had one treatment this morning but by mid morning he was in respiratory distress with audible wheezing and visible retractions He cannot speak in full sentences Wait indefinitely for O2 and Albuterol Wait indefinitely for second inhalatio
142. will be no need to set the lung sound again It will already be set The same principle applies to the heart sound and other settings 2 Include notes to guide the facilitator during the simulation It is common for scenario designers especially those who act as facilitators to neglect the importance of notes in the scenario They think that they will remember the learning objectives patient history and other details at the time they are ready to conduct the simulation hey usually don t especially when revisiting a scenario months after creating it When you add Wait and Wait Indefinitely steps to a scenario you have an opportunity to edit the item description Use this description field to hold notes to the facilitator Typically scenario designers write notes in that space to indicate what the provider s or facilitator should be doing at that point Further when saving the scenario you may edit the scenario description This is the best place to put patient history and any other longer notes and instructions Pediatric HAL S3005 User Guide 127 3 Assume that providers will do the right thing Usually you should create a scenario with the assumption that the providers will perform correctly As long as they do the scenario can simply be allowed to continue Naturally you must be prepared for what might happen to HAL when providers deviate from expectations The consequences of such deviations can sometimes be includ
143. y customizable If the VM tab is not displayed by default go to page 103 to activate the virtual monitor add on 12 10 04 ay 02 13 2013 VIRTUAL MONITOR far Sle ate aa eae Click the waveform name to access the waveform options e Freeze Pause the waveform reading To unfreeze the selection click the waveform menu and select Go e Time Set length of the ECG waveform The options available are 5 seconds 10 seconds 15 seconds and 20 seconds e Display Open the waveform properties menu Edit the waveform color amplitude intensity and scroll direction To change the type of waveform displayed click the waveform menu and select close Click the empty waveform menu and select the new waveform type While operating on the Automatic mode the ECG option displays a sub menu for 12 individual leads Capnography Pediatric HAL S3005 User Guide 35 The new waveform type is now displayed Click the numeric menu to access the numerical parameter options To change the type of numerical parameter displayed click the numeric menu and select close Click the empty numerical menu and select the new parameter type Numerical parameters can be adjusted directly from the virtual monitor tab Double click the numerical parameter to open the floating control window Adjust the parameter to the new value and submit the changes using the Apply NOW or trending options 36 Pediatric HAL S30
144. y events to alter the progress and trajectory of the nodes within the scenario A branching scenario consists of several Nodes Each node is preconfigured to run a normal scenario or a series of palettes simulating a specific condition or effect Click the Add node button to create a new node for the first set of vital signs BRANCH SCENARIO Palette Scenario Path v 00 10 1 Node Name 1 v Pediatric HAL S3005 User Guide 47 Click the node s identifier number to edit the node properties a Click to Change Node Properties Enter a name for the node and description and then click Save Node Properties Unique Identifier 1 Name Start Bradycardia Description Bradycardia Start Bradycardia M ET Scenario Path gt X 48 Pediatric HAL S3004 User Guide Add more nodes each with palette items to simulate every stage in the scenario In this example several nodes simulate the effects of medications that maybe administered to the patient by the provider The first two nodes simulate the complication 1 Start Bradycardia 2 Deteriorate The following nodes 3 Interventions 4 Atropine 5 Epinephrine 6 Dopamine and 7 Pace are activated only when the provider administers the applicable medication or electrical therapy Each node is programmed with palettes that simulate the effect descr
145. y return the uninstalled media and accompanying items to Gaumard at the address indicated below 1 Grant of License Gaumard hereby grants to you an individual or institution the right to install and activate the Software on one computer for use with one Interactive patient simulator system The software may also be installed on any number of other computers at the same institution so that students may access the learning resources One copy of the software may be made for backup purposes You may not network this Software or allow multiple users unless you purchased a multi user workstation license Sharing this Software with other individuals or allowing other individuals to view the contents of this Software is in violation of this license 2 Copyright The Software is owned by Gaumard and protected by United States copyright laws and international treaty provisions Therefore you must treat this Software like any other copyrighted material You may not make this Software or copies thereof available in any manner or form or use copy or transfer the Software in whole or in part except as provided herein 3 Other Restrictions You may not rent or lease this Software to any other party You may not alter merge modify adapt reverse engineer decompile or disassemble the software or disclose the contents of this Software to any other party 4 Electronic Transmission of Software lf you received the Software by electronic transmission or

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