METIman - CAE Healthcare

METIman
®
User Guide
License/Copyright
CAE Healthcare
METIman® Simulator Software and Users Guide©
THIS IS A LEGAL AGREEMENT. PLEASE READ THIS DOCUMENT CAREFULLY.
The software you are about to access is provided to you pursuant to the purchase of the Product by the legal entity which
employs you, or which you represent (the “Licensee” or You”), from CAE Healthcare. This purchase of the Product is subject
to CAE Healthcare’s Healthcare Education Products General Terms and Conditions (the “HEPGTC”) and this End-User License
agreement (“License”).
This License governs the grant of licenses for the software, in object code only, embedded in or bundled with the Product
or required to operate the Product, as the case may be (“Software”), as well as all related Product documentation and
information (“Data”) supplied by CAE Healthcare either with or separately from the Product, which items as indicated in the
HEPGTC are not sold but licensed.
Acceptance of these terms and conditions must be without modification of any of the terms, conditions and notices
contained herein.
Consequently, please be sure to read the terms of this License carefully.
If You agree to these terms, conditions and other provisions in their entirety, then click the “ACCEPT” button below.
If You do not accept these terms, conditions and other provisions in their entirety, without modification of any sort, then
click the “DECLINE” button below and your access to the Software and Data is prohibited.
1.
DEFINITIONS AND INTERPRETATION
1.1
The preamble forms an integral part of this License.
1.2
Terms with a capital letter defined in the Preamble have the meaning indicated in the Preamble. Whenever used
in this License, the following terms have the meaning set out below:
(a)
“Confidential Information” means any and all scientific and technical information which is in the possession of,
or belonging to, CAE Healthcare and relating to the Product, including without limitation, all Data, Software, trade secrets,
know-how, processes, methodologies, samples, components, analyses, compilations, guides and other information or
documents prepared by CAE Healthcare, its subsidiaries and affiliates and/or their officers, servants, agents, representatives,
employees or advisers which contain or are otherwise generated from or reflect any CAE Healthcare proprietary
information, whether or not covered by intellectual property rights or explicitly designated as confidential or proprietary,
which is disclosed by any means in written, oral, electronic, or any other form.
(b)
“Purpose” means the use of the Software and the Data solely for the operation and maintenance of the Product,
and the use of the Product solely as an educational tool.
2.
LICENSE
2.1
In consideration of Licensee’s agreement and compliance with the terms and conditions contained in the HEPGTC
and in this License, CAE Healthcare grants to Licensee, and Licensee accepts, a personal, non-exclusive, non-transferable
license to use the Software and Data exclusively with the Product, and with the computer on which this License appears.
2.2
Except for the License granted herein, CAE Healthcare grants no express or implied right under any patent,
copyright, mask work right, trademark, know how or other intellectual property rights. Without limiting the foregoing,
the Licensee shall not obtain any rights to CAE Healthcare’s property, or any part thereof, by implication, estoppel or
otherwise. Title to and full ownership of any trade secrets and other intellectual property rights related to the Product and
components thereof shall remain with CAE Healthcare and, if applicable, its suppliers. For clarification, Licensee agrees that
the source code for the Software is a trade secret of CAE Healthcare and only CAE Healthcare shall have the right to alter,
maintain, enhance or otherwise modify the Software.
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License/Copyright
2.3
Without limiting the foregoing or any other terms in this License, Licensee shall, and shall ensure that any
person authorized to access the Product, which are limited to Licensee’s employees, agents, representatives, medical staff
and students (“Authorized Users”):
(a)
not copy (save and except for normal back up and disaster recovery purposes provided such copy shall include
CAE Healthcare’s copyright and any other proprietary notices indicated on the Software and Data), ghost, export or
produce any derivative works from the Product, or any part thereof, not network the Product without CAE Healthcare’s
prior written approval, or make it available for concurrent use;
(b)
not sell, attempt to sell or transfer (unless in compliance with the HEPGTC), sublicense, encumber the Software
or Data;
(c)
not modify the Product in any way, combine with other programs, or reverse engineer, screen scratch,
decompile or disassemble any Software nor otherwise attempt to create or derive the source code related thereto;
(d)
not deface or remove any copyright or proprietary notices;
(e)
not use the Product without the Key, if provided with the Product, or attempt to develop or develop any means
or technology which would enable Licensee to bypass the use of the Key to operate the Product;
(f )
prevent anyone other than Authorized Users from accessing or using the Product;
(g)
not incorporate the Product, in whole or in part, to any product or service that Licensee would make available to
a third party, on a commercial basis or not.
2.4
Notwithstanding anything else contained in this License, in no event shall Licensee use the Product and/or
Confidential Information to enable, support, or otherwise aid Licensee or a third party to develop any product, software
or service competitive with any of CAE Healthcare’s products.
2.5
Licensee agrees to grant CAE Healthcare, its agents and representatives, at any time during Licensee’s normal
business hours and upon reasonable prior notice, the right to access to Licensee’s premises, to ensure that the use of the
Product is done at all times in compliance with the terms and conditions of this License.
2.6
CAE Healthcare reserves the right to embed a software security mechanism within the Product to monitor
usage of the Product to verify Licensee’s compliance with this Agreement, as well as to control access to the Software
through use of: a) a hardware lock device and/or b) a license administration software and/or c) a license authorization key
(collectively, the “Key”).
2.7
Some Products may provide Licensee with the option of saving and reproducing the images created by such
Products (“Work”) during their use. In this regard, Licensee hereby recognizes that the entire rights, title and interests
in and to such Work remain the exclusive property of CAE Healthcare. Licensee shall not modify such Work in any way
whatsoever and shall not remove or alter any CAE Healthcare notices. However, Licensee is permitted to produce and
reproduce such Work only for non-commercial educational purposes.
3.
FEEDBACK
Licensee agrees to provide CAE Healthcare, from time to time, with comments, suggestions, data, information or
feedback (“Feedback”) on the Product. Licensee acknowledges and agrees that such Feedback may be freely used by
CAE Healthcare, at its sole discretion, for the design, development, improvement, marketing and commercialization of its
products and services, without any restrictions based on confidentiality or intellectual property rights.
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License/Copyright
4.
TERM AND TERMINATION
4.1
This License shall become effective as of the date of Your execution of this License and shall remain in effect
until terminated as provided hereafter.
4.2
This License terminates immediately upon termination of the HEPGTC.
4.3
CAE Healthcare may terminate this License immediately, upon written notice, should Licensee:
(a)
fail to comply with any of the terms and conditions of this License;
(b)
terminate or suspend its business; make an assignment for the benefit of creditors, or any proceedings are
instituted by any party or against it seeking to declare it bankrupt or insolvent, or seeking liquidation, winding-up,
reorganization, arrangement, adjustment, protection, relief or composition of its debts under any law relating to
bankruptcy, insolvency, reorganization or relief of debtors, or seeking the entry of an order for relief or the appointment
of a receiver, trustee or other similar official for it or for any substantial part of its property;
4.4
Upon termination of this License, Licensee agrees to immediately discontinue use of the Confidential
Information and the Product, and to return same to CAE Healthcare as well as any copies, summaries or extracts thereof,
with any associated CD ROM(s), DVD, keys, dongles or other devices as may be directed by CAE Healthcare. At CAE
Healthcare’s request, Licensee shall promptly provide a written certificate signed by an officer of Licensee confirming
that such items have been returned to CAE Healthcare or destroyed as so directed by CAE Healthcare.
4.5
The following shall survive and continue in full force and effect notwithstanding any termination of this
License: the obligations of Licensee under Sections 2 (License), 5 (Non-Disclosure); as well as any other clauses which by
their nature and context are intended to survive.
5.
NON-DISCLOSURE
5.1
Licensee agrees to keep this License and all Confidential Information obtained hereunder in strict confidence,
and shall only disclose same a) to Authorized Users solely for the Purpose and provided such access to the Product
conforms, at all times, to the terms and conditions governing the use of the Product contained herein, or b) if required
to be disclosed by law, and only to the extent of such disclosure and limited to the purpose requested, with prior notice
to CAE Healthcare to permit it to seek an appropriate remedy to prevent the disclosure, or alternatively to agree to the
terms of such disclosure.
5.2
The obligations of confidentiality, use and non-disclosure referred to in this Section 5 shall not apply to
information which: (i) is or becomes publicly available through no fault of Licensee; (ii) was already in the rightful
possession of Licensee prior to its receipt from CAE Healthcare; (iii) is independently developed by Licensee, provided it
is not, in whole or in part, related to the Product; and (iv) is obtained by Licensee in good faith and on a non-confidential
basis and without a use restriction from a third party who lawfully obtained and disclosed such information. However,
Confidential Information does not come within the foregoing exceptions merely because features of it may be found
separately or within a general disclosure in the public domain.
5.3
Licensee agrees to be responsible for enforcing the terms of this Section 5 and to take such action, legal or
otherwise, to the extent necessary to cause anyone having access to the Confidential Information to comply with the
terms and conditions set forth herein (including all actions that Licensee would take to protect its own trade secrets and
confidential information but with not less than reasonable care). Licensee shall be responsible and indemnify, defend
and hold harmless CAE Healthcare for any default caused by any such persons.
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License/Copyright
6.
IRREPARABLE HARM
6.1
Licensee acknowledges that the Software and Data constitute a special, irreplaceable asset of great value
to CAE Healthcare, and that a breach, in any way, of any of Licensee’s obligations under Sections 2 (License), and 5
(Non-Disclosure) hereof would cause serious and irreparable harm to CAE Healthcare which may not be adequately
compensated for in damages. If the Licensee breaches any of such provisions, Licensee consents to an injunction
being issued against it restraining it from any further breach of such provision, without derogation from any other
remedy which CAE Healthcare may have in the event of such a breach.
7.
WARRANTY, LIMITATION OF LIABILITY
7.1
THE SOLE WARRANTIES PROVIDED BY CAE HEALTHCARE ARE LIMITED TO THE WARRANTIES PROVIDED IN
THE HEPGTC. ANY WARRANTIES PROVIDED ARE PERSONAL AND NOT TRANSFERABLE.
7.2
CAE HEALTHCARE’S LIABILITY SHALL IN NO CIRCUMSTANCES EXCEED THE LIMITATION OF LIABILITY
INDICATED IN THE HEPGTC. LIABILITY, IF ANY, SHALL BE SOLELY FOR DIRECT DAMAGES, NOT TO EXCEED ON A
CUMULATIVE BASIS THE AMOUNT PAID BY LICENSEE FOR THE PRODUCT.
8.
GOVERNING LAW
8.1
This Agreement shall be governed by, subject to, and interpreted according to the laws of the State of
Florida, U. S. A., without regard to its conflict of law rules. In all cases, the Parties expressly exclude and waive the
application of the United Nations Convention on Commercial Agreements for the International Sale of Goods (1980)
(Vienna Sales Convention) as amended.
8.2
The exclusive forum for the resolution of any and all disputes arising out of or in connection with this
Agreement shall be a court of appropriate jurisdiction located in the State of Florida, U.S.A. Each Party hereby
waives any right that it might otherwise have to object to such venue or seek dismissal of the action on the basis
of forum non-conveniens. EACH PARTY HERETO IRREVOCABLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY
APPLICABLE LAW, ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATING
TO THIS AGREEMENT.
8.3
Notwithstanding the foregoing, if a party seeks injunctive proceedings to preserve confidentiality
obligations or intellectual property rights, then it is entitled to seek relief before the competent court/body of any
jurisdiction.
9.
MISCELLANEOUS
9.1
United States Government Customer: If Licensee is the United States Government (“U.S. Government”) or
a unit or agency of the U.S. Government, the Software and Data are deemed to be “commercial computer software”
and “commercial computer software documentation”, respectively, pursuant to DFAR Section 227.7202 and FAR
Section 12.212 b) as applicable. Any use, modification, reproduction, release, performance, display, or disclosure
of the Software and/or Data by the U. S. Government, or any of its units or agencies shall be governed solely by
the terms of this License and the HEPGTC. Any technical data provided by CAE Healthcare with the Product that is
not covered by the above provisions is deemed to be “technical data-commercial items” pursuant to DFAR Section
252.227.7015(a).
9.2
Amendment. This License may only be amended by the duly authorized representatives of CAE
Healthcare.
9.3
No Waiver: The failure of CAE Healthcare to enforce at any time any of the provisions of this License, or
to require at any time the performance by Licensee of any of the provisions hereof, shall not be construed to be a
waiver of such provisions, nor in any way affect the validity of this License or any part thereof, or the right of CAE
Healthcare thereafter to enforce any such provision.
9.4
No third-party beneficiaries. Nothing in this Agreement shall be construed as creating or giving rise to any
rights for any third parties or any persons other than the parties to this Agreement.
9.5
Notices: Notices or communications pertaining to this Agreement must be given in writing and delivered
to the addressee as indicated in the HEPGTC.
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METIman Specifications
9.6
Preamble/Headings. The preamble forms an integral part of this Agreement. The division of this Agreement
into Clauses, Articles, sections, subsections and other subdivisions and the insertion of headings are for convenience
of reference only and will not affect the construction or interpretation of this Agreement.
9.7
Severability. If any one or more of the provisions of this License shall be held to be invalid, illegal or
unenforceable, the validity, legality or enforceability of the remaining provisions of this Agreement shall not in any way
be affected or impaired thereby.
9.8
Assignment and Succession. Licensee may not assign or delegate this Agreement in whole or in part,
expressly or by operation of law, without CAE Healthcare’s prior written consent. CAE Healthcare may assign this
Agreement, in whole or in part, and/or its rights and obligations, in CAE Healthcare’s sole discretion, to any party. This
Agreement shall be binding upon and enure to the benefit of the parties hereto and their permitted successors and
assigns. Any assignment of this Agreement, or any license granted herein, in violation of the provisions of this Section
shall be void.
9.9
Entire Agreement. This License constitutes the complete agreement of the parties with respect to the subject
matter referred to herein, and supersede any other agreements, written or oral, concerning the subject matter hereof.
9.10
Language. The parties declare that they have requested and hereby confirm their express wish that this
License, and related agreements and documents be drawn up in the English language and that any notification, letter
or any other communication from a party to the other pertaining thereto shall be solely in the English language.
End of License
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METIman Specifications
METIman Specifications
Size
Mannequin/Simulator 74” H x 26” W x 11” D (188cm x 66cm x 28cm)
Weight
Mannequin/Simulator
100 lbs (45.36 kg)
Environmental Requirements
Ambient Temperature Range
Mannequin/Simulator
Operation:
40°F to 104°F (4°C to 40°C)
Storage:
40°F to 122°F (4°C to 50°C)
Relative Humidity: 0% to 90% non-condensing
Power
Mannequin/Simulator
AC Input:
AC 90 – 240VAC, 50/60Hz
Consumption:
70W nominal
Internal Batteries:
18.5V lithium-ion, rechargeable
Run Time:
4 hours (Typical)
Communications
Simulator Network
Wired:
10/100 Ethernet or
Wireless:
IEEE 802.11g
Wireless Voice
537 MHz to 819MHz (Country Specific)
Electrotherapy
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Defibrillation:
20 to 360 joules (Monophasic, Biphasic)
Pacing:
20mA to 180mA
Cautions and Warnings
Cautions/Warnings
Please read and understand these cautions and warnings before you begin using the METIman
system.
USE OF THIS EQUIPMENT IN AN UNSPECIFIED MANNER MAY IMPAIR DESIGNED
PROTECTION.
Your safety is in your hands. Be sure to follow the instructions on the proper setup, breakdown
and use of the METIman system.
SHOCK HAZARD
Electrical Safety
• This product must be connected to an electrical outlet that is properly grounded.
Precautions should be taken so that grounding or polarization is not defeated.
• Do not place defibrillator paddles on or adjacent to the ECG patient electrodes. Contact
between defibrillator paddles and the electrodes may cause injury to the user and damage
to the equipment.
• Always use the supplied power cords. Do not substitute.
• Always use the supplied power adapter to run the simulator from AC.
• Operate the system from a power source with the following rating:
- 115VAC, 50/60 hertz (cycles per second) (e.g., North America, Japan)
- 230VAC, 50/60 hertz (cycles per second) (e.g., Europe)
• Do not allow excess fluids to flow on or into electronic parts.
• Do not attempt to disassemble the simulator or service any of the electrical
components other than the resetting of circuit breakers.
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Cautions and Warnings
General Use Warnings
Electrical System
• Operate the system from a power source with the following rating: 115VAC, 50/60 hertz
(cycles per second) (e.g. North America, Japan), and 230VAC, 50/60 hertz (cycles per
second) (e.g. Europe)
• Do not operate the METIman system in rain. Apply water to the mannequin only in
accordance with the supported clinical procedures identified in this User Guide.
• Do not allow excess fluids to flow on or into electronic parts.
CO2 Production System
• Care must always be taken when using high-pressure equipment.
• Do not disassemble or alter regulator.
• Store CO2 canisters in dry location between 32° and 104° F. (0 to 40°C). Do not expose CO2
canister to heat above 140° F as rupture may occur.
• Never point CO2 canister towards your face or someone nearby.
• Use only CAE Healthcare specified CO2 canisters.
• Wear protective gloves and eye protection when removing canister from regulator
assembly.
Bleeding and Secretion System
•
•
•
•
DO NOT modify the tank or any assembly component.
ALWAYS protect eyes, skin and clothing against accidental exposure.
NEVER exceed 35 strokes while pressurizing the tank.
ALWAYS read and follow instructions for creating trauma fluids (e.g. blood). NEVER fill the
tank with more than 6 liters (1.6 gallons) of fluid.
• After use, ALWAYS release pressure and clean the tank. DO NOT store liquids in
the tank.
• ALWAYS release tank pressure before servicing. NEVER transport or ship in a pressurized
and/or full state or leave a pressurized tank unattended.
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Cautions and Warnings
Mannequin
• Do not disassemble factory-assembled parts of the mannequin.
• Do not clean the mannequin with chemical solvents. Use water and a light soap solution
only.
• Make sure that mannequin is set up on a stable, sturdy work surface to
avoid collapsing and causing injury to users.
• METIman should be operated in ambient temperatures below 104° F (40° C).
• Do not introduce foreign substances into the airway - with the exception of small amounts
of approved lubricant. Only perform invasive procedures supported by the system as
described in the applicable sections of the User Guide.
• Do not pick the mannequin up by the limbs — support head and leverage weight with torso.
It may be necessary to have the help of a second person to lift and move METIman.
Latex Warning
CAE Healthcare simulators incorporate latex into their design. When performing certain
maintenance procedures, the latex can become exposed. Users with latex sensitivity should
take necessary precautions when handling the simulator while performing those procedures.
ix
Cautions and Warnings
Battery
General Warnings
METIman uses Li-ion batteries. Li-ion batteries have special requirements during handling to
avoid hazardous situations.
• The Polymer Li-ion Battery pack should be stored indoors and be kept far
from fire and high temperatures.
• Do not store batteries with hairpins, coins, screws or other similar objects.
• Do not heat the battery.
• Do not throw the battery into a fire.
• Do not use or leave the battery close to heat or flame.
• Do not use the battery inside of a car where temperature may exceed
80˚C (176˚F). Also do not charge/discharge the battery in such conditions.
• Do not short-circuit the positive (+) and negative (-) terminals with other
metals.
• Do not place the battery in a device with the positive (+) and negative (-)
terminals in the incorrect positions.
• Do not strike the battery with force.
• Do not step on, throw or drop or drop the battery to cause strong shock.
• Do not disassemble or modify the battery.
• Do not solder a battery directly.
• Do not use a battery that has been damaged or deformed.
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Cautions and Warnings
Additional Warnings
• Stop charging the battery if the battery has not completed charging
within the specified time.
• When leakage or foul odor is detected, do not use and keep away from
heat or flame.
• Immediately wash thoroughly with fresh water if liquid leaks onto your
skin or clothes.
• If liquid leaking from the battery gets into your eyes, do not rub your
eyes. Immediately wash eyes completely with clean water and seek
medical attention.
• If the amount of time the battery is able power the equipment
diminishes significantly, the battery life is at an end. Replace the battery
with a new battery of the exact same make and model.
• Immediately remove a battery whose life cycle has expired from the
equipment.
• When the battery is thrown away, apply vinyl tape to the positive (+) and
negative (-) terminals to avoid short circuits.
• When not using battery for an extended period, remove it from the
equipment and store it in a place with low humidity and temperature.
• In all instances, keep the battery away from objects or materials with
static electric charges.
• The battery can be used within the following temperature range. Do not
exceed this range:
Charge temperature range: 0˚C (32˚F) to 45˚C (113˚F)
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Müse Software Specifications
System Requirements
If you are not using a TouchPro computer provided by CAE Healthcare, please be sure to utilize
a computer with wireless capability. When operating the TouchPro software, a computer with
a Macintosh® or Microsoft Windows® operating system may be used.
To run the TouchPro software, the computer used must meet the following minimum
requirements:
Macintosh® Operating System
• Mac OS X 10.5.8 (minimum)
• Safari® 5.x.x or Firefox® 10 ESR (minimum)
• Adobe Flash Player® 10.1.x.x (minimum)
• Adobe Reader 9.x (or higher)
Windows® Operating System
• XP Service Pack 2, Vista or Windows 7
• Firefox® 10 ESR, Internet Explorer® 8 or Safari 5.x.x (minimum)
• Adobe Flash Player® 10.1.x.x (minimum)
• Adobe Reader 9.x (or higher)
Hardware (Windows and Macintosh)
• Intel Core Duo, 2.0 GHz (minimum)
• 2 GB DDR3 RAM (minimum)
• 8 GB Hard Drive space available
• 1024x768 screen resolution (minimum)
• USB 2.0
• Wireless 802.11b/g/n Ethernet card
• 100BASE-T Ethernet Adapter
Macintosh, Quicktime and Safari are registered trademarks of Apple Inc. Windows Media and Internet
Explorer are registered trademarks of the Microsoft Corporation in the United States and/or other countries.
Firefox is a registered trademark of the Mozilla Foundation. Adobe® Flash Player is a trademark of Adobe
Systems Inc.
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Table of Contents
Table Table of Contents
License/Copyright�������������������������������������������������������������������������������������������������������� i
METIman Specifications.............................................................................................. vi
Cautions/Warnings .....�����������������������������������������������������������������������������������������������vii
System Requirements.....�������������������������������������������������������������������������������������������xii
Introduction��������������������������������������������������������������������������������������������������������������� 1
METIman ..........................................�������������������������������������������������������������������������������������� 1
Equipment Overview ............................................................................................................... 2
Standard Components Inventory............................................................................................................. 2
Optional Components Inventory..............................................................................................................3
METIman Standard Equipment ................................................................................................. 4
Full-Body Wireless Simulator................................................................................................................... 4
Battery Charger and External Power Supply............................................................................................. 4
Instructor Workstation (Laptop or Tablet) ............................................................................................... 4
CO2 Canisters (Prehospital Only)............................................................................................................... 4
Inventory Kit ........................................................................................................................................... 5
Wireless Microphone . ............................................................................................................................. 6
Wireless Voice Link................................................................................................................................... 6
Trauma Fill Tank....................................................................................................................................... 7
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Table of Contents
Optional Equipment for METIman.............................................................................................. 7
METIman Replacement Lithium Battery ................................................................................................. 7
External Compressed Air Kit .................................................................................................................... 7
External CO2 Kit ....................................................................................................................................... 8
Air Compressor......................................................................................................................................... 8
Hands-Free Training Cables ..................................................................................................................... 9
METIman Learning Applications and Training Courses ........................................................................... 10
METIman Learning Applications ..................................................................................................................... 10
METIman Training Courses .............................................................................................................................. 10
Tool Kit................................................................................................................................................... 10
METIVision............................................................................................................................................. 11
METI FX.................................................................................................................................................. 11
Moulage Kit........................................................................................................................................... 12
METIman Setup......................................................................................................... 13
Before Beginning Setup.......................................................................................................... 14
Step 1: Place METIman in the Work Area................................................................................... 15
Step 2: Connect the Lower Legs to METIman............................................................................. 16
Step 3: Power On METIman...................................................................................................... 18
Step 4: Power On the Instructor Workstation............................................................................ 19
Step5:ConnecttotheMETImanNetwork–LaptopInstructorWorkstation(Macintosh) Option............................... 20
Step 5: Connect to the METIman Network – Tablet Instructor Workstation (MicrosoftWindows) Option........ 22
Optional: Connect the SpO2 Probe............................................................................................ 23
Optional: Connect External Air................................................................................................ 24
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Optional: Insert the CO2 Canister (Prehospital Only).................................................................. 25
Use of CO2 Canisters................................................................................................................................ 25
Assembly of the CO2 Regulator............................................................................................................... 25
Insertion of the CO2 Canister (Prehospital Only)..................................................................................... 26
Optional: Detach the Arms...................................................................................................... 28
Optional: Prepare the Bleeding System.................................................................................... 30
Using the Trauma Fill Tank.................................................................................................................................. 30
Attaching the Overflow Bottle to the Trauma Fill Tank Assembly.................................................................. 31
Operating the Trauma Fill Tank............................................................................................................... 31
Step 1: Pour the Fluid into the Trauma Fill Tank................................................................................................ 31
Step 2: Connect the Trauma Fill Tank Connector to the Simulator...................................................................... 32
Step 3: PressurizetheTraumaFillTankandFilltheOn-BoardBloodReservoir.........................................................................................................32
Step 4: Release Pressure from the Trauma Fill Tank.......................................................................................... 33
Step 5: Disconnect the Trauma Fill Tank Umbilical from the Simulator.............................................................. 33
Preparing for Storage............................................................................................................................. 33
Step 1: Clean the Simulator and Fluid System.................................................................................................. 33
Step 2: Clean the Trauma Fill Tank................................................................................................................... 33
Step 3: Store the Trauma Fill Tank.................................................................................................................... 33
Optional: Connect a TouchPro™ Computer to the Wireless Network............................................. 34
Step 1: Set Up METIman......................................................................................................................... 34
Step 2: Obtain METIman’s IP Address..................................................................................................... 34
Step 3: Configure the TouchPro Computer’s Network Settings................................................................ 35
Step 4 - Option 1: Join the METIman Network Using a Macintosh Operating System.................................... 36
Step 4 - Option 2: Join the METIman Network Using a Windows Operating System...................................... 38
Step 5: Access the Software from the TouchPro Computer...................................................................... 40
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Table of Contents
Using the Software.................................................................................................... 41
Starting the Application......................................................................................................... 41
The Home Page...................................................................................................................... 44
The SCE Selection Panel.......................................................................................................... 45
The SCE Library....................................................................................................................... 46
Printing SCEs.......................................................................................................................... 47
The Run Screen....................................................................................................................... 48
Using the Patient Status Display............................................................................................................ 49
The Event Logs....................................................................................................................................... 50
Adding a Scenario to an SCE................................................................................................................... 51
Physiological Views................................................................................................................................ 51
Setting Parameters................................................................................................................................ 53
Using the Conditions Palette to Set Parameters................................................................................................ 53
Using the Physiological Views to Set Parameters.............................................................................................. 55
Performing Interventions...................................................................................................................... 56
Using the Medications Palette......................................................................................................................... 56
Using the Interventions Palette........................................................................................................................ 58
Changing Scenario States...................................................................................................................... 60
Changing Scenario States from the Scenario Screen......................................................................................... 60
Changing Scenario States from the Run Screen................................................................................................ 62
SCE Time................................................................................................................................................ 63
Exiting the SCE....................................................................................................................................... 63
Stopping the SCE.................................................................................................................................... 63
Saving a Patient..................................................................................................................................... 64
Resetting a Patient................................................................................................................................ 66
Medication Monitor............................................................................................................................... 67
xvi
Table of Contents
Creating and Editing SCEs........................................................................................................ 68
Creating an SCE...................................................................................................................................... 68
Creating a Patient’s Profile and Baseline................................................................................................ 70
Content Management............................................................................................................................ 71
SCE Configuration . ................................................................................................................................ 72
Condition Setup Screen and Creating Quick Links............................................................................................. 72
TouchPro Setup............................................................................................................................................... 73
Patient Status Display..................................................................................................................................... 74
The Scenario Designer............................................................................................................ 75
The Scenario Button............................................................................................................................... 76
Scenario Designer Views ....................................................................................................................... 77
Creating a New Scenario........................................................................................................................ 79
Modifying Scenario States............................................................................................................................... 79
Adding Parameters and Interventions............................................................................................................. 80
Adding Transitions.......................................................................................................................................... 82
ELSE Statements.............................................................................................................................................. 84
Deleting Scenario States.................................................................................................................................. 85
Deleting Parameters and Transitions............................................................................................................... 86
Emptying the Trash......................................................................................................................................... 87
Saving the Scenario......................................................................................................................................... 88
Saving States to the State Library.................................................................................................................... 89
xvii
Table of Contents
Administrative Tools.................................................................................................. 90
History.................................................................................................................................. 90
System Administration........................................................................................................... 91
Content Management............................................................................................................................ 91
Learning Applications...................................................................................................................................... 92
SCEs................................................................................................................................................................ 93
Base Patients.................................................................................................................................................. 94
Scenarios......................................................................................................................................................... 95
User Accounts........................................................................................................................................ 96
Creating a User................................................................................................................................................ 97
Editing a User.................................................................................................................................................. 98
Deleting a User................................................................................................................................................ 98
Groups................................................................................................................................................... 99
Privilege System..............................................................................................................................100
Creating a New Group................................................................................................................................... 101
Deleting a Group........................................................................................................................................... 101
Maintenance........................................................................................................................................ 102
System Settings................................................................................................................................... 103
System Configuration.................................................................................................................................... 103
Data Management........................................................................................................................................ 103
Product Licensing.......................................................................................................................................... 104
Error Log....................................................................................................................................................... 104
Localization................................................................................................................................................... 104
xviii
Table of Contents
Account Profile .....................................................................................................................105
Profile Information.............................................................................................................................. 105
Favorite SCEs........................................................................................................................................ 106
Medication Preferences........................................................................................................................ 107
Profile Preferences............................................................................................................................... 108
Using TouchPro........................................................................................................ 109
Accessing the TouchPro Software............................................................................................109
Modifying the TouchPro Display.............................................................................................111
Changing the Layout............................................................................................................................ 111
Selecting a Preconfigured Layout.....................................................................................................112
Changing a Waveform or Numeric Display.......................................................................................113
Adding a Waveform Display............................................................................................................114
Adding a Numeric Display...............................................................................................................115
Moving a Waveform or Numeric Display..........................................................................................116
Saving a Layout..............................................................................................................................117
Sounds.................................................................................................................................118
12-Lead ECG..........................................................................................................................119
NIMB Cycling and Manual NIBP...............................................................................................120
Patients................................................................................................................................122
Configuring the TouchPro Software........................................................................................123
Changing the Language of the TouchPro Software...................................................................124
Exiting the TouchPro Software...............................................................................................124
xix
Table of Contents
Using METIman........................................................................................................ 125
Neurological.........................................................................................................................126
Eyes..................................................................................................................................................... 127
Convulsions ......................................................................................................................................... 127
Neuromuscular Blockade..................................................................................................................... 127
Body Temperature................................................................................................................................ 127
Blood Temperature.............................................................................................................................. 127
Head Secretions (Prehospital Only)...................................................................................................... 128
Respiratory...........................................................................................................................129
Airway................................................................................................................................................. 130
Swollen Tongue............................................................................................................................................. 132
Posterior Pharynx Swelling (Prehospital Only)............................................................................................... 132
Realistic Upper Airway (Prehospital Only)..................................................................................................... 133
Laryngospasm (Prehosptial Only).................................................................................................................. 134
Teeth with Breakaway Incisors (Prehosptial Only)......................................................................................... 134
Airway Secretions (Nursing Only).................................................................................................................. 135
Cricothyrotomy.............................................................................................................................................. 136
Replacing the Cricothyrotomy Tape................................................................................................................ 136
Resealing the Membrane After a Puncture..................................................................................................... 137
Pulmonary........................................................................................................................................... 138
Needle Decompression (Prehospital Only).............................................................................................................. 139
Bronchial Occlusion (Prehospital Only).......................................................................................................... 140
Respiratory Rate............................................................................................................................................ 140
Pulse Oximetry.............................................................................................................................................. 140
CO2 Exhalation (Prehospital Only).................................................................................................................. 140
Positive Pressure Ventilation.......................................................................................................................... 141
Gastric Distention (Prehospital Only)............................................................................................................. 141
xx
Table of Contents
Chest Tube: METIman Prehospital.................................................................................................................. 141
Chest Tube: METIman Nursing....................................................................................................................... 143
Cardiovascular......................................................................................................................144
Pulses: METIman Prehospital............................................................................................................... 146
Pulses: METIman Nursing . .................................................................................................................. 147
Blood Pressure..................................................................................................................................... 148
Systolic and Diastolic Blood Pressure............................................................................................................. 148
Non-Invasive Blood Pressure Measurement................................................................................................... 148
Heart Rate............................................................................................................................................ 152
Five-Lead ECG...................................................................................................................................... 152
Cardiovascular Interventions/Therapy.................................................................................................. 153
Chest Compressions....................................................................................................................................... 154
Defibrillation and Cardioversion.................................................................................................................... 154
Pacing........................................................................................................................................................... 155
Subclavian Catheter (Nursing Only)..................................................................................................... 156
Intramuscular Injection........................................................................................................................ 156
IV Cannulation..................................................................................................................................... 156
Fluids................................................................................................................................................... 158
Hemorrhage Setup........................................................................................................................................ 159
Hemorrhage Control...................................................................................................................................... 159
Tourniquet Application.................................................................................................................................. 160
Fluid Loss Blood............................................................................................................................................. 160
Fluid Loss Plasma.......................................................................................................................................... 160
xxi
Table of Contents
Gastrointestinal ...................................................................................................................161
Gastrointestinal Gavage, Lavage and Suction (Nursing Only)............................................................... 161
Gavage (Nursing Only).................................................................................................................................. 161
Lavage (Nursing Only)................................................................................................................................... 161
Gastric Suction (Nursing Only)....................................................................................................................... 162
Genitourinary System............................................................................................................163
Urinary Catheterization........................................................................................................................ 163
Simulating Urine Output...................................................................................................................... 164
Changing the Simulator’s Genitalia...................................................................................................... 165
Sounds.................................................................................................................................166
Speech................................................................................................................................................. 166
Vocal Sounds................................................................................................................................................. 166
Speech Sounds.............................................................................................................................................. 168
Wireless Voice Capability............................................................................................................................... 170
Wireless Voice Link........................................................................................................................................ 170
Throat Sounds...................................................................................................................................... 171
Breath Sounds..................................................................................................................................... 172
Heart Sounds....................................................................................................................................... 173
Bowel Sounds...................................................................................................................................... 174
xxii
Care and Maintenance............................................................................................. 175
METIman Warranty Programs.................................................................................................176
General Information............................................................................................................................ 176
Units Out of Agreement....................................................................................................................... 176
How to Contact Customer Service........................................................................................................ 177
Contract Period.................................................................................................................................... 178
Limitations of Agreement.................................................................................................................... 178
Return Materials Authorization (RMA)................................................................................................. 178
System Software Upgrade Support.........................................................................................179
Pricing Structure...................................................................................................................179
Time and Materials.............................................................................................................................. 179
Breakdown...........................................................................................................................180
Step 1: Stop All Running SCEs.............................................................................................................. 180
Step 2: Clean the Simulator and the Fluid System................................................................................ 180
Step 3: Shut Down the Software.......................................................................................................... 180
Step 4: Power off the Simulator........................................................................................................... 181
Maintenance Advice..............................................................................................................181
General Simulator Care........................................................................................................................ 181
Storage................................................................................................................................................ 181
Care of Electronic Equipment............................................................................................................... 182
Airway Inspection................................................................................................................................ 182
Replacing the Battery.......................................................................................................................... 182
Recharging the Battery........................................................................................................................ 184
Draining Condensation from the Simulator.......................................................................................... 185
xxiii
Cleaning the Simulator and the On-Board Bleeding System......................................................186
Cleaning the Trauma Fill Tank ................................................................................................187
Cleaning the In-Line Filter................................................................................................................... 188
Troubleshooting the Trauma Fill Tank................................................................................................... 189
Emptying and Flushing the Chest Tube Reservoir................................................................................. 190
Flushing the IV Lines............................................................................................................................ 190
Emptying the Genitourinary Reservoir................................................................................................. 190
Emptying the Head Secretions Lines (Prehospital Only)....................................................................... 190
Emptying the Airway Secretions Reservoir (Nursing Only)................................................................... 190
Flushing the Subclavian Catheter (Nursing Only)................................................................................. 190
Handling CO2 Canisters ..........................................................................................................191
Removing CO2 Canisters from the Regulator......................................................................................... 191
Important Canister Information........................................................................................................... 192
Related CAUTIONS/WARNINGS............................................................................................................. 192
CO2 Canister...................................................................................................................................................192
CO2 Regulator Assembly................................................................................................................................192
Use of Equipment..........................................................................................................................................192
Condition Guidelines for Programming METIman....................................................... 193
Appendix A –Müse Parameters Descriptions............................................................... A-1
Appendix B - Wireless Voice Link................................................................................B-1
xxiv
Introduction
Introduction
METIman Nursing and Prehospital simulators give you all the power of CAE Healthcare’s
cutting edge simulation technology with more of what you want. METIman Nursing was
created by nurses to teach the fundamentals of nursing practice, and METIman Prehospital
was built for medics by medics. Both simulators are less expensive than other simulators, are
easy to use and have everything you need with nothing you don’t.
METIman
METIman is fully wireless with on-board fluid, pneumatic and electrical systems and is built
tough to withstand a wide variety of real-life, indoor and outdoor learning environments.
METiman comes with extensive clinical features and capabilities designed specifically for
emergency medical personnel and nurses.
The simulator can be placed on standard operating room tables, on an ICU bed, on the ground
or even in a vehicle (in the case of a simulated accident). METIman can also be seated in an
upright position.
In addition, METIman has the assessment, cardiovascular, genitourinary and trauma features
familiar to CAE Healthcare customers plus an SpO2 finger probe, fluids on board, bilateral
noninvasive blood pressure and IV access. Wireless and tetherless, METIman takes simulation
education to a new and exciting level of realism.
1
Introduction
Equipment Overview
METIman has been designed to be used in any learning environment. METIman’s standard
features are easily integrated into a laboratory setting or remote locations.
Standard Components Inventory
METIman comes with all the necessary equipment for establishing an educational simulation
center.
Standard Equipment
METIman Simulator
Battery Charger and External Power Supply
Instructor Workstation (Laptop or Tablet)
CO2 Canisters (Prehospital Only)
Inventory Kit
Wireless Microphone or Wireless Voice Link
Trauma Fill Tank
NOTE: As you would with any shipment, cross-check this inventory with your CAE Healthcare
packing invoice to verify that all components have been received.
2
Introduction
Optional Components Inventory
Optional equipment is available to accommodate special customer requirements. For example,
options like an air compressor, METIVision and METI FX enable instructors to create real-life
scenarios at authentic locations.
Optional Equipment
METIman Replacement Lithium Battery
External Compressed Air Kit
External CO2 Kit
Air Compressor
Hands-Free Training Cables
METIman Learning Applications and Training Courses
Tool Kit
METIVision
METI
METIFX
FX
Moulage Kit
Contact CAE Healthcare Customer Service at 866-462-7920 if there are any questions or if
optional equipment is needed.
3
Introduction
METIman Standard Equipment
METIman comes with standard equipment that allows students and instructors the ability to
create an endless number of possible clinical situations. The following equipment is provided
with your METIman simulator.
Full-Body Wireless Simulator
All patient assessments and clinical interventions are played out on the METIman mannequin,
which represents a human patient. At six feet, two inches (188 cm) in height and weighing
100 pounds (45.36 kg), METIman is fully operational in the supine, lateral, prone and seated
positions. The simulator offers features like arm pronation and supination; breath, heart and
bowel sounds; palpable pulses; patient voice; and genitourinary features.
Battery Charger and External Power Supply
The simulator is rechargeable using the Battery Charger provided.
Instructor Workstation (Laptop or Tablet)
The Instructor Workstation is a computer that utilizes Müse Software to operate as the main
simulation control center.
Instructors control the simulation session from the Workstation by using SCEs that meet their
learning objectives.
The standard METIman configuration includes a choice of Laptop Instructor Workstation or a
ruggedized Tablet Instructor Workstation.
CO2 Canisters (Prehospital Only)
Four CO2 canisters are included with METIman to supply the on-board CO2 exhalation feature.
4
Introduction
Inventory Kit
iStan comes with a number of accessories and replacement components.
Included in the Inventory Kit are:
• iStan Start-Up Kit (Quick Start Chart and Setup Map)
• iStan Logo Accessories
• Priming syringe
• Roll (4 ft) of VHB tape and roll of 2-inch-wide red tape (for cricothyrotomy)
• Cricothyrotomy skin
• BP adapter kit
• Silicone lubricant
• Chest tube priming tube
• ECG posts
• Pacing/Defibrillation disks
• Condensation drain
• Wound umbilicals
• SpO2 probe
• Female genitalia
• VGA mini adapter
5
Introduction
Wireless Microphone
The wireless receiver enables the user to communicate through the simulator using a
microphone. The clip-on microphone is attached to a transmitter that may be attached to a
belt or waistband.
Wireless Microphone
The microphone is battery-operated and has a power switch on the top to turn it on and off.
Wireless Voice Link
The wireless voice link replaces the wireless microphone feature in some METIman simulators
and comes packaged separately. For more information about this feature, see Appendix B
-Wireless Voice Link on page B-1.
6
Introduction
Trauma Fill Tank
Fluids are supplied to the simulator using a trauma fill tank. One tank is supplied and can be
used for distilled water mixed with red food coloring to create simulated blood.
Disassembled
Trauma Fill Tank
Trauma Fill Tank (Disassembled and Assembled)
Assembled
Trauma Fill Tank
This tank should be cleaned after each use.
Optional Equipment for METIman
Additional components enable the METIman system to be customized to fit the specific needs
of a wide variety of education environments.
METIman Replacement Lithium Battery
Under normal usage, a battery pack should last up to two years.
External Compressed Air Kit
The External Compressed Air Kit gives the user the ability to connect METIman to a CAE
Healthcare compressor, tank or wall air using the kit’s hose and fittings. When connecting to
wall air, the kit attaches to the customer’s wall adapter.
7
Introduction
External Compressed Air Kit
The internal pump turns off automatically when external compressed air is sensed.
The External Compressed Air Kit includes a flexible 30 ft (9 m) hose attached to a preset air
regulator, a fitting for air compressors and adapters for wall or tank air.
External CO2 Kit
The External CO2 Kit gives the user the ability to connect METIman to an external source of CO2
(30-120 psi). The External CO2 Kit includes a flexible 30 ft (9 m) hose attached to a preset air
regulator and an adapter for wall or tank fittings.
Air Compressor
An air compressor (product #AIR-003) designed for quiet operation is available for same-room
use, and an alternative air compressor (product #AIR-002) is available for situations where the
compressor resides in a location, such as a storage room, set apart from the simulator.
Both Air Compressors are AC powered and include a regulator and an air hose with the
appropriate connector fitting.
A 220VAC/50 Hz version of the Quiet In-Room Air Compressor (product #AIR-004) is also
available.
8
Introduction
Hands-Free Training Cables
Hands-Free Training Cables connect to most popular defibrillators and cardiac pacing units
and take the place of non-reusable electrode pads.
Three different cable designs are available to support the most popular defibrillation and
pacing equipment. Each cable kit includes posts that attach to the defibrillator or pace
locations on METIman.
Physio-Control (Medtronic, Inc.)
(product #ACC-005)
Zoll (Zoll Medical Corporation)
(product #ACC-006)
Philips (Koninklijke Philips Electronics, N.V.)
(product #ACC-007)
9
Introduction
METIman Learning Applications and Training Courses
METIman Learning Applications
CAE Healthcare Learning Applications enhance the use of the simulator by providing
preprogrammed scenarios and corresponding support documentation (i.e., course objectives,
instructor’s notes) that can be readily integrated into a lesson plan, a specific curriculum or an
educational program.
EMS Learning Application 1 (EDU-047)
Adult Nursing Learning Apllication (EDU-071)
METIman Training Courses
METIman Basic and Advanced courses offer learners at all levels in-depth instruction in the
setup, operation, development of scenarios and maintenance related to the use of METIman.
The METIman Basic course provides learners with an overview of the system and its
components, as well as an introduction to patient creation and scenario design.
METIman Basic - two days at CAE Healthcare facility (TRN-018)
METIman Basic On-Site - two days at learner-defined facility (TRN-020)
The METIman Advanced course builds upon the concepts introduced in the prerequisite Basic
course. After a quick review of the Basic course, Advanced instruction spends the majority of
the two days providing learners with the ability to design patients and scenarios that can be
used immediately upon completion of the course.
METIman Advanced - two days at CAE Healthcare facility (TRN-019)
METIman Advanced On-Site - two days at learner-defined facility (TRN-021)
Tool Kit
To simplify common adjustments and periodic repairs, CAE Healthcare has put together a kit
containing tools selected for use with the simulator (product #TOL-001).
Tool Kit
10
Introduction
METIVision
METIVision is a fully integrated, digital audio-visual management system that is datasynchronized in real-time for use with CAE Healthcare simulators. METIVision is the only
solution available with the capability not only to capture and store simulation data, but to
broadcast and review any medical simulation exercise using CAE Healthcare simulators.
Complete with physiologic data logs, event logs, pharmacology logs and patient monitoring
data, METIVision offers the capability to provide a complete record of your simulation exercise
for debriefing, assessment and evaluation (product #MTV-001).
METIVision Console
METI FX
CAE Healthcare takes realism to the next level with METI FX: a realistic set of advanced
moulage wound simulation and special effects. METI FX includes incredibly lifelike wounds
that accurately replicate muscle, tissue and subcutaneous fat and reflect the true physical
nature of a wound and its treatment. And, METI FX comes complete with CAE Healthcare’s
own educational learning tools – a set of how-to treatment cards explaining procedures and
learning objectives for both civilian and military patient scenarios (product #MFX-100).
METI FX Simulation
11
Introduction
Moulage Kit
The kit provides the materials needed to create wounds on METIman (product #MODS-999).
Moulage Kit
The Moulage Kit may also be ordered separately.
12
Setup
METIman Setup
The following pages will guide you through assembling and configuring METIman. Below is a
list of steps required to prepare METIman for operation.
1
Place METIman in the Work Area
2
Connect the Lower Legs to METIman
3
Power On METIman
4
Power On the Instructor Workstation
5
Connect to the METIman Network
Connect the SpO2 Probe (Optional)
Connect the External Air (Optional)
Insert the CO2 Canister (Optional, Prehospital Only)
Detach the Arms (Optional)
Prepare the Bleeding System (Optional)
Connect the TouchPro (Optional)
13
Setup
Before Beginning Setup
Proper operation of the METIman simulation unit requires correct configuration. Before setting
up the system, keep in mind these basic guidelines:
Understand the Cautions and Warnings information located in the Introduction section of this
User Guide.
• Follow the sequence of steps carefully.
• Complete all steps in order.
• Do not power on any components until instructed in the text.
• KEEP all original shipping materials, including BOXES — warranty and repair items must
be return shipped to CAE Healthcare in their original packaging.
When unpacking METIman for the first time, careful use of a box cutter protects both the
packaging and the product.
A Setup Map, included with the unit, covers these same steps in abbreviated fashion.
14
Setup
Step 1: Place METIman in the Work Area
Select a work area with enough room for all equipment, providing ample space for easy
access to the simulator. At a least 10’ x 12’ (3 meter x 4 meter) work area is recommended for
movement and positioning of components around the simulator.
Positioning METIman
METIman and the Laptop or Tablet Instructor Workstation can be operated from their batteries,
allowing for wireless use.
In a lab environment, make sure a multi-plug AC power outlet exists within the workspace to
recharge the simulator’s battery and its powered components.
Before placing the simulator on a surface, be certain the surface can easily support 200
pounds.
NEVER lift the simulator by the LIMBS. When lifting, be sure to support the torso and head of
the simulator while lifting.
15
Setup
Step 2: Connect the Lower Legs to METIman
NOTE: Use extreme care when handling the sensor cables and pulse tubes. NEVER let a leg
hang off a surface without the locking pin securely in place. Doing so can seriously damage
the sensor cables and pulse tubes.
a. On each leg, at the knee, remove the locking pin from its position.
Removing the Locking Pin
b. Place lower limbs in their correct positions, leaving enough room to manipulate
connectors.
c. On each leg, match and connect the color-coded tubing to the three white tubing
connectors.
Connecting Tubing
16
Setup
d. Match and connect the color-coded tubing to the three black electrical
connectors.
Connecting Electrical
e. Carefully place tubes and cables in the hole on the lower leg.
f. Align holes on the knees and insert the locking pin.
g. Screw the nut on the locking pin, holding it in place.
Affixing the Locking Pin
17
Setup
Step 3: Power On METIman
a. Locate the ON/OFF button beneath the skin covering METIman’s left hip.
The ON/OFF
Button
METIman’s ON/OFF Button
b. Press and hold the ON/OFF button for one second. The power light blinks,
indicating the system is busy. In approximately one minute, the light stops
blinking and remains solid, indicating the simulator is now ready.
NOTE: METIman can be operated continuously for approximately four hours without
recharging the battery.
18
Setup
Step 4: Power On the Instructor Workstation
a. Place the Laptop or Tablet Instructor Workstation near METIman in a convenient
location.
b. Ensure the Instructor Workstation battery is fully charged, or connect the AC
adapter to the workstation and a surge-protected power outlet.
c. Power on the Instructor Workstation.
19
Setup
Step 5: Connect to the METIman Network – Laptop
Instructor Workstation (Macintosh) Option
a. Click the AirPort icon located in the top-right-hand corner of the screen.
Clicking the AirPort Icon
b. If the AirPort is not on, select Turn AirPort On.
Activating the AirPort Card
c. Select the network (e.g., MMPXXX or MMNXXX, where XXX is the simulator’s unit
number).
Selecting the Network
20
Setup
The AirPort dialog box appears.
The AirPort Dialog Box
d. Enter the password metiadmin into the Password field.
e. Click OK.
Connecting to the METIman Network
The Müse software can now be launched.
21
Setup
Step 5: Connect to the METIman Network – Tablet
Instructor Workstation (Microsoft Windows) Option
Once METIman and the Instructor Workstation are both powered on, they automatically
establish a wireless connection and, when the Internet Explorer browser is opened, the Müse
software launches. If the auto-connect does not occur, perform the following steps:
1. Tap on the Wireless Network icon in the task bar.
2. Select the METIman wireless network (e.g., MMPXXX or MMNXXX, where XXXX
is the serial number for the unit). The network password is metiadmin and the
password is case-sensitive.
3. Click the Connect button.
The wireless connection is established. The Müse software can now be launched
using Internet Explorer.
22
Setup
Optional: Connect the SpO2 Probe
Connect and attach the SpO2 probe to METIman.
a. Locate the SPO2 port on METIman’s left hip.
b. Connect the SpO2 probe to the SPO2 port.
c. Place the SpO2 probe on METIman.
Attached
SpO2 probe
Attached SpO2 Probe
The probe must be connected to view pulse oximetry data on the TouchPro software.
23
Setup
Optional: Connect External Air
Using the External Air kit allows METIman to be run by an external air source rather than the
internal compressor. The air hose can be connected to or disconnected from METIman at
any time. When the external air pressure is sensed, the pump internal to METIman turns off
automatically. When you want to make METIman mobile again, simply disconnect the hose.
The optional External Compressed Air Kit consists of a flexible 30 ft (9 m) hose attached to a
preset air regulator and a fitting for air compressors and adapters for wall or tank air.
To connect the air hose:
1. Connect the External Compressed Air Kit to a CAE Healthcare compressor using
the Quick Coupler attached to the regulator. (Other compressed air sources have
their own adapters. Locate the adapter for your compressed air source.)
2. Connect the other end of the External Compressed Air Kit to the EXTERNAL AIR
port on the left shoulder.
The
EXTERNAL
AIR port
METIman Prehospital’s Left Shoulder
The
EXTERNAL
AIR port
METIman Nursing’s Left Shoulder
24
Setup
Optional: Insert the CO2 Canister (Prehospital Only)
Some SCEs include the simulation of CO2 exhalation. The following instructions show how to
safely connect the CO2 canister to the simulator.
WARNING: Careful handling, including the use of eye protection, is required when using CO2
canisters.
Please read and understand all the important cautions and warnings on removing canisters as
well as safety steps that must be used when handling CO2 canisters.
Use of CO2 Canisters
• Store the CO2 canisters in a dry location between 32° and 104° F. (0° to 40°C)
• Do not expose the CO2 canister to heat above 140° F, as rupture may occur.
• Never point the CO2 canister toward your face or someone nearby.
• Use only CAE Healthcare specified CO2 canisters.
• Do not remove the canister from the regulator base until empty. The canister end is
punctured when screwed into the regulator base.
• Never ship the CO2 canister attached to the regulator assembly.
Assembly of the CO2 Regulator
• Care must always be taken when using high-pressure equipment.
• Do not disassemble or alter the regulator.
• Dry completely if the regulator becomes wet.
• Discontinue use of this equipment if leakage or visible damage is evident.
25
Setup
Insertion of the CO2 Canister (Prehospital Only)
To insert the CO2 canister:
a. Lift the chest skin at the waist and lift the abdominal insert.
b. From the simulator’s right midsection, remove the pull pin and disconnect the
blue CO2 hose.
Remove
the pull pin
Remove the Pull Pin
c. Remove the regulator from the simulator.
d. While holding the regulator firmly, carefully twist the CO2 canister into the
regulator as far as it will go. The final turns puncture the CO2 canister, which is
necessary for correct operation.
Insert the CO2
canister into the
regulator
Connecting the CO2 Canister
CAUTION: Do not loosen the canister once it has been inserted into the regulator assembly
until the contents are exhausted and pressure relieved.
CAUTION: Removing the canister before it is empty results in the sudden release of all highpressure gas with a possibility of liquid CO2 spray. Unprotected skin could receive freezing
burns.
26
Setup
e. Place the CO2 canister, regulator and hoses inside the simulator. Use the pull pin
to secure this assembly to the tray. A properly installed assembly will have the CO2
canister pointed down toward the rear of the simulator.
Place the
canister, regulator
and hoses inside
the simulator
Placing the Canister, Regulator and Hoses
f. Attach the blue CO2 hose to the connection on the regulator.
g. Carefully reposition the abdominal insert and pull the skin back over the simulator
to its original location.
Once the canister and regulator assembly are in place, CO2 is measurable with a disposable
ETCO2 detector during positive pressure ventilation.
Based on the training environment, a CO2 canister may last from 10 minutes (rapid ventilation)
to 25 minutes.
See important Cautions and Instructions for removing, transporting and disposing of the CO2
canisters in the Care and Maintenance section.
27
Setup
Optional: Detach the Arms
METIman’s arms may be removed for use with trauma scenarios.
To detach METIman’s arms:
1. Unscrew and remove the locking pin at the elbow.
Removing the Locking Pin
2. Carefully separate the lower arm from the upper arm.
3. Twist to disconnect the four tubing connectors (white).
Disconnecting the Tubing
28
Setup
4. Squeeze to disconnect the three electrical connectors (black).
Disconnecting the Electrical Connectors
5. Place the loose connectors carefully within the upper arm.
NOTE: When replacing arms, ensure tubing and electrical connectors are matched using the
color-coding.
29
Setup
Optional: Prepare the Bleeding System
ONLY distilled water or distilled water containing food coloring should be used with the
secretion system.
A mixture of no more than 29 mL (1 oz) red food coloring with 3.8 liters (1 gallon) of distilled
water should be used to create simulated blood. The blood mixture should be created in
advance in a separate distilled water container.
NOTE: The higher the ratio of food coloring, the greater the possibility of staining.
Using the Trauma Fill Tank
The Trauma Fill Tank is used to fill the on-board blood reservoir.
CAUTIONS and WARNINGS
Carefully follow all instructions for using the Trauma Fill Tank. Pay particular
attention to the following cautions and warnings:
• ALWAYS read and follow instructions for creating trauma fluids (e.g.
blood).
• ALWAYS protect eyes, skin and clothing against accidental exposure.
• After use, ALWAYS release pressure and clean the tank.
• ALWAYS release tank pressure before servicing.
• DO NOT modify the tank or any assembly component.
• DO NOT store liquids in the tank.
• NEVER transport or ship in a pressurized and/or full state.
• NEVER leave a pressurized tank unattended.
• NEVER fill the tank with more than 6 liters (1.6 gallons) of fluid.
• NEVER exceed 35 strokes while pressurizing the tank.
30
Setup
Attaching the Overflow Bottle to the Trauma Fill Tank Assembly
The overflow bottle is used to collect overflow when the METIman on-board tank is filled.
To attach the Overflow Bottle to the Trauma Fill Tank:
1. Connect the clear trauma fill tank hose to the bottle lid fitting.
Connect the
clear hose to the
bottle lid fitting
Connecting the Trauma Fill Tank Umbilical to the Overflow Bottle
2. Clip the bottle to the tank using the attached carabiner mechanism.
The carabiner
The Carabiner
Operating the Trauma Fill Tank
Be careful to complete the following steps correctly to ensure proper use and maintenance of
the METIman and its peripherals.
Step 1: Pour the Fluid into the Trauma Fill Tank
Pour the desired amount of fluid into the Trauma Fill Tank, being careful to NOT to exceed 6
liters (1.6 gallons) of fluid.
NOTE: The right thigh tank holds 1.5 liters and is used for blood.
Three (3) liters of simulated blood provides enough fluid to fill the right thigh reservoir twice.
The amount of blood used in a training session varies with the patient, the wounds simulated
and the learner’s experience.
31
Setup
Step 2: Connect the Trauma Fill Tank Connector to the Simulator
a. Locate the tan FILL port and white VENT port.
b. Connect the FILL (with the tan label) and VENT (with the white label) hoses of the
Trauma Fill Tank to the corresponding ports on the simulator
Both connections must be made for correct operation.
Step 3: Pressurize the Trauma Fill Tank and Fill the On-Board Blood
Reservoir
An integrated hand pump is used to create the pressure for the Trauma Fill Tank.
WARNING: To prevent ejected pump assembly and/or solution from striking and injuring
you, NEVER stand with your face or body directly over the top of the tank when pumping
or loosening the pump.
To operate the pump and fill the reservoir:
a. Unlock the pump handle by turning counter-clockwise. (Be careful not to loosen
the pump from the tank.)
b. Stroke the pump handle up and down from 25 to 35 times to transport 2 liters of
simulated blood to the on-board blood reservoir. NEVER exceed 35 strokes while
pressurizing the tank.
c. Lock the pump handle back into the pump assembly by turning clockwise.
d. Watch the Overflow Bottle located on the tank assembly. When liquid begins to
appear in this bottle, the on-board blood reservoir is full. (Filling the on-board
blood reservoir takes approximately 3 to 5 minutes.)
32
Setup
Step 4: Release Pressure from the Trauma Fill Tank
Immediately release pressure from the tank by turning and holding the yellow pressure relief
knob clockwise until all air pressure is gone.
If pressure will not release using the relief knob:
a. Place a rag over the top of the tank and pump handle.
b. While firmly pushing down on the pump handle, slowly turn the handle counterclockwise.
NEVER leave a pressurized tank unattended.
Step 5: Disconnect the Trauma Fill Tank Umbilical from the Simulator
Disconnect the Trauma Fill Tank Umbilical from the simulator and store the assembly out of the
way for later use.
After use, ALWAYS release pressure and clean the tank.
Preparing for Storage
After filling and using the Trauma Fill Tank and the simulator’s blood reservoir, both must be
cleaned for storage.
Step 1: Clean the Simulator and Fluid System
When the simulation is completed and the Trauma Fill Tank has been disconnected, remove
the fluids and clean the simulator (see Cleaning the Simulator and the On Board Bleeding System
in the Care and Maintenance section of this User Guide).
Step 2: Clean the Trauma Fill Tank
Before storing the Trauma Fill Tank, make sure the equipment is clean (see Cleaning the Trauma
Fill Tank in the Care and Maintenance section of this User Guide.)
Step 3: Store the Trauma Fill Tank
After cleaning, the Trauma Fill Tank assembly should be stored securely for future use.
a. Allow the interior of the tank to dry by loosening the pump assembly. Do NOT
leave the pump assembly out of bottle, however, because dust contaminates the
system.
b. Loosely wrap the Trauma Tank Umbilical around the neck of the tank to protect it.
c. Store all components in a clean, dry area.
33
Setup
Optional: Connecting a TouchPro Computer to the
Wireless Network
The CAE Healthcare TouchPro computer is pre-configured for use with METIman. If you wish to
supply your own TouchPro computer, use the following instructions to connect the computer
to the METIman network.
Up to two additional computers may be used to run the TouchPro software. The additional
computers must meet the TouchPro Software Specifications mapped out in the Muse and
TouchPro Specifications section of this User Guide on page xii. Follow the steps below to use the
TouchPro software on a TouchPro computer.
Step 1: Set Up METIman
The METIman simulator must be set up and powered on, and the Instructor Workstation must
be powered on and connected to the METIman network. If you have followed the complete
setup procedure, you may proceed to Step 2.
Step 2: Obtain METIman’s IP Address
METIman’s IP address is the same as the IP address used to access the Müse software on the
Instructor Workstation. It can be found in the Address field of the web browser on the Müse
Start screen.
METIman’s
IP address
The Müse Start Screen
IMPORTANT: The IP address is different for each simulator.
NOTE: If the Address field does not appear, check the view settings of your browser. In Safari,
access the View menu and select Show Toolbar.
34
Setup
Step 3: Configure the TouchPro Computer’s Network Settings
Access the Networking screens (the TCP/IP settings screens) for your operating system. If you
are unfamiliar with these screens, contact your Network Administrator or CAE Healthcare
Customer Service (1-866-462-7920) for help with this step.
TCP/IP Network Screen – Macintosh
Internet Protocol Version 4 (TCP/IPv4) Properties Screen – Windows
Enter a unique IP address in the IP address or IPv4 Address field and a subnet mask in the
Subnet Mask field.
The unique IP address must match the IP address obtained in Step 2 except for the number
after the third and final period. This number can be any number between 2 and 254 BUT must
be different from the final number of the IP address obtained in Step 2 (METIman’s IP address)
and the IP address of the Instructor Workstation and any other computers on the network. No
two IP addresses can be the same, including the Instructor Workstation’s IP address.
Unique IP Address: 192.168.XXX.XXX
Subnet Mask: 255.255.255.0
Router/Gateway: (Leave Blank)
Example: If the IP address of your METIman is 192.168.206.5, and the IP address of your
Instructor Workstation for your METIman is 192.168.206.10, you could assign the TouchPro
computer the IP address 192.168.206.20.
35
Setup
Step 4 – Option 1: Join the METIman Network Using a Macintosh
Operating System
a. Click the AirPort icon located in the top-right-hand corner of the screen.
Clicking the AirPort Icon
b. If the AirPort is not on, select Turn AirPort On.
Selecting Turn AirPort On
36
Setup
c. Select the network - e.g., for METIman Prehospital, MMPXXX (where XXX is the
simulator’s unit number).
Select a
network
Selecting METIman’s Network
The AirPort dialog box appears.
The AirPort Dialog Box
d. Enter the password metiadmin into the Password field.
e. Click OK.
Click OK
Connecting to METIman’s Network
The computer has joined the METIman network. You can now proceed to Step 5.
37
Setup
Step 4 – Option 2: Join the METIman Network Using a Windows
Operating System
a. Click the Wireless Network icon located in the bottom-right-hand corner of the
screen.
Clicking the Wireless Network Icon
b. Click Connect to a Network.
Clicking Connect to a Network
The Connect to a network dialog box appears.
38
Setup
c. Select the network, i.e., METIman Prehospital MMPXXX (XXX is the simulator’s unit
number).
Select a
network
Selecting METIman’s Network
d. If prompted for a password, enter metiadmin into the available field
e. Click Connect.
Click Connect
Connecting to METIman’s Network
The computer has joined the METIman network. You can now proceed to Step 5.
39
Setup
Step 5: Access the Software from the TouchPro Computer
a. On the TouchPro computer, launch the web browser (e.g., Safari®).
b. Enter the IP address obtained in Step 2 into the browser’s address field. The Müse
Start screen appears.
The Müse Start Screen
The TouchPro software can now be launched.
OPTIONAL: From your web browser, a bookmark can be created on the TouchPro computer for
ease of access to the Müse or TouchPro software. Please consult your web browser’s help menu
for aid in creating a bookmark.
I MPORTANT: The Instructor Workstation MUST remain on and connected to the METIman
network for the TouchPro computer to be able to operate.
40
Using the Software
Using the Software
The Müse software used with the METIman simulator is a web-based application that can
communicate directly with the simulator. With the software, users can run SCEs, create
scenarios and SCEs, import and export data and perform administrative functions.
NOTE: For optimal Müse performance, no other software programs should be open while Müse
is running.
IMPORTANT: Only one Müse application window and/or tab can be used per Instructor
Workstation, per simulator at a time.
IMPORTANT: Do NOT use any of the browser’s navigational tools while operating Müse.
Starting the Application
Once the METIman simulator is powered on and the Instructor Workstation is connected to the
METIman network, the Müse software can now be launched.
To launch the software:
1. Using the Laptop or Tablet Instructor Workstation, launch the web browser (e.g.,
Safari, Internet Explorer).
NOTE: If using a computer other than the one supplied, the computer will have
to be configured to the METIman network. (The directions for using a different
computer are the same as the directions for Connecting a TouchPro Computer to
the Wireless Network, found on page 34.)
The Müse Start Screen appears.
The Müse icon
The Müse Start Screen
41
Using the Software
2. Select Müse. The Login Screen appears.
The Login Screen
NOTE: The METIman User Guide (English version) is available for download by
clicking the User Guide link in the bottom, left-hand corner of the screen. To
access the User Guide in other languages, please visit www.caehealthcare.com
and click the Support link.
Click the globe-shaped Language icon in the bottom left corner to change the
language of the Müse software.
42
Using the Software
3. Enter the Username admin and the Password admin in the appropriate fields to
access the software.
Enter the admin
and the admin in the
appropriate fields
Entering the Username and Password
The software opens to the Home page by default.
43
Using the Software
The Home Page
From the Home page, users can run, create, search for and edit SCEs.
The Home page can be accessed by clicking the Home button in the top, right-hand corner of
any screen in the Müse software.
The Print SCE and Add to
Favorites buttons
The Home Button
The SCE
Summary Panel
The SCE
Selection Panel
A selected
SCE
Open Library and
New SCE buttons
Run button
Review button
The Home Page
44
Using the Software
The SCE Selection Panel
Simulated Clinical Experiences, or SCEs, are process tools that enable the faculty/educator to
execute a learning strategy using simulation. Each process tool provides an extensive overview
and outline of the learning exercise and requires minimal additional faculty development time
for use. Each SCE is comprised of a patient and can include up to four (4) scenarios.
Available SCEs appear in the SCE Selection panel. Click any SCE to select it.
Search field
Running Now SCE
Locked SCEs
Base SCEs
The SCE Selection Panel
The SCE Selection panel has four tabs that access SCEs: Running Now, Recent, Favorites and
All.
• Running Now — lists the SCEs that are currently running and is only available when at
least one SCE is running
• Recent — lists all the recently run or edited SCEs
• Favorites — lists all SCEs that have been selected as favorites. To add a favorite SCE
to your profile, click the Add to Favorites button at the top of any SCE on the Home
screen. Managing favorites is achieved in the Account Profile portion of the software.
• All — lists all available SCEs from all available Learning Applications
Click the arrow buttons to view more installed SCEs. Once selected, the SCE appears in the SCE
Summary panel.
45
Using the Software
To search for an installed SCE, enter part of the name of an SCE in the Search field and click the
Search button.
Click Run to execute the SCE.
The SCE Library
Access more SCEs from your library by clicking the Open Library button at the bottom of the
SCE Selection panel. The SCE Library appears, listing all available Learning Applications.
Click the desired Learning Application name to access the SCEs for that Learning Application.
The SCEs for that Learning Application appear.
Click the name of the SCE you want to open.
Click the SCEs icon to view all user-created SCEs.
Click Close Library to exit the SCE Library.
User-created
SCEs
The SCE Library
46
Using the Software
Printing SCEs
To print an SCE:
1. From the Home page, select the SCE to print.
The SCE summary panel appears.
2. From the SCE summary panel, click the Print SCE button.
A PDF of the selected SCE appears in a new browser window.
3. Save the PDF to a CD or flash drive for printing from another computer,
OR
To print from the Instructor Workstation, consult your network administrator
for assistance connecting to a printer. If the Instructor Workstation is connected
to a wireless printer, the Instructor Workstation will need to be disconnected
from the simulator network and connected to the network on which the printer
resides before printing. After printing, the Instructor Workstation will need to
be disconnected from the printer’s network and reconnected to the simulator
network.
When finished saving or printing the PDF, close the browser window containing
the PDF to return to Müse.
47
Using the Software
The Run Screen
The Run screen is available when users are running an SCE. From the Run screen, users
can manage the SCE, view physiological status and events and perform overrides and
interventions.
From the Home screen, click Run to access the Run screen.
Clicking the Run Button
The Run Screen appears.
SCE Name
Patient
Physiological
Display widgets
Conditions,
Medications and
Interventions
palettes
Scenario
Events
Physiological View
The Run Screen
48
Using the Software
Using the Patient Status Display
On the Run screen, there are widgets that display the patient’s physiological status. The Patient
Status Display widgets can be changed to reflect the user’s needs. There are six available
display panels for the widgets. Waveform widgets utilize two display panels.
The Patient Status Display Widgets
49
Using the Software
To change a Patient Status Display widget, click the widget you would like to change. A list of
available parameters appears.
Click any widget to access
a menu to change the display
Changing a Patient Status Display Widget
Choose the desired parameter from the list, and the widget changes to reflect the new
selection.
The Event Log
During an SCE, all software operations sensed by the simulator or entered manually (e.g.,
virtual defibrillation), are recorded by an event entry that appears on the screen. The event
entry notes what occurred and the time it happened. Events Logs can also be exported.
The Event Logs
50
Using the Software
Adding a Scenario to an SCE
SCEs incorporate scenarios that contain preprogrammed physiology. Additional scenarios can
be added to SCEs to enhance the current scenario’s physiology. Click the Add Scenario button
on the Run screen to add a scenario to an SCE that is running.
The Add Scenario Button
Click the Add
Scenario button to
add a scenario to an
SCE
The Select a Scenario Dialog Box
Physiological Views
From the Run screen, users can select from five different views representative of various body
systems and features:
Neurological
Respiratory
Cardiovascular
Fluids
Sounds
51
Using the Software
To access each view, click the appropriate organ, icon or button.
• For Speech Sounds, click the speech balloon
• For Neurological, click the brain.
• For Respiratory, click the lung
• For Cardiovascular, click the heart.
• For Fluids, click the blood droplet.
• For Sounds, click the Sounds button.
Speech balloon
Brain
Heart
Lung
Blood
droplet
Sounds
button
Physiological Views
From each view, various parameters can be determined and managed.
52
Using the Software
Setting Parameters
Parameter settings may be established or changed while an SCE is running in two ways: from
the Conditions palette or by selecting a parameter from one of the physiological views on the
Run screen.
Using the Conditions Palette to Set Parameters
There are two ways to apply conditions using the Conditions palette: using a Quick Link or
using the complete Conditions menu. Quick Links are preconfigured conditions that are made
accessible in the Conditions palette for quick application. Quick Links can also be created for
the Medications and Interventions palettes.
To set parameters using the Quick Links in the Conditions palette, click a Quick Link. The
condition is applied and is reflected in the patient’s physiology.
Conditions
button
Quick Links
The Conditions Menu
NOTE: Quick Links must be added while creating or editing the SCE.
53
Using the Software
Or, to apply a condition that is not preconfigured in the Conditions palette, click the
Conditions button. Conditions are organized by system, or all available conditions can be
listed by choosing ALL CONDITIONS.
Conditions Menu
Navigate through the menus, and once the condition has been located, click the condition’s
name from the list.
Selecting a Condition
The condition is applied and appears in the patient’s physiology.
NOTE: Not all conditions affect the patient’s physiology.
54
Using the Software
Using the Physiological Views to Set Parameters
From the appropriate physiological view, locate the desired parameter. Select the parameter
and set the new value. The parameter is changed and is reflected in the patient’s physiology.
Parameters have varying controls, such as sliders, switches and menus. In the image below, the
Heart Rate parameter is shown. Within the Heart Rate parameter, there are switches that toggle
between Modeled and Override and Seconds and Minutes, a slider that sets the beats per
minute and a field where the beats per minute value can be keyed in.
Toggle the switch
from Override to
Modeled to return to
its original state
Drag the slider to
set the value
Setting a Parameter from a Physiological View
Once the parameter has been set, it is reflected in the patient’s physiology.
55
Using the Software
Performing Interventions
An intervention in the Müse software is the application of a medication or medical intervention
occurring while an SCE is running. Interventions are applied using the Medications and
Interventions palettes or by interacting with the simulator.
Using the Medications Palette
There are two ways to administer medications using the Medications palette: using a Quick
Link or using the Medications menu. Quick Links are preconfigured medications that are made
accessible in the Medications palette for quick application. Quick Links can also be created for
the Conditions and Interventions palettes.
To set parameters using the Quick Links in the Medications palette, click a Quick Link. The
medication is applied and is reflected in the patient’s physiology, if applicable.
NOTE: Not all medications affect the patient’s physiology, but all are logged.
Medications
button
Quick Links
The Medications Palette
NOTE: Quick Links must be added while creating or editing the SCE.
56
Using the Software
Or, to apply a medication that is not preconfigured in the Medications palette, click the
Medications button. Medications are organized by type, or all available medications are listed
under ALL MEDICATIONS.
The Medications Menu
Navigate through the menus, and once the medication has been located, click the medication’s
name from the list.
Selecting a Medication
The medication is applied and is reflected in the patient’s physiology, if applicable.
NOTE: Not all medications affect the patient’s physiology, but all are logged.
57
Using the Software
Using the Interventions Palette
There are two ways to perform and/or administer interventions using the Interventions palette:
using a Quick Link or using the complete Interventions menu. Quick Links are preconfigured
interventions that are made accessible in the Interventions palette for quick application.
Quick Links can also be created for the Conditions and Medications palettes.
To apply an intervention using the Quick Links in the Intervention palette, click a Quick Link.
The intervention is applied and is reflected in the patient’s physiology.
The Interventions
button
Quick Links
The Interventions Palette
NOTE: Quick Links must be added while creating or editing the SCE.
58
Using the Software
Or, to apply an intervention that is not preconfigured in the Interventions palette, click
Interventions button. Interventions are organized by type, or all available interventions can be
listed by choosing ALL INTERVENTIONS.
Interventions Menu
Navigate through the menus, and once the intervention has been located, click the
intervention’s name from the list.
Selecting an Intervention
The intervention is applied and is reflected in the patient’s physiology.
59
Using the Software
Changing Scenario States
From the Run screen, users can advance scenario states as desired. A scenario state can be
changed from the Scenario screen or from the Run screen.
Changing Scenario States from the Scenario Screen
To change a scenario state from the Scenario screen:
1. From the Run screen, click the desired loaded scenario.
The Scenario Management pop-up menu appears.
The Scenario Management Pop-Up Menu
2. Select Show Scenario from the Scenario pop-up menu.
60
Using the Software
The Scenario screen appears displaying the scenario.
Jump to State
button
A selected state
Click a scenario
and select Show
Scenario to access
the Scenario screen
States
The Scenario Screen
At the top of this screen, the Scenario Time and State Time are visible. Additionally,
users can also pause and continue playing the scenario by clicking the Pause and Play
buttons on the Scenario Management pop-up menu, which can still be accessed from
the left side of the screen.
NOTE: Pausing a scenario does NOT pause the SCE.
3. Click the Jump to State button.
Click the Jump
to State button
The Jump to State Button
The Jump to State menu appears, displaying the available states.
4. Select the desired state.
The scenario transitions to the selected state and the state is highlighted.
NOTE: Double-click a state to expand to the full view.
Click the Close Window button to return to the Run screen.
The Close Window Button
61
Using the Software
Changing Scenario States from the Run Screen
The scenario state can also be changed from the Run screen.
To change the scenario state from the Run screen:
1. Click the desired scenario. The Scenario Management pop-up menu appears, and
all available states are listed.
States in the
scenario
The Scenario Management Pop-Up Menu
Pause or continue the scenario by selecting the Pause and Play options from the
menu.
2. Select the desired state. The scenario proceeds to the selected state.
62
Using the Software
SCE Time
The Timeline bar along with the Play, Pause, Fast-Forward and Reset buttons are located at
the top of the Run screen.
Timeline Bar
The Play button starts the SCE time if it has been paused.
The Pause button pauses the SCE time.
The Fast-Forward button accelerates the SCE time.
The Timeline bar shows the amount of time that has elapsed and shows bookmarks that have
been created. Bookmarks are used to create a point in the SCE timeline to which users may
easily return. To create a bookmark, click Bookmark.
The Bookmark
button
Bookmarks
Bookmarks
Exiting the SCE
To exit the SCE and return to the Home page, click the Return button.
The Return Button
Stopping the SCE
To stop the simulation, exit the SCE and return to the Home page, click Stop.
The Stop Button
IMPORTANT: Another SCE cannot be run until the current SCE has been stopped.
63
Using the Software
Saving a Patient
Save a Patient when an additional patient with different physiology is needed for repeated use.
To save a Patient:
1. From the Home screen, run an SCE that has a Patient with the same gender as the
Patient to be created.
2. From the Run screen, apply the desired conditions and set the necessary
parameters.
3. Once complete, click Patient at the bottom of the Run screen.
Clicking Patient
The Patient pop-up menu appears.
4. Click Save.
Clicking Save from the Patient Pop-Up Menu
The Save a copy of the Patient dialog box appears.
The Save a Copy of the Patient Dialog Box
64
Using the Software
5. Enter a name for the new Patient in the Enter the new patient name field of the
Save a copy of the Patient dialog box.
Entering a Name for the Patient
6. Click Save. The new Patient is now available in the Patients Palette.
The Patient in the Patients Palette
65
Using the Software
Resetting a Patient
Resetting a Patient brings the Patient back to its original physiological state at the start of the
SCE. However, the SCE time is unaffected. Additionally, the reset appears in the Events Log.
NOTE: If patient baseline physiology settings have been selected, they are removed when the
Patient is reset.
To reset a Patient:
1. While running an SCE, click Patient at the bottom of the Run screen.
Clicking Patient
The Patient pop-up menu appears.
2. Click Reset.
Clicking Reset from the Patient Pop-Up Menu
The Reset the Patient warning box appears stating that the patient’s physiology
will be reset to its state at the load time and all running scenarios will be paused.
The Reset the Patient Dialog Box
3. Click Reset. The Patient returns to its original physiological state at the start of the
SCE.
66
Using the Software
Medication Monitor
The Medication Monitor tracks the infusion of medication administered. To activate the
Medication Monitor, from the Run screen, click Medication Monitor at the bottom, right-hand
portion of the screen.
Select Medication Monitor
The Medication Monitor appears as a movable box on the Run screen.
The Medication Monitor
The number shown on the Medication Monitor next to each medication listing is the
normalized effector site concentration.
When a medication is reset from the Medication Monitor by clicking the Reset button, the
reset clears the medication from the physiological model and from the Medication Monitor.
With continuous infusions, the amount infused goes back to zero, but the infusion continues.
If you want the infusion to completely stop, the infusion must be stopped via the Medications
Library.
67
Using the Software
Creating and Editing SCEs
Creating and editing SCEs is a similar process. Once the SCE is created, the steps for editing are
the same.
Use the New SCE button to create a new SCE.
New SCE Button
Use the Review button to edit an existing SCE.
Review Button
The minimal requirements for creating a new SCE include selecting a Patient, naming the SCE
and saving the SCE. Once the new SCE is created, you can continue with the SCE creation or use
the Review button to edit later.
To edit an existing SCE, click Review.
Creating an SCE
Creating an SCE begins with naming the SCE and determining the Patient Profile.
To name a new SCE:
1. From the Home screen, click New SCE.
New SCE Button
The Patients Palette appears.
2. Select a Patient from the palette and click Create.
Click the Create
button to begin
creating an SCE
Selecting a Patient
68
Using the Software
The SCE Editor appears, showing the Enter a name for the SCE dialog box.
The Enter a
name for the SCE
dialog box
The SCE Editor Screen
3. Enter the name for the SCE.
IMPORTANT: When naming the SCE, the name of the SCE may NOT exceed 80
characters. Additionally, SCE file names CANNOT contain any special characters,
such as / \ : * ? < > % ‘ | "
4. Click Save. Once the SCE is saved, it is stored and can be edited and reviewed
at any time, including while creating a Patient Profile and content, determining
settings and programming scenarios.
69
Using the Software
Creating a Patient’s Profile and Baseline
To create the Patient Profile:
1. From the SCE Editor, in the Profile field, click Edit.
2. Set the Patient’s name, age, gender and weight by filling in the appropriate fields.
Setting the Patient’s Name, Gender and Weight and Changing the Patient’s Picture
3. Click the Change Picture button if you wish to change the patient’s picture.
4. Click Save.
IMPORTANT: No aspect of the patient’s profile can contain any special characters,
such as / \ : * ? < > % ‘ | "
To set the Patient’s Baseline:
1. From the SCE Editor, click Baseline. The Patient Baseline screen appears.
The Patient Baseline Screen
2. Set the Patient’s baseline by setting parameters.
3. Click Save.
When the SCE begins, the Patient presents with these settings.
Once the SCE is named and the Patient Profile determined, the SCE content can be entered and
set up using the SCE Editor.
70
Using the Software
Content Management
SCE Content is entered by clicking the Overview, Background, Preparation and Notes
buttons under the Content Management heading in the SCE Editor.
The Content Management Buttons
Each screen allows users to enter different information. Click the Edit button of each section on
the SCE Editor to access a rich-text editor that enables data entry.
IMPORTANT: Text can be copied and pasted into the fields from TextEdit or Notepad programs
only.
The Rich-Text Editor
Click Save when all data for the field has been entered.
71
Using the Software
SCE Configuration
Conditions, the TouchPro software and the Patient Status Display can be configured by clicking
the buttons under the SCE Configuration heading in the SCE Editor.
SCE Configuration Buttons
Condition Setup Screen and Creating Quick Links
Click Condition Setup to access the Condition Setup screen. From the Conditions Setup
screen, conditions, medications and interventions can be preconfigured for the SCE creating
Quick Links.
On the Condition Setup screen, Conditions, Medications and Interventions buttons are
available. Click the Conditions, Medications and Interventions buttons to navigate through
the available conditions and interventions.
Condition Setup Screen
To create a Quick Link, drag and drop the desired choice(s) to the list of Quick Links to add
them to the SCE.
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Using the Software
TouchPro Setup
TouchPro software is an additional feature of the Müse software. To preconfigure the TouchPro
for use with the Müse software, click TouchPro Setup under the SCE Configuration heading on
the SCE Editor.
The TouchPro Pre-selected Layout screen appears.
The TouchPro Setup Screen
From the TouchPro Pre-selected Layout screen, the following predefined layouts can be made
available in the TouchPro software for a particular SCE:
Saturation-Pulse
ICU-OR No CVP
ICU-OR
ICU-Arterial Line Only
EMS-ED-Telemetry
Switch On to activate a desired layout. Switch Off to deactivate a layout. Any number of the
layouts may be selected.
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Using the Software
Patient Status Display
To configure the Patient Status Display shown on the Run screen, click Patient Status Display
under the SCE Configuration heading on the SCE Editor.
The Patient Status Display screen appears.
Patient Status Display Screen
To preconfigure the Patient Status Display for an SCE, drag and drop the desired waveform,
numeric or volume widgets on the Patient Status Display screen to an available display panel.
Drag and drop
the waveform into an
available display panel
Assigning a Waveform
NOTE: Waveforms occupy two display panels.
Once placed, click the widget to assign a particular physiologic parameter.
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Using the Software
Scenario Designer
The Scenario Designer allows users to create or edit new scenarios.
To access the Scenario Designer from the SCE Editor screen, click the Add Scenario button
under the Preloaded Scenarios heading.
Click the Add
Scenario button
Clicking the Add Scenario Button
The Choose Scenario dialog box appears.
The Choose Scenario Dialog Box
To choose a saved scenario from the list, select the scenario and click Add. The scenario
appears beneath the Preloaded Scenarios heading. Click the scenario to open it in the Scenario
Designer.
Enter a keyword in the Search field to search for a scenario.
To create a scenario from scratch, click New. The Scenario Designer appears.
IMPORTANT: When naming a new Scenario, the scenario name may NOT exceed 128
characters. Additionally, scenario file names CANNOT contain any special characters, such as / \
: * ? < > %‘ |“
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Using the Software
Once the choice has been made, the Scenario Designer appears.
Scenario
button
View buttons
Conditions
Canvas
The Scenario Designer
The Scenario Button
Clicking the Scenario button accesses the Scenario drop-down menu, which allows users to
save scenarios, add blank states and rename and delete selected states.
The Scenario Drop-Down Menu
IMPORTANT: When naming a new Scenario, the scenario name may NOT exceed 128
characters. When naming a Scenario State, the state name may NOT exceed 127 characters.
Additionally, scenario file and state names CANNOT contain any special characters, such as
such as / \ : * ? < > % ‘ | "
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Using the Software
Scenario Designer Views
The Scenario Designer has two views: The Graphical View and the Line Item view. The Graphical
View allows users to branch out scenario states. The Line Item view places the states into a
linear format.
Click the Graphical View button to utilize the Graphical View.
Double-click on any state to expand and view it with all its components as shown in the
example below.
Graphical View
button
The Graphical View
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Using the Software
Click the Line Item View icon to utilize the Line Item view.
Double-click on any state to expand and view all its components as shown in the example
below.
Line Item
View button
Line Item View
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Using the Software
Creating a New Scenario
When beginning to create a new scenario, the canvas is blank. Scenario states can be created
by dragging and dropping conditions, medications and interventions from their respective
menus on the right side of the Scenario Designer to the canvas.
Drag and drop a
Condition to the canvas to
create a State
Dragging-and-Dropping a Condition to the Canvas
Or, a new, empty state can be added by clicking the Scenario button. Once clicked, the
Scenario drop-down menu appears. Click New State, and a new state appears on the canvas.
NOTE: When naming a Scenario State, the state name may NOT exceed 127 characters.
Additionally, scenario file and state names CANNOT contain any special characters, such as
such as / \ : * ? < > % ‘ | “
Modifying Scenario States
Once a scenario state has been placed on the canvas, it can be modified. Additional
parameters, transitions and notes can be added. Each state can contain multiple parameters
and transitions. Click the state name to rename the state.
Collapse State
button
A State
Click the Collapse State button to minimize the state.
Double-click the collapsed state to expand.
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Using the Software
Adding Parameters and Interventions
Additional parameters and interventions can be set in two ways.
Users can drag and drop additional parameters from the Conditions menu to the canvas or to
states.
Drag a Condition
to a state
Adding a Condition
Or, click the Parameters button within the state to be modified.
The Parameters
button
The Parameters Button
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Using the Software
The Patient Control screen appears.
The Patient Control Screen
Click the various organs to change the views, and select the desired parameter. Once a
parameter has been selected, it appears in the Patient Control panel.
Add as many parameters as needed. Added parameters appear consecutively within the state.
Drag and drop to reorder as needed. Click Complete to save and exit the Patient Control
screen, or click Cancel to exit without saving.
NOTE: If the physiology of any of the parameters conflicts, the Müse software reflects the
physiology of the last parameter entered.
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Using the Software
Adding Transitions
To add a transition, you must have both an original state and a state that results from the
transition.
To add a transition:
1. Click the Create button in the original state.
Creating a Transition
A menu appears with all available transition variables.
Transitions Menu
2. Select the desired variable from the menu. For example, if a medication is desired,
select Medications, and select the desired medication from the list. Once the
medication is selected a dialog box appears, asking for the proper dose and the
variable.
Setting a Medication Dosage and Variable
3. Once the dose and variable have been selected, click Accept.
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Using the Software
4. Click the GOTO arrow to connect the transition. A menu listing all the available
states appears. Select the resulting state from the menu.
Select a State
from the menu to
transition to
GOTO
arrow
Transition Menu
An orange connector line appears linking the transition to the state.
The orange connector
line indicates a
connected transition
A Connected Transition
5. Follow the same steps to add multiple transitions to the state.
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Using the Software
ELSE Statements
An ELSE statement is used to transition to a state automatically when none of the other
programmed transitions occur.
Before specifying an ELSE statement, at least one other state must be created first.
To add an ELSE statement, click ELSE in the original state. A menu appears with all the
available states listed.
Select a State from
the ELSE menu
ELSE Menu
Click the desired state. A black connector line appears linking the ELSE statement to the state.
The black connector line
indicates a connected ELSE
statement
A Connected ELSE Statement
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Using the Software
Deleting Scenario States
To delete a state, in the Graphical view, drag and drop the state into the trash.
Drag and drop the
state in the trash
Deleting a State in the Graphic View
In the Line Item view, drag and drop the state into the trash.
Drag and drop the
state in the trash
Deleting a State in the Line Item View
Deleted states remain in the trash can until you log out of the software or the trash is cleared.
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Using the Software
Deleting Parameters and Transitions
From an active state, drag and drop the desired parameter or transition into the trash.
Drag and drop the
parameter in the trash
Deleting a Parameter
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Using the Software
Emptying the Trash
From the Scenario Designer screen, click the Trash Can. All items placed in the trash are listed.
Trash Can Contents
Click Empty Trash to empty the trash. If you do not wish to delete the items listed, they can
be dragged back into the scenario, at which time they are removed from the trash.
Logging out of the software automatically empties the trash.
NOTE: Items emptied from the trash cannot be retrieved.
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Using the Software
Saving the Scenario
At any time during scenario creation or modification, the scenario can be saved. To save
scenarios, click the Scenario button to access the Scenario drop-down menu.
To save on the most recent version of a modified scenario, click Save.
To save a new scenario, click Save As. Or, when Save is clicked when saving a new scenario,
users receive the same prompts.
To save a modified scenario as a new scenario, click Save As.
The Scenario Drop-Down Menu
When Save As is clicked, the Save Scenario dialog box appears.
Enter a name for the
scenario in the Enter
scenario name field.
The Save Scenario Dialog Box
Enter the name for the scenario in the Enter scenario name field and click Save.
IMPORTANT: When naming a new scenario, the scenario name may NOT exceed 128
characters. Additionally, scenario file names CANNOT contain any special characters, such as /
\ : * ? < > %‘ | "
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Using the Software
Saving States to the State Library
Users can save states in the State Library for later use.
To save a state, drag and drop the state to the State Library button.
Drag and drop states
to the State Libary
button to save them
A Saved State
The state is stored in the library and appears in the State Library panel.
A saved state
A Saved State
Click Conditions Library to Exit the State Library.
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Using the Software
Administrative Tools
The Müse software has administrative tools that allow users to manage logs, stored content,
users and system settings. The administrative tools are accessed via the Administrative Tools
buttons, located on the Home screen.
System
Administration
button
History
button
Account Profile
button
Administrative Tools Buttons
Click the History button to view and manage Simulation Session Logs.
Click the System Administration button to manage stored content, user accounts, groups
and system settings.
Click the Account Profile button to manage and determine preferences for the active
account.
History
From the History screen, users can view and export the Simulation Session Logs of performed
SCEs. Each Simulation Session lists the Start Time, the title of the SCE and the Patient’s name.
In addition, the Physiological Data and Simulation Events Logs are available for review and
download.
The History Screen
By clicking the Simulation Events link of a Simulation Session, users can view the entire log of
the simulation and all the events that occurred during the SCE.
When the Physiological Data link of a Simulation Session is clicked, users can view all the
physiological data that occurred during the SCE.
On both the Simulation Events and Physiological Data screens, there is an Export button that,
when clicked, exports the data to a CSV file that can be stored on an external device.
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Using the Software
System Administration
From the System Administration screen, users can control and access Content Management,
User Accounts, Groups and System Settings.
To access the System Administration screen, click the System Administration button from
the Home screen.
The System Administration Button
Content Management
From the Content Management screen, users can manage Learning Applications, SCEs,
Patients, Scenarios and Conditions.
To access the Content Management screen, from the System Administration screen, click
Content Management.
The Content Management Button
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Using the Software
Learning Applications
From the Content Management screen, click Learning Modules to access the Learning
Applications screen.
Click Learning Modules
to access the Learning
Applications screen
Install Learning
Module button
The Learning Applications Screen
The Learning Applications screen appears, listing all available CAE Healthcare Learning
Applications and their accompanying SCEs.
Additionally, Learning Applications can be installed from this screen.
To install a Learning Application:
1. Click Install Learning Module. The Select file to upload dialog box appears.
2. Locate the correct Learning Application file on the Learning Application CD. The
file extension is sce.
3. Select the file and click Select.
4. Refresh the screen by clicking the Home button in the Müse software and then
follow the steps above for accessing the Learning Applications screen. The
Learning Application appears on the Learning Applications screen and is available
for use.
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Using the Software
SCEs
From the Content Management screen, click SCEs to access the SCEs screen. All user-created
SCEs appear in the SCEs panel.
Click SCEs
to access the
SCEs screen
Import SCE
button
The SCEs Screen
On the SCEs screen, users can import and export the SCEs they have created.
NOTE: SCEs purchased from CAE Healthcare CANNOT be exported.
Click Import SCE to import an SCE from an external device as an sce file. Click Export to
export an SCE to an external device.
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Using the Software
Base Patients
From the Content Management screen, click Base Patients to access the Base Patients screen.
All Patients appear in the Patients panel.
Click Base Patients to
access the Base Patients
screen
Import Patient
button
The Base Patients Screen
On the Base Patients screen, users can rename, review, delete, import and export Patients they
have created by clicking the respective buttons within each Patient. Locked Patients can only
be reviewed from this screen.
Click Import Patient to import a Patient file from an external device. Click Export to export
a Patient file to an external device, such as the Instructor Workstation’s hard drive or a USB
portable device.
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Using the Software
Scenarios
From the Content Management screen, click Scenarios to access the Scenarios screen. All
Scenarios appear in the Scenarios panel.
Click Scenarios
to access the
Scenarios screen
Create New
Scenario button
Import Scenario
button
The Scenarios Screen
On the Scenarios screen, users can rename, review, delete, import and export Scenarios they
have created. Locked Scenarios can only be reviewed from this screen. Users can also create
new scenarios from the Scenarios screen by clicking the Create New Scenario button.
User-created scenarios can be renamed, reviewed and deleted from the Scenarios screen by
clicking the respective buttons within each scenario.
Click Import to import a scenario file from an external device. Click Export to export a
scenario file to an external device.
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Using the Software
User Accounts
From the User Accounts screen, users can create, edit and delete users. To access the User
Accounts features, on the System Administration screen, click User Accounts.
Click User Accounts to
access the User Accounts
screen
The User Accounts Screen
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Using the Software
Creating a User
To create a new user:
1. Click the New button in the Users panel. The User Data panel appears on the
screen and requests information about the user.
Creating a New User
2. Enter the user’s personal data.
First Name
Last Name
Email
Password – The password should be one that is not easily guessed
Confirm Password
NOTE: A suggested User ID is generated automatically when the user’s first and
last names are entered; however, an alternate User ID can be entered.
3. Assign the user to a Group by clicking on the group name in the Groups panel.
New groups can be created as well. Users may be assigned to only one group.
4. Click Create.
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Using the Software
Editing a User
Edit a user when changes are needed to the user account.
To edit a user’s information or privileges:
1. From the Users panel, select the user to edit.
2. Click Edit. The user’s details appear in the User Data panel.
3. Make the desired changes and click Save.
Deleting a User
Delete a user when the user is no longer needed.
To permanently delete a user:
1. From the Users panel, select the user to be deleted.
2. Click Delete.
3. The User Deletion Warning box appears stating any content created by this user
will be reassigned to your account and asks if you are sure you want to delete the
user.
The User Deletion Warning Box
4. Click Yes.
The user and his corresponding data are deleted. However, any SCEs, scenarios or
Patients created default to the user who deleted him.
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Using the Software
Groups
Users are assigned to groups to define access privileges. To access the Groups screen, from the
System Administration screen, click Groups.
Click Groups to access
the Groups screen
The Groups Screen
From the Groups screen, users can create new groups, delete groups and assign privileges to
groups.
In the Groups panel, three groups appear by default.
Administrators
Educators
Deactivated Users
Each default group has privileges assigned.
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Using the Software
Privilege System
The Müse software has three different privileges:
System Management
User Management
Content Management
User Management and Content Management can be assigned independently or combined.
The System Management privilege contains all privileges.
System Management
Users with the System Management privilege have access to all features of the Müse software,
including the benefits of the User Management and Content Management privileges, listed
below. Users with the System Management privilege can also view system settings, back up
and restore data and apply software updates.
User Management
Users with the User Management privilege can manage all users and groups.
Content Management
Users with the Content Management privilege can create and manage all SCEs.
IMPORTANT: Users with the System Management or User Management privilege can DELETE
other users, including the default meti admin account. Once deleted, this account cannot be
recovered. Please ensure users with the System Management or User Management privilege
take care not to delete the default meti admin account.
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Using the Software
Creating a New Group
Create a new Group to have an alternative to the preconfigured Groups.
To create a new Group:
1. From the Groups screen, click New.
The Group Name field appears.
2. Enter the name of the Group in the Group Name field.
3. Click Create Group.
The group appears in the Groups panel on the Groups screen. Privileges can now
be selected.
4. Select the privilege(s) to be assigned to the Group.
5. Click Save.
Deleting a Group
Delete a group when it is no longer needed. Once a Group is deleted, all users who were
affiliated with the Group default to the Deactivated Users Group.
To permanently delete a Group:
1. From the Groups screen, click the group to be deleted.
2. Click Delete. The Group Deletion warning box appears asking if you want to
continue.
3. Click Yes. The Group is deleted.
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Using the Software
Maintenance
From the Maintenance screen, users can flush the fluids from their METIman simulators. For
more instructions on how to flush the simulator, see the Care and Maintenance section.
Click Maintenance to
access the Maintenance
screen
The Maintenance Screen
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Using the Software
System Settings
From the System Settings screen, users can view system information, back up and restore
data, manage product licensing, view the error log and change the language of the Müse
software.
To access the System Settings screen, from the System Administration screen, click System
Settings.
Click System Settings
to access the System
Settings screen
The System Settings Screen
System Configuration
Under System Configuration, Disk Space and System Time are displayed.
Data Management
The Data Management feature allows users to back up data to an external device. Users can
also restore the backup data.
Backing Up Data
Back up data to protect and store content and user data.
To back up data:
1. On the System Settings screen, click the Back Up Data button.
A Save dialog box appears.
2. Select a location to save the backed up data.
3. Click Save.
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Restoring Data
Restore data when the backed up data needs to be replaced on the software. Restoring data
only restores the last backup and does NOT merge the backup data with the current data.
To restore backup data:
1. On the System Settings screen, click Restore Data.
2. The System Restore warning box appears stating that restoring data erases all
current data and asks if you want to continue.
3. Click Yes.
A select file dialog box appears.
4. Locate the appropriate file to restore the data.
5. Click Select. The data is restored.
Product Licensing
To view product licensing information for your simulator or to enter a license key to activate
your software, click Product Licensing.
Error Log
The Error Log is available for technicians and is used when diagnosing the Müse software.
Localization
To change the language of the Müse software, click Change Language, select a language and
click OK or Accept.
NOTE: Only the English version of the User Guide is available via the software, regardless of
the Müse language selection. To access the User Guide in other languages, please visit
www.caehealthcare.com and click the Support link.
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Using the Software
Account Profile
From the Account Profile screen, users can view, update and reset personal profile
information. From the Account Profile screen, users can also view and add favorite SCEs.
Click the Account Profile button to access the Account Profile features.
The Account Profile Button
Profile Information
From the Account Profile screen, click Profile Information to access the Profile Information
screen. From this screen, users can change their profile information and reset their passwords.
Click Profile
Information to
access the Profile
Information screen
The Profile Information Screen
To change profile information, enter the new information in the appropriate field and click
Update Profile when finished.
To reset a password, enter the new password in the New Password field and re-enter the new
password in the Confirm Password field. Click Change Password when finished.
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Using the Software
Favorite SCEs
To access the Favorite SCEs screen, click Favorite SCEs from the Account Profile screen. All of
the logged-in user’s favorite SCEs appear in the Favorite SCEs panel.
Click Favorite SCEs
to access the Favorite
SCEs screen
Add Favorites
button
The Favorite SCEs Screen
To add SCEs to the Favorite SCEs panel, click Add Favorites. The SCE Library appears. Select
the desired SCE, and it automatically appears in the Favorite SCEs panel.
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Using the Software
Medication Preferences
From the Medication Preferences screen, found under Account Profile, users can import
customized medication response files created in the Pharmacology Editor software.
Click Medication Preferences
to access the Medication
Preferences screen
The Medication Preferences Screen
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Using the Software
Profile Preferences
Profile preferences allow users to change the font size.
Click Profile Preferences to access
the Profile Preferences screen
The Profile Preferences Screen
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Using the Software
Using TouchPro
The TouchPro software enables users to view the patient’s physiology.
The software can be used from the Instructor Workstation or on another computer provided
that computer has joined METIman’s wireless network.
Accessing the TouchPro Software
Like the Müse software, the TouchPro software is compatible with computers that have touchscreen capabilities.
To run the TouchPro software, the Instructor Workstation must be connected to the METIman
network.
An SCE must be running on the Müse software for any physiological data to be
displayed on the TouchPro software. The TouchPro software can only show one Patient
at a time.
1. Using the Instructor Workstation, with the Müse software running, open a new tab
in the web browser and go to the Home page of the web browser.
The Müse Start Screen appears.
The Müse Start Screen
2. Select the TouchPro icon.
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When TouchPro opens, the simulated patient monitor appears.
The TouchPro Display
NOTE: If using TouchPro on a separate computer other than the Instructor Workstation,
the additional computer must be on METIman’s network. For instructions on how to join the
TouchPro computer to the METIman configuration, please refer to page 34.
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Using the Software
Modifying the TouchPro Display
The layout of the waveforms and numeric data shown on the TouchPro software can be
customized.
Changing the Layout
The TouchPro software can show up to six waveforms plus an additional four numeric
readouts.
There are five preconfigured layouts:
EMS-ED-Telemetry - preconfigured with a waveform and numeric readout for ECG
Lead II and numeric readouts for SpO2 and noninvasive blood pressure (NIBP).
ICU-OR Arterial Line Only - preconfigured with waveform and numeric readouts for
ECG Lead II, ECG Lead V, ABP, Pleth and a numeric readout for Body Temperature.
ICU-OR No CVP - preconfigured with waveform and numeric readouts for ECG Lead
II, ECG Lead V, ABP, PAP and Pleth, and numeric readouts for NIBP, Thermodilution C.O.,
Blood Temperature and Body Temperature.
ICU-OR - preconfigured with waveform and numeric readouts for ECG Lead II, ECG
Lead V, ABP, PAP, CVP and Pleth, and numeric readouts for NIBP, Thermodilution C.O.,
Blood Temperature and Body Temperature.
Saturation-Pulse - preconfigured with numeric readouts for SpO2 and pulse.
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Using the Software
Selecting a Preconfigured Layout
To select a preconfigured layout, click Settings, select the layout from the Layouts panel and
click the Close Settings button.
Close
Settings button
Select a layout from
the Layouts panel
Settings Menu
NOTE: Preconfigured layouts must be enabled in the Müse TouchPro Setup for the currently
running SCE to be accessible in the Layouts panel. For more information, see TouchPro Setup
on page 73.
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Using the Software
Changing a Waveform or Numeric Display
Waveforms and numeric displays can be changed to suit the user’s needs.
To change a waveform or numeric display:
1. Click the waveform or numeric to be changed.
The Wave Vital Selection menu or the Numeric Vital Selection menu appears,
displaying all the available waveforms or numerics.
Wave Vital Selection Menu
2. Select the desired waveform or numeric.
The new waveform or numeric is reflected on the screen.
From the Wave Vital Selection menu, the alarm, color and scale can be set for the waveform
using the Set Alarm, Set Color and Set Scale buttons. From the Numeric Vital Selection
menu, the color and alarm for the numeric can also be established using the Set Color and
Set Alarm buttons.
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Adding a Waveform
The TouchPro software supports up to six waveforms.
To add a waveform:
1. Click the Settings button in the bottom right corner of the TouchPro display.
The Settings Button
The Settings menu opens and the Add Waveform and Remove Waveform
buttons appear.
2. Click the plus button in the location above which you want the empty waveform
to appear.
An empty waveform field appears.
Add or Remove
Waveform buttons
An empty
waveform field
Adding an Empty Waveform Field
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3. Click the empty waveform field.
The Wave Vital Selection menu appears.
The Wave Vital Selection Menu
4. Select the desired waveform from the Wave Vital Selection menu.
The new waveform or numeric is reflected on the screen.
Adding a Numeric Display
The TouchPro software contains four numeric display fields. All four numeric display fields are
located on one row beneath the waveform displays.
When fewer than four numeric readouts are being displayed, the remaining fields are blank.
To add a numeric to a blank display field:
1. Click a blank numeric display field.
Click a blank numeric
display field
Clicking a Blank Numeric Display Field
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The Numeric Vital Selection menu appears.
The Numeric Vital Selection Menu
2. Select the desired numeric.
The new numeric vital display is reflected on the screen.
Moving a Waveform or Numeric Display
Waveforms and numerics can be moved on the screen to suit the user’s needs.
To move a waveform or numeric, click the desired waveform or numeric, and drag and drop
the display to a desired location.
Drag and drop a
waveform to a desired
location
Moving a Waveform
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Saving a Layout
Once a desired layout has been configured, it can be saved and reused.
To save a layout:
1. Ensure the correct waveforms and numerics are in place.
2. Click Settings.
The Settings menu appears.
3. Click Save As.
The Save Layout window appears.
4. In the Save Layout window, in the Layout Name field, enter a name for the layout.
Enter the name
for the layout in the
Layout Name field
Entering a Layout Name
5. Click Save.
6. Click the Close button to exit the Settings menu.
Saved layouts can be deleted from the Settings menu by dragging and dropping them in the
Trash.
NOTE: When a layout is saved, it is available for use only with the current SCE. To enable the
layout for use with any other SCE, enable the layout from the TouchPro Setup panel for the
desired SCE. See TouchPro Setup on page 73 for more information.
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Using the Software
Sounds
All sounds can be silenced by clicking Mute.
The Mute Button
To set up the audio for the TouchPro, from the Settings menu, click Audio Setup.
The Audio Setup Menu
From the Audio Setup window, select a waveform to set it as the pulse sound. Once a
waveform is selected, the Audio Setup window automatically closes.
Clicking the Mute button from the Audio Setup window mutes all alarms. Click the Mute
button again to return the alarms to their original state.
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Using the Software
12-Lead ECG
To view a 12-lead ECG report, click the 12-Lead ECG button at the bottom of the TouchPro screen.
The 12-Lead ECG Button
The report appears.
A 12-Lead ECG Report
The report can be printed or saved by clicking the Print button in the bottom right corner of the 12lead ECG report.. To close the report, click the Close button.
IMPORTANT: Prior to saving the report as a PDF or printing to a network printer, the print presets must be
adjusted. The page oritentation must be set to Landscape and the margins must be set to .25 inches on all
sides. These settings vary in location depending on the operating system (i.e., Macinstoh, Windows).
To save the report to a PDF file on a Macintosh Instructor Workstation:
1. From the 12-lead ECG report screen, click the Print button located in the bottom right
corner of the 12-lead ECG report.
2. Select the Save As PDF option.
3. The report saves as a PDF on the Macintosh Instructor Workstation.
To save the report to a PDF file on a Windows Instructor Workstation:
1. From the 12-lead ECG report screen, click the Print button located in the bottom right corner
of the 12-lead ECG report.
2. The Print dialog box appears.
3. From the drop-down menu, select Microsoft XPS Document Writer.
4. The report saves on the Windows Instructor Workstation.
To print a report:
1. From the 12-lead ECG report screen, click the Print button located in the bottom right corner
of the 12-lead ECG report.
2. Select the appropriate network printer.
NOTE: A network printer must be configured in order to appear as an option.
3. Click the Print button.
4. The report prints to the designated network printer.
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Using the Software
NIBP Cycling and Manual NIBP
When non-invasive blood pressure (NIBP) is displayed, the patient’s NIBP can be updated at
specified intervals using NIBP Cycling, or the current NIBP can be displayed immediately using
the Manual NIBP button.
To set the patient’s NIBP to be updated at regular intervals, from the Settings menu, click NIBP
Cycling. The NIBP Cycling menu appears. From the NIBP Cycling menu, select the desired
interval for the cycling and click Start.
The NIBP Cycling Menu
Custom cycling is also available.
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Using the Software
To display the patient’s current NIBP, click the Manual NIBP button.
The Manual
NIBP button
The Manual NIBP Button
The current NIBP is displayed.
NOTE: Manual NIBP can be used at any time during cycling. However, this turns off autocycling.
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Using the Software
Patients
To view the available Patients, click the Settings button in the bottom, right-hand corner of
the TouchPro screen to access the Settings menu. From the Settings menu, click Patients to
view the current Patient.
Available Patients
NOTE: When connected to the simulator, the TouchPro only displays the active Patient.
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Using the Software
Configuring the TouchPro Software
Configure the background color, alarm suspension time and language selection of the
TouchPro from the Configure panel.
To access the Configure panel:
1. Click the Settings button in the bottom, right-hand corner of the TouchPro screen.
2. Click the Configure button from the Settings menu.
3. From the Configure panel, set the background color and alarm suspension time.
Exit
button
The Configure Panel
4. Click the Exit button to exit the Configure panel when finished.
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Using the Software
Changing the Language of the TouchPro Software
To change the language of the TouchPro software:
1. Click the Settings button in the bottom, right-hand corner of the TouchPro screen.
2. Click the Language Selection button from the Settings menu.
3. From the Language Selection panel, select a language.
The Language Selection Panel
Click Accept.
Exiting the TouchPro Software
To exit the TouchPro Software,
1. Click the Settings button from the bottom, right-hand corner of the TouchPro
screen.
2. From the Settings menu, click Shutdown. A warning box appears asking if you
want to exit.
3. Click Shutdown.
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Using METIman
Using METIman
Once METIman has been set up (see the Setup section) and the software has been launched
(see the Using the Software section), the simulator is ready for learner interventions.
The features of METIman are broken down by Neurological, Respiratory, Cardiovascular,
Gastrointestinal and Genitourinary systems.
The Run Screen
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Using METIman
Neurological
The clinical features that can be controlled from the Neurological Assessment view
are Blinking Eyes, Reactive Pupils, Convulsions, Neuromuscular Block, Body and Blood
Temperature and Speech.
To access the Neurological view, from the Run screen, click the brain on the human form.
Click the brain
to access the
Neurological view
Neurological
parameters
The Neurological View
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Using METIman
Eyes
The pupil diameter, pupil reactivity, blinking and blink speed of the simulator’s eyes can be
controlled from the software.
Click the Reactive drop-down menus of each eye to determine reactivity: Reactive, NonReactive, Pinpoint or Blown.
Click Auto to have the eyes blink while the patient is conscious. Click Closed to close the eyes.
Click Blinking to force the eyes to be open and blinking regardless of patient consciousness.
These features can be controlled on both eyes.
Click Slow, Normal or Fast to control the blink speed.
Convulsions
METIman simulates convulsions when the feature is activated on the software. To activate
the Convulsions feature, click the Convulsions switch. The Convulsions feature is activated
when On appears. To deactivate the convulsions feature, click the switch again. The feature is
deactivated when Off appears.
Neuromuscular Blockade
To manually adjust the Neuromuscular Blockade (NMB: Set), click NMB. The NMB slider
appears. Set the percentage by dragging the arrow up or down. Click Accept to exit and save
the changes.
Body Temperature
To control a patient’s body temperature, click Temperature: Body. The Body Temperature
slider appears. Set the body temperature by dragging the arrow up or down. Click Accept to
exit and save the changes.
Blood Temperature
To manually control a patient’s blood temperature, click Temperature: Blood. The Blood
Temperature slider appears. Set the temperature by dragging the arrow up or down. Click
Accept to exit and save the changes.
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Using METIman
Head Secretions (Prehospital Only)
Secretions of the eyes, nose and mouth are manually controlled with a gravity feed.
NOTE: An IV bag is needed for each site in use.
To use the head secretion features:
1. Using a 60 mL syringe, prime the line of the desired secretion by injecting fluid
into the NOSE, MOUTH or EYES port on METIman’s left shoulder until fluid
emerges from the secretion sites.
2. Set up the IV pole near the simulator.
3. Fill an IV bag with the clinically appropriate fluid. Use distilled water only, with
food coloring, if desired.
4. Hang the IV bag on the IV pole.
5. Ensure the roller clamp is closed and insert the IV spike into the IV bag.
6. Connect to the simulator by attaching the end of the IV spike set tubing to the
NOSE, MOUTH or EYES port on the simulator’s left shoulder. (Repeat for each site
necessary.)
The NOSE,
MOUTH and
EYES ports
METIman Prehospital’s Left Shoulder
7. Open the clamp and allow fluid to flow into the simulator.
8. Keep the IV bag attached. Adjust the flow rate manually using the roller clamp.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
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Using METIman
Respiratory
METIman Prehospital’s Respiratory system is comprised of the airway management,
spontaneous breathing and ventilation features. On METIman Nursing, various clinical signs
such as breath sounds, chest excursion and airway patency can be physically demonstrated.
A series of speakers inside each simulator can generate a range of breath and throat sounds
used in diagnosing conditions. To access the Respiratory parameters of METIman, on the
Run screen, click the lung on the human form. The respiratory parameters appear on the Run
screen.
Click the lung to access
the Respiratory view
Respiratory
parameters
The Respiratory View
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Using METIman
Airway
Various clinical signs such as breath sounds, chest excursion and airway patency can be
physically demonstrated. A series of speakers inside the simulator can generate a range of
breath and throat sounds used in diagnosing conditions.
METIman Prehospital’s anatomically realistic upper airway provides for the opportunity to
intubate the patient as well as apply other airway interventions. In addition, the METIman
Prehospital airway was designed to be a difficult airway that teaches learners to use the
best technique when encountering clinical situations with real patients. The airway is best
visualized when using the Sellick maneuver, which is performed when a patient is undergoing
the intubation procedure.
The METIman Nursing airway has the ability to produce secretions to allow for suctioning.
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Using METIman
Airway Features
Anatomy, Physiology
and Clinical Signs
Clinical Interventions, Patient
Monitoring and Scenarios.
Software Control
Manual
Control
Realistic Upper
Allows direct laryngoscopy, oral and
nasal intubation and use of specialty
Airway (Oropharynx,
Nasopharynx and Larynx) airway devices. Simulator detects
and responds appropriately to right
mainstem intubation. Endobronchial
(Prehospital only)
intubation results in unilateral chest
excursion and breath sounds.
None required.
None required.
Trachea, Left and Right
Mainstem Bronchi
Tracheal intubation results in bilateral
chest excursion and breath sounds.
None required.
None required.
Alveolar and arterial gas concentrations
appropriately reflect the efficacy of
ventilation and oxygen administration.
Oxygen
None required.
administration input
by the instructor.
(Prehospital only)
Airway Management and
Ventilation
VIEW: Respiratory
Gastric Distention
Esophageal intubation results in gastric
distension and the absence of breath
sounds, chest excursion and CO2 output.
None required.
None required.
Upper front teeth can be dislodged if
laryngoscopy is performed incorrectly.
None required.
See Breakaway
Teeth
Tongue Edema
(On/Off )
Hinders, but does not prevent,
intubation.
VIEW: Respiratory
None required.
Posterior Pharynx
Swelling
Obstructs view of larynx to prevent
intubation, but allows mask ventilation
“can’t intubate, can ventilate” scenario.
VIEW: Respiratory
None required.
Closes vocal cords and prevents
VIEW: Respiratory
intubation and ventilation. When used
with posterior pharynx swelling, creates
a “can’t intubate, can’t ventilate” scenario.
None required.
Allows needle cricothyrotomy,
transtracheal jet ventilation, retrograde
wire techniques and cricothyrotomy.
See
Cricothyrotomy,
(Prehospital only)
Breakaway Teeth
(Prehospital only)
(Prehospital only)
Laryngospasm
(Prehospital only)
Cricothyroid Membrane
None required.
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Using METIman
Swollen Tongue
The swollen tongue feature is activated on the Respiratory view by setting the Swollen
Tongue switch to Swollen.
Posterior Pharynx Swelling (Prehospital Only)
Swelling of the posterior oropharynx (posterior airway occlusion) can be activated to obstruct
the view of the larynx and prevent intubation, but allow mask ventilation of the patient’s
lungs, thereby creating a “cannot intubate, can ventilate” scenario. Click the Airway Occluder
switch to activate the feature.
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Using METIman
Realistic Upper Airway (Prehospital Only)
The upper airway of METIman Prehospital is designed to allow for intubation and
laryngoscopy. Oral and nasal intubation can be performed using a variety of airway devices,
including LMAs (3), endotracheal tubes (6.5 mm to 7.5 mm), nasal-pharyngeal airways (30 mm)
and oropharyngeal airways (90 mm).
Intubation
The simulator detects and responds appropriately to right mainstem intubation, and an event
is recorded in the Event Log.
Intubation incorrectly applied into the esophagus causes abdominal distension.
IMPORTANT
Airways can be damaged by improper insertion of an
airway adjunct (e.g. endotracheal tube). To protect the
airway, lubricate the adjunct prior to insertion using the
silicone spray provided.
Use ONLY the provided SILICONE SPRAY to lubricate the
adjunct. NEVER use a water-based lubricant because of
resulting residue damage.
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Using METIman
Laryngospasm (Prehospital Only)
A laryngospasm actuator closes the patient’s vocal cords and prevents both ventilation and
intubation. Click the Laryngospasm switch to activate the feature.
Teeth with Breakaway Incisors (Prehospital Only)
METIman Prehospital is equipped with Breakaway Teeth whose front incisors become
dislodged with improper handling of a laryngoscope.
The teeth are tied to the upper denture with a lanyard, which prevents losing the teeth down
the airway or misplacing them during storage.
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Using METIman
Airway Secretions (Nursing Only)
METIman Nursing allows for suctioning of fluids from the airway using a manual feed. Ensure
all fluids have been removed from previous uses before each new use to prevent overfilling.
Tracheostomy Suction
To use the airway secretion feature, inject up to 40 mL of clinically appropriate colored fluid
into the AIRWAY FILL port on METIman Nursing’s left shoulder.
The AIRWAY
FILL port
METIman Nursing’s Left Shoulder
The trachea is now ready to be suctioned. Using the proper clinical technique, insert the
suction catheter (14 Fr) until resistance is encountered at the bifurcation. Withdraw and apply
suction. Fluid can be suctioned over a distance of approximately 4 cm distal to the bifurcation.
NOTE: Use only distilled water with food coloring, if desired.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
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Using METIman
Cricothyrotomy
Cricothyrotomy can be simulated on METIman. Before performing a needle cricothyrotomy,
the Cricothyrotomy plug must be removed, and a 2.25-inch (6-cm) length of red tape from the
roll provided must be placed over the hole.
To replicate a needle cricothyrotomy:
1. Spray the silicone lubricant onto the airway adjunct prior to the simulation
session. To prevent damage to the simulator, always spray silicone lubricant into
the airway.
2. Locate the simulated cricothyroid membrane sealed with tape underneath the
neck skin.
3. Follow standard clinical techniques and palpate to find the cricothyroid space.
4. Puncture the space through the neck skin of the patient simulator and into
the tape “membrane.” This puncture goes all the way through to the “trachea,”
simulating the clinical procedure.
5. Users must replace the tape that simulates the cricothyroid membrane after each
cricothyrotomy.
NOTE: Replacement components are available in the Inventory Kit.
NOTE: When ventilating through a surgical airway, the Laryngospasm feature must be
deactivated, or the chest rise is not observed.
NOTE: When finished using the Cricothyrotomy feature, replace the Crichothyrotomy plug.
Replacing the Cricothyrotomy Tape
Remove the old, punctured tape completely from the cricoid feature and use alcohol to clean
the glue residue from the surface. (An alcohol prep pad works well.) Allow to dry.
Cut an approximately 2.25-inch (6 cm) length of the double-sided tape from the roll provided.
Carefully remove the paper backing and lightly stretch the newly revealed adhesive side of the
tape over the cricoid hole and down the far side of the cricoid feature. Use the non-stick paper
backing to press the tape against the cricoid feature.
Cut a 2.5-inch to 3-inch (7 cm to 8 cm) length of red tape and apply it over the cricoid feature
and the tape.
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Using METIman
Resealing the Membrane After a Puncture
To reseal the cricoid feature, apply a small piece of red tape over the punctured area. This
can be repeated a brief number of times, but when the number of layers impedes the
cricothyrotomy, all existing tape must be removed and replaced with new tape.
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Using METIman
Pulmonary
METIman uses both physical and mathematical models to achieve an extremely accurate
simulation of respiration. METIman’s chest rises and falls, mimicking inspiration and expiration.
METIman Prehospital’s lungs also react realistically to intubation as well as to pathophysiologic
states.
Pulmonary System
Anatomy,
Physiology and
Clinical Signs
Clinical Interventions, Patient Monitoring Software Control
and Scenarios.
Manual Control
Spontaneous
Breathing
Normal tidal breathing and pathophysiological
conditions such as atelectasis, pneumothorax,
asthma and COPD.
None required, but
adjustable
None required.
Exhaled CO2
(Prehospital only)
Measure the presence or absence of CO2 during
positive pressure ventilation.
None required.
CO2 canister is
inserted
Pneumothorax or
Hemothorax
Increase in intrapleural volume, leading to
asymmetrical breathing.
None required, but
adjustable
None required.
VIEW: Respiratory
VIEW: Respiratory
CONTROL: Intrapleural
Volume
(Left or Right)
138
Chest Excursion
Synchronized with ventilation (spontaneous or
positive pressure ventilation). Excursion depth
proportional to tidal volume.
None required.
None required.
Breath Sounds
Normal and abnormal breath sounds are
independently synchronized with ventilation of
the right and left lungs. Breath sounds can be
auscultated over anterior and posterior anatomic
locations.
None required, but
adjustable
None required.
Bronchial
Occlusion
Completely obstructs right and/or left mainstem
bronchi, simulating a lower airway obstruction
(e.g. mucus plug). This yields an inability to
ventilate the lungs and asymmetric chest
excursion.
VIEW: Respiratory
None required.
Pulse Oximetry
Oxyhemoglobin saturation (SpO2) automatically
correlates with the oxygen concentration in the
lungs and the intrapulmonary shunt fraction.
None required, but
adjustable
SpO2 probe is
attached.
Arterial Blood
Gases
PaO2, PaCO2 and pH are continuously calculated,
and the Patient Status Display can be configured
to show them.
None required, but
adjustable
None required.
Venous Blood
Gases
PvO2 and PvCO2 are continuously calculated, and
the Patient Status Display can be configured to
show them.
None required, but
adjustable
None required.
VIEW: Sounds
Using METIman
Pulmonary System
Needle
Decompression
(Prehospital Only)
Decompression of a pneumothorax can be
The instructor must
performed bilaterally by inserting a needle at the adjust the amount
midclavicular line of the second intercostal space. of physiologic
intrapleural air present.
See Needle
Decompression
setup,.
VIEW: Respiratory
CONTROL: Needle
Decompression,
Intrapleural Vol: Left,
Intrapleural Vol: Right
Needle Decompression (Prehospital Only)
Needle decompression can be performed bilaterally into a small hole located in the
midclavicular line of the second intercostal space using a 14-gauge needle.
To enable the Needle Decompression feature, activate the switch for the appropriate side(s).
From the Respiratory view, turn the desired Needle Decompression switch to On.
Needle Decompression Switch
Needle Decompression
When a needle is inserted in the second intercostal space, along the midclavicular line, air is
released while intrapleural volume is present.
Needle Decompression and Chest Tube
When using the METIman Prehospital system, the Needle Decompression and Chest Tube
features can be enabled simultaneously. Intrapleural volume will decrease when both are in
use.
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Using METIman
Bronchial Occlusion (Prehospital Only)
When bronchial occlusion is enabled, unilateral chest excursion is observed during
spontaneous breathing or positive pressure ventilation. To stop airflow to the bronchi,
creating a bronchial occlusion, the switch for the appropriate side(s) must be activated. From
the Respiratory view, turn the desired Bronchial Occlusion switch to On.
Bronchial Occlusion Switch
Respiratory Rate
To adjust the respiratory rate manually, from the Respiratory view, click Respiratory Rate. The
Respiratory Rate slider appears. Set the rate by dragging the arrow up or down. Click Accept
to exit and save the changes. The switch is now orange, indicating a change has been made. To
return to the programmed physiologic model, click the switch and turn the Override switch to
Modeled.
Respiratory Rate Parameter
Pulse Oximetry
To adjust the SpO2 percentage manually, from the Respiratory view, click SpO2. The SpO2
slider appears. Set the rate by dragging the arrow up or down. Click Accept to exit and save
the changes. The switch is now orange, indicating a change has been made. To return to the
programmed physiologic model, click the switch and turn the Override switch to Modeled.
SPO2 Parameter
The SpO2 probe is integrated with the TouchPro (optional) and the physiological model. The
connection for the SpO2 probe is located on the left side of the simulator. The SpO2 probe must
be connected for pulse oximetry data to be displayed.
CO2 Exhalation (Prehospital Only)
Whether supplied via a portable canister or from an external source, the simulator exhales CO2
during positive pressure ventilation.
NOTE: An optional regulator kit must be purchased to use CO2 from an external source.
To use the CO2 Exhalation feature, connect the CO2 canister to the CO2 canister socket or
connect the external source on the simulator’s right shoulder, and METIman Prehospital
exhales CO2 gas. There are approximately 15 minutes of CO2 gas available once the canister is
connected.
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Using METIman
Positive Pressure Ventilation
When positive pressure ventilation is administered, the process is automatically detected by the
simulator, and the physiologic model is sensitive to the volume administered.
Gastric Distention (Prehospital Only)
During esophageal intubation or overly aggressive bag valve mask ventilation, gastric distention
occurs. Gastric distention is relieved by putting pressure on the abdomen.
Chest Tube: METIman Prehospital
METIman Prehospital has the ability to simulate chest tube drainage. The Chest Tube sites are located
bilaterally in the fifth intercostal space. Use only a 28 Fr chest tube. Ensure all fluids have been removed
from previous uses before each new use to prevent overfilling. Please refer to the Care and Maintenance
section for directions on fluid removal.
To simulate continuous chest tube drainage:
1. Insert the METIman Priming Tube in the Chest Tube site.
2. Set up the IV pole near the simulator.
3. Fill an IV bag with the clinically appropriate fluid. Use distilled water only, with food
coloring if desired.
4. Hang the IV bag on the IV pole.
5. Ensure the roller clamp is closed and insert the IV spike into the IV bag.
6. Connect to the simulator by attaching the end of the IV spike set tubing to the
corresponding CHEST TUBE port (LEFT or RIGHT) on the simulator’s right shoulder.
Chest Tube ports
METIman’s Right Shoulder
7. Open the clamp and allow fluid to flow into the simulator until fluid is seen in the METIman
Priming Tube.
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Using METIman
8. Once fluid appears in the METIman Priming Tube, remove the METIman Priming
Tube. The simulator is ready for chest tube insertion.
9. Keep the IV bag attached and adjust the flow rate manually using the roller clamp.
The chest tube must be fully inserted for the fluid to flow.
Chest Tube Insertion
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
When the Chest Tube feature is used on METIman Prehospital, the simulator automatically
detects the tube insertion and creates a log entry.
On METIman Prehospital, if a small volume of fluid is needed to simulate proper chest tube
insertion, the internal reservoir may be filled.
To insert a small amount of fluid into the Chest Tube reservoir:
1. Insert the METIman Priming Tube in the Chest Tube site.
2. Using a 60 mL syringe filled with clinically appropriate fluids, inject the contents
into the CHEST TUBE port (LEFT or RIGHT) until fluid is seen in the METIman
Priming Tube. Use distilled water only, with food coloring, if desired.
3. Remove the METIman Priming Tube.
4. Inject the remaining contents of the syringe into the CHEST TUBE port.
5. Remove the syringe.
Chest Tube and Needle Decompression
The Chest Tube and Needle Decompression features can be enabled at the same time on the
METIman Prehospital system. Intrapleural volume will decrease when both are in use.
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Using METIman
Chest Tube: METIman Nursing
METIman Nursing has the ability to simulate chest tube drainage. The Chest Tube sites are
located bilaterally in the fifth intercostal space. Use only a 28 Fr chest tube. Ensure all fluids
have been removed from previous uses before each new use to prevent overfilling. Please refer
to the Care and Maintenance section for directions on fluid removal.
To simulate continuous chest tube drainage:
1. Insert the METIman Priming Tube in the Chest Tube site.
2. Set up the IV pole near the simulator.
3. Fill an IV bag with the clinically appropriate fluid. Use distilled water only, with
food coloring if desired.
4. Hang the IV bag on the IV pole.
5. Ensure the roller clamp is closed and insert the IV spike into the IV bag.
6. Connect to the simulator by attaching the end of the IV spike set tubing to
the corresponding CHEST TUBE port (LEFT or RIGHT) on the simulator’s right
shoulder.
Chest Tube ports
METIman’s Right Shoulder
7. Open the clamp and allow fluid to flow into the simulator until fluid is seen in the
METIman Priming Tube.
8. Once fluid appears in the METIman Priming Tube, remove the METIman Priming
Tube. The simulator is ready for chest tube insertion.
9. Keep the IV bag attached and adjust the flow rate manually using the roller clamp.
The chest tube must be fully inserted for the fluid to flow.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
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Using METIman
Cardiovascular
With METIman’s Cardiovascular system, users can replicate the clinical signs associated with
cardiac activity, including palpable pulses, heart sounds and electrical activity.
Cardiovascular System
Anatomy,
Physiology and
Clinical Signs
Clinical Interventions, Patient Monitoring Software Control
and Scenarios.
Heart Sounds
Normal and abnormal heart sounds are
synchronized to the cardiac cycle and audible
to a standard stethoscope. Heart sounds can be
auscultated over the left and right upper sternal
border, right lower sternal border and apex.
None required;
None required.
specific sounds can be
selected.
5-Lead ECG
ECG waveforms can be viewed on a standard
monitor and/or on the TouchPro Patient monitor.
Normal and abnormal cardiac rhythms are
linked to patient physiology (e.g. blood pressure,
cardiac output).
None required;
specific rhythms can
be selected.
ECG monitor may
be utilized.
Myocardial
Ischemia
Myocardial oxygen supply and demand
automatically influence the cardiac rhythm,
yielding response to hypoxemia.
None required, but
adjustable.
None required.
Palpable Pulses
Carotid, brachial, radial, femoral, popliteal,
posterior tibial and dorsalis pedis pulses can be
palpated bilaterally and are synchronous with
the cardiac cycle. A pulse deficit automatically
occurs if the systolic arterial blood pressure falls
below specified thresholds.
None required, but
adjustable.
None required.
Systemic blood pressure can be measured using
the return-to-flow technique. Korotkoff sounds
can also be auscultated.
None required.
Non-Invasive
Blood Pressure
Measurement
144
Manual
Control
VIEW: Cardiovascular
VIEW: Available on
all views on the Run
screen
Use of modified
blood pressure
cuff.
Using METIman
To access the Cardiovascular parameters of METIman, on the Run screen, click the heart on the
human form. The cardiovascular features appear on the Run screen.
Click the heart to access the
Cardiovascular view
Pulses
Cardiovascular
parameters
The Cardiovascular View (Prehospital)
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Using METIman
Pulses: METIman Prehospital
METIman Prehospital has 14 pulse sites that are activated by touch.
• Carotid (2)
• Brachial (2)
• Radial (2)
• Femoral (2)
• Popliteal (2)
• Posterior Tibial (2)
• Dorsalis Pedis (2)
NOTE: The Dorsalis Pedis and Posterior Tibial pulses are controlled together. The left and right
Carotid pulses are also controlled together.
Pulses are visible and can be controlled from any physiological view. To disable a pulse, click
the pulse location on the human form. To enable a pulse, click the pulse location again.
Activated pulse
Deactivated
pulse
Pulses: METIman Prehospital – Active and Inactive
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Using METIman
Pulses: METIman Nursing
METIman Nursing has 14 pulse sites that are activated by touch.
• Carotid (2)
• Brachial (2)
• Radial (2)
• Femoral (2)
• Popliteal (2)
• Posterior Tibial (2)
• Dorsalis Pedis (2)
NOTE: The left and right Carotid pulses are controlled together.
Pulses are controlled from the Cardiovascular view only. All pulses, unless altered by an SCE,
are enabled by default. To disable a pulse, click the pulse location on the human form. To
enable a pulse, click the pulse location again.
Activated pulse
Deactivated
pulse
Pulses: METIman Nursing – Active and Inactive
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Using METIman
Blood Pressure
METIman supports non-invasive blood pressure measurements, and systolic and diastolic
readings can be obtained and manipulated through the software.
Systolic and Diastolic Blood Pressure
To manually adjust the systolic and/or diastolic blood pressure:
1. From the Cardiovascular view, click the parameter of desired blood pressure.
2. Set the pressure by dragging the arrow up or down.
3. Click Accept to exit and save the changes. The switch is now orange, indicating a
change has been made.
4. To return to the programmed physiologic model, click the switch and turn the
Override switch to Modeled.
Non-Invasive Blood Pressure Measurement
Blood pressure can be taken manually on either arm. Non-invasive blood pressure (NIBP)
monitoring techniques can be used by attaching the standard cuff modified with a T-fitting
and adapters.
To modify a standard blood pressure cuff:
1. Cut the blood pressure cuff tube approximately 9 cm from the cuff.
2. Insert the barbed end tubing connectors into the cut ends of the blood pressure
cuff tubes.
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Using METIman
3. Secure the tubing connectors with cable ties.
An Attached Tubing Connector
4. Attach the blood pressure adapter to the connectors.
An Attached Blood Pressure Cuff Adapter
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Using METIman
To get a blood pressure reading, connect the extension from the T-fitting on the blood
pressure cuff adapter to either of the NIBP ports on METIman’s left and right shoulders.
NIBP LEFT port
METIman Prehospital’s Left Shoulder
NIBP LEFT port
METIman Nursing’s Left Shoulder
NIBP RIGHT port
METIman’s Right Shoulder
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Using METIman
Connect the T-fitting extension to the hose.
Take the non-invasive blood pressure reading using the return-to-flow technique.
Attached Blood Pressure Cuff
At appropriate cuff pressures, Korotkoff sounds are produced, and the radial pulse disappears.
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Using METIman
Heart Rate
To manually adjust the heart rate, from the Cardiovascular view, click Heart Rate. Set the rate
by dragging the arrow up or down.
Click Accept to exit and save the changes. The switch is now orange, indicating a change has
been made.
To return to the programmed physiologic model, click the switch and turn the Override switch
to Modeled.
Five-Lead ECG
On METIman, a 5-lead ECG is emitted from the appropriate positions for display on a standard
monitor. A contact is available on METIman’s chest for each of the five cables.
Five-Lead
ECG sites
5-Lead ECG Sites
The simulator generates a normal sinus ECG, as well as a broad range of abnormalities such as
myocardial ischemia, sinus tachycardia and bradycardia, ventricular fibrillation and asystole.
The hemodynamic response to the arrhythmias is physiologically correct. Myocardial oxygen
balance and cardiac ischemia automatically influence the cardiac rhythm resulting in a
realistic and automatic response of the rhythm to hypoxemia. The degree of influence can be
controlled or completely overridden by the instructor.
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Cardiovascular Interventions/Therapy
METIman can simulate chest compressions and three types of electrical therapy: defibrillation,
cardioversion and pacing.
Realistic Cardiovascular Interventions
Anatomy,
Physiology and
Clinical Signs
Clinical Interventions, Patient
Monitoring and Scenarios.
Software Control
Manual
Control
Chest
Compression
Effective chest compression results in artificial
circulation, cardiac output, central and
peripheral blood pressures, palpable pulses, and
CO2 return.
None required, but
adjustable.
None required.
Cardiac
Monitoring
The desired arrhythmia can be selected.
The response to
clinical intervention
must be controlled by
the instructor.
None required.
Defibrillation
METIman supports operation with a variety of
manual and automatic external defibrillators.
VIEW: Cardiovascular
Defibrillation can
be simulated by the
instructor under the
Interventions palette
VIEW: Cardiovascular
Cardiac Pacing
Transthoracic cardiac pacemaker can be used
with METIman. Pacing results in appropriate
physiological changes in blood pressure and
cardiac output.
None required.
See Defibrillation
below for
defibrillation disk
locations and
instructions.
See Pacing below
for cardiac pacing
disk locations and
instructions.
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Using METIman
Chest Compressions
METIman supports normal hand placement and standard compression techniques, and chest
compressions can be performed. METIman can detect the compressions, and the physiology
responds accordingly.
Defibrillation and Cardioversion
Manual defibrillation and cardioversion can be performed on METIman. Additionally,
defibrillation and cardioversion are available virtually through the software.
METIman is designed to safely absorb the energy discharged from manual and automatic
defibrillators. Standard defibrillation energy levels should be used for positive learning
reinforcement and to avoid negative training transfer.
Defibrillation sites
Defibrillation Sites
However, use of a defibrillator for training purposes represents an operational hazard
equivalent to use of a defibrillator on a real patient. Consequently, ALL SAFETY PRECAUTIONS
for the use of defibrillators MUST BE FOLLOWED as if the simulator were a patient. Consult the
specific defibrillator’s user manual for further information.
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Using METIman
The following cautions should be observed:
• Defibrillation should be performed on the defibrillation electrodes only. If defibrillation
is performed over any ECG electrode, high voltage may be present on the remaining
connectors during the shock. This may also damage ECG circuitry.
• To prevent overheating, do NOT provide more than three (3) defibrillator discharges
(maximum 200 joules with a biphasic defibrillator) in a sequence. Do NOT exceed an
average of two (2) defibrillator discharges per minute during the training session.
• Avoid a large number of consecutive discharges. For example, 20 or 25 discharges
without any recovery interval may damage the system.
• Do NOT let the simulator come in contact with electrically conductive surfaces or
objects during defibrillation. A flame-supporting atmosphere, for example, with a high
content of oxygen, should be avoided during defibrillation.
• Keep the simulator’s chest dry. Special attention should be taken when using the urinary
system or the chest tube feature.
• To prevent pitting of the chest skin electrode, do NOT apply conductive gel or
conductive defibrillation pads intended for patient use.
• Do NOT use cables or connectors having visible damage.
• Do NOT spill fluids over any component inside the simulator torso. This could damage
the system and may also present a possible hazard for the operator.
• When using a manual defibrillator, the ECG can be monitored via the defibrillator
paddles. Coarse ventricular fibrillation and high-rate ventricular tachycardia cardiac
rhythms are automatically recognized as “shockable” rhythms.
• With each defibrillation, the METIman automatically records the amount of energy
discharged and the time defibrillation was performed. The simulated patient response
to defibrillation is determined by the scenario script or instructor intervention. Thus,
cardioversion is not automatically determined by the physiological models.
• The minimum electrical charge recognized by the circuitry within the simulator is 20
joules.
• For paddle placement on the chest, the simulator has two anterior defibrillation disks,
which can be unscrewed, leaving threaded connections, if required.
• Biphasic defibrillators can be used with either paddles or hands-free connectors.
Pacing
Pacing can be achieved virtually by selecting the appropriate intervention in the Interventions
palette. A standard transthoracic cardiac pacemaker can be connected to the simulator using
the anterior contacts. The simulator automatically detects and responds to pacing signals (from
20 mA to 200 mA, in increments of 10).
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Using METIman
Subclavian Catheter (Nursing Only)
The Subclavian Catheter feature allows for cleaning and dressing practice. When using the
Subclavian Catheter feature, users can infuse up to 50 mL of distilled water in the line.
Subclavian Catheter
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
Intramuscular Injection
METIman allows for the administration of a deltoid intramuscular (IM) injection. Injection sites
are located on both of METiman’s arms. Use only a 20- to 22-gauge needle.
Intramuscular Injection
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Using METIman
IV Cannulation
Veins for the IV Cannulation feature are located in the dorsum of the hands, forearms and
antecubital region of the arms. Use only a 20- to 22-gauge needle. To simulate realistic
flashback, the system must be primed prior to use. Ensure all fluids have been removed
from previous uses before each new use to prevent overfilling. Please refer to the Care and
Maintenance section for directions on fluid removal.
IV Cannulation
To prime the IV access ports, connect a 60 mL syringe filled with distilled water (with clinically
appropriate food coloring if desired) to the IV FILL port on METIman’s right shoulder and firmly
inject all 60 mL. This primes the arms and charges the system for Flashback and Venipuncture
support.
WARNING: If a flash does NOT occur, do NOT inject any fluid and remove the needle
immediately. Repeat the priming directions and ensure you have injected the needle
properly and into the simulated vein.
IV FILL and IV
DRAIN ports
METIman’s Right Shoulder
Fluids and medications can be administered intravenously. Approximately 50 mL of fluid may
be infused. To support infusion of larger volumes, connect an empty IV bag or other receptacle
to the IV DRAIN port located on METIman right shoulder.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
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Using METIman
Fluids
METIman is capable of bleeding simultaneously at two sites from an internal tank. Arterial and
venous bleeding can be simulated.
Venous settings produce a continuous bleed at three user-adjustable flow rates.
Arterial settings produce a pulsing flow synchronized with the cardiac cycle at three useradjustable flow rates.
The flow rate is determined by the selected bleeding vessel size and the blood pressure.
In addition, the simulator features auto-sensing of hemorrhage control (e.g., tourniquet
application or direct pressure).
Bleeding results in an automatic loss of blood from the physiologic models with subsequent
changes in hemodynamics. Blood loss occurs at a rate dependent on wound size and Mean
Arterial Pressure (MAP).
Setup must be completed before using the bleeding feature.
To enable bleeding, on the Run screen, click the blood droplet. The Fluids view appears.
Bleeding
parameters
Click the blood
droplet to access
the Bleeding view
The Fluids View
Simulated blood MUST be removed from the simulator after each use. Failure to remove
simulated blood from the simulator can void the warranty. For instructions on how to clean the
simulator after using the Bleeding feature, please refer to the Care and Maintenance section for
directions on fluid removal.
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Using METIman
Hemorrhage Setup
The user determines the type and placement of the bleeding moulage for the lesson. An
optional Moulage Kit can provide molded gunshot wounds, broken and protruding bones,
amputations and an abdominal wound as well as theatrical components.
To decrease the likelihood of staining, apply a thin coat of petroleum to the area of bleeding.
To use one of the moulage wounds from the Moulage Kit:
1. Secure the wound over the simulator using the integrated straps.
2. Connect the wound haptic to the one of the moulage ports located on METIman’s
right shoulder (UPPER MOULAGE) or right hip (LOWER MOULAGE).
UPPER
MOULAGE port
METIman’s Right Shoulder
LOWER
MOULAGE port
METIman’s Right Hip
3. Enable Bleeding: Upper or Bleeding: Lower on the Fluids view of the Müse
software, as desired.
Hemorrhage Control
When bleeding is controlled (e.g., hemostat, tourniquet), the action is detected and logged,
and the physiology responds accordingly.
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Using METIman
Tourniquet Application
A tourniquet may be applied to stop the flow of blood.
The wound umbilical contains an 18-inch section of soft tubing that allows the use of a
tourniquet to stop the flow of blood.
For added realism, the simulator should be dressed in clothing that can be torn to “conform”
with the type of injury being demonstrated. Bleeding moulages and the wound umbilical
should be concealed under the victim’s clothing with only the wound showing.
Tourniquet Application
Fluid Loss Blood
To manually control a patient’s blood loss, from the Fluids view, click the Fluid Loss Blood
parameter. The Fluid Loss Blood slider appears. Set the amount of blood loss by dragging the
arrow up or down. Click Accept to exit and save the changes.
Fluid Loss Plasma
To manually control a patient’s plasma loss, from the Fluids view, click the Fluid Loss Plasma
parameter. The Fluid Loss Plasma slider appears. Set the amount of Plasma loss by dragging the
arrow up or down. Click Accept to exit and save the changes.
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Using METIman
Gastrointestinal
METIman produces realistic bowel sounds. In addition, on METIman Nursing, gastric lavage,
gavage and suction can be administered.
Gastrointestinal Gavage, Lavage and Suction (Nursing Only)
METIman Nursing has a gastric reservoir that allows for simulated gavage, lavage and gastric
suction. Before each use, ensure the reservoir has been drained completely. The reservoir
should be primed with 60 mL of fluid before performing gastric suction (see Gastric Suction on
page 162 for more information). A maximum of 100 mL of fluid may be added to the gastric
reservoir once the reservoir is primed.
Gavage (Nursing Only)
To perform gastrointestinal gavage, ensure the reservoir is empty and infuse fluid according to
procedure using a 14 Fr nasogastric tube.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
NOTE: Ice the nasogastric tube if extra rigidity is needed for insertion.
Lavage (Nursing Only)
To perform gastrointestinal lavage, ensure the reservoir is empty and infuse fluid normally
using a 14 Fr nasogastric tube. Fluids can then be removed according to proper clinical
procedure.
Gastric Lavage
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
NOTE: Ice the nasogastric tube if extra rigidity is needed for insertion.
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Using METIman
Gastric Suction (Nursing Only)
To perform gastric suction, the reservoir must be primed prior to use. To prime the
gastrointestinal reservoir, attach a syringe with a luer-lock extension set (provided) and inject
60 mL of distilled water into the GASTRIC FILL port on the simulator’s left shoulder.
The GASTRIC
FILL port
METIman Nursing’s Left Shoulder
Fluids can then be removed according to procedure using a 14 Fr nasogastric tube.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
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Using METIman
Genitourinary System
METIman may be configured with either male or female genitalia, either of which allows for
the insertion of a urinary catheter. The genitourinary system also provides for the excretion of
urine.
Urinary Catheterization
Catheterize the simulator using a standard 16-Fr urinary catheter lubricated with silicone spray.
Urinary Catheterization
The bladder for the simulated urine is accessed directly via the urethra.
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Using METIman
Simulating Urine Output
METIman allows urinary catheterization and simulation of urinary output. Ensure all fluids have
been removed from previous uses before each new use to prevent overfilling. Please refer to the
Care and Maintenance section for directions on fluid removal.
To simulate continuous urinary output:
1. Set up the IV pole near the simulator.
2. Fill an IV bag with the clinically appropriate fluid. Use distilled water only, with food
coloring if desired.
3. Hang the IV bag on the IV pole.
4. Ensure the roller clamp is closed and insert the IV spike into the IV bag.
5. Connect to the simulator by attaching the end of the IV spike set tubing to the GU
port on the simulator’s left shoulder.
The GU port
METIman Prehosptial’s Left Shoulder
The GU port
METIman Nursing’s Left Shoulder
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Using METIman
6. Open the clamp and allow fluid to flow into the simulator. There is a reservoir
inside the simulator that fills up with the fluid.
7. Keep the IV bag attached. Adjust the flow rate manually using the roller clamp.
8. Catheterize the simulator using a 16-Fr urinary catheter lubricated with silicone
spray. The urinary catheter must be fully inserted for the fluid to flow.
NOTE: Cleanup is very important when using simulated fluids. Please refer to the Care and
Maintenance section for directions on fluid removal.
If a small volume of fluid is needed to simulate proper urinary catheterization in a field location,
the internal reservoir may be filled. To fill the genitourinary reservoir, attach a syringe with a
Luer-lock extension set (provided) and inject 60 mL of distilled water into the GU port on the
simulator’s left shoulder.
Changing the Simulator’s Genitalia
METIman comes with male and female genitalia.
To switch genitalia:
1. Pull apart the Velcro holding the genitalia.
2. Loosen and remove the urethra connector. This connection may be tight when
genitalia are removed the first time.
3. Remove the genitalia.
4. Attach urethra tube to the urethra connector.
5. Attach the desired genitalia using the Velcro.
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Using METIman
Sounds
A variety of simulated sounds are available to enhance realism. A patient must be running on
METIman for any sounds to be available.
Speech
Speech can be added to simulations using the Vocal Sounds and Speech Sounds features on
the software or by using an external microphone.
Vocal Sounds
A variety of programmable vocal sounds are available. Vocal sounds are male or female based
on the gender of the active patient.
Vocal Sounds
None
Audible Wheezing
Crying
Gagging
Gasping
Groaning
Long loud cough
Long soft cough
Mumbling
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Using METIman
To select a sound from the Vocal Sounds drop-down menu, click the Sounds button on the
Run screen. The Sounds panel appears.
Vocal Sounds Menu
Click Vocal Sounds and select the type of sound desired from the Vocal Sounds drop-down
menu. Vocal Sounds play continuously when selected and are emitted immediately when
selected from the Vocal Sounds drop-down menu. To stop playing one of the vocal sounds,
select None from the list.
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Using METIman
Speech Sounds
Speech Sounds include a male or female voice that can utter pain rating indicators from 0 to
10, various phrases and a series of other utterances. Unlike Vocal Sounds, Speech Sounds only
play once.
Speech Sounds
Loud Cough
Soft Cough
Short Loud Cough
Short Soft Cough
Scream
Grunt
“Yes”
“No”
“Sometimes”
“Ouch”
“My leg hurts”
“My belly hurts”
“My chest is tight”
“I can’t breathe”
“Ow, that hurts”
“0” through “10” - Pain
Ratings
“Sharp”
“Pressure”
“Aching”
“Dull”
“Stabbing”
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Using METIman
To play a Speech Sound, click the Speech balloon. A list of Speech Sounds appears.
The Speech
Sounds menu
The Speech Sounds Menu
Select the desired sound. The sound plays, and the list disappears.
To replay the last sound, click the Play button in the Speech balloon.
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Using METIman
Wireless Voice Capability
In addition to the pre-programmed speech, any response can be transmitted through the
speakers using the wireless microphone.
Wireless Microphone
The microphone volume can be adjusted on the microphone itself using the volume control.
Wireless Voice Link
If a wireless voice link package was included with the METIman simulator, see Appendix B Wireless Voice Link on page B-1 for additional instructions.
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Using METIman
Throat Sounds
Stridor throat sounds can be enabled using the software. Throat sounds can be adjusted by
clicking the Sounds button on the Run screen. When the Sounds panel appears, select Throat
Sounds.
The Throat Sounds Menu
Click the Throat Sounds drop-down menu to change the type of sound. Click and drag the
slider to adjust the volume.
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Using METIman
Breath Sounds
Breath sounds are independently synchronized with ventilation of the left and right lungs.
Fourteen speakers, eight anterior and six posterior, provide breath sounds that can be
auscultated. Each of the four quadrants of the torso can be set independently to produce a
particular breath sound.
Breath Sounds
Normal
Crackles
Diminished
Gurgling
Pleura Rub
Rhonchi
Wheezing
Click any one of the Breath Sounds drop-down menus that each control one of four
quadrants to change the type of sound. Click and drag the slider for each location to adjust the
volume.
A patient must be running on a METIman simulator for any sounds to be available.
By default, Normal breath sounds are heard.
Breath sounds can be adjusted by clicking the Sounds button on the Run screen. When the
Sounds panel appears, select Breath Sounds.
The Breath Sounds Menu
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Using METIman
Heart Sounds
Heart sounds emanate from four speakers and are synchronized with the cardiac cycle. Heart
sounds can be auscultated over the left and right sternal border, right lower sternal boarder
and apex.
By default, heart sounds are set to the Normal sound. The following sounds are available:
Heart Sounds
Normal S1-S2
S3
S4
S3 and S4
Early Systolic Murmur
Mid Systolic Murmur
Late Systolic Murmur
Pan Systolic Murmur
Late Diastolic Murmur
Heart sounds can be adjusted by clicking the Sounds button on the Run screen. When the
Sounds panel appears, select Heart Sounds.
The Heart Sounds Menu
Click the Heart Sounds drop-down menu to change the type of sound. Click and drag the
slider to adjust the volume.
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Bowel Sounds
Learners can auscultate bowel sounds over each of four intestinal quadrants: the Upper
Right, Upper Left, Lower Right and Lower Left. The sounds can be independently set in each
anatomical region to Normal, Hypoactive, Hyperactive or None (bowel sounds are absent).
The Bowel Sounds Menu
Bowel sounds can be adjusted by clicking the Sounds button on the Run screen. When the
Sounds panel appears, select Bowel Sounds.
Click any one of the Bowel Sounds drop-down menus that each control one of four quadrants
to change the type of sound.
Click and drag the slider for each location to adjust the volume.
Normal bowel sounds are present by default.
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Care and Maintenance
Care and Maintenance
Maintaining METIman requires careful treatment of the electronic and mechanical
components. Each time METIman is assembled or disassembled, make sure all components
are properly handled and either removed from or placed into storage correctly.
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Care and Maintenance
METIman Warranty Programs
General Information
CAE Healthcare patient simulator products come with a one-year Manufacturer’s Warranty
(excluding batteries and consumables). All warranties begin at date of shipment or CAE
Healthcare installation. You may upgrade your first year Warranty to an Enhanced Warranty
and receive remedial and planned maintenance. To prevent equipment downtime and delays
after your warranty expires, we encourage you to contract for extended maintenance services
for all subsequent years.
Units Out of Agreement
For units no longer under warranty requiring repairs, the Time and Materials service plan will
apply (see Time and Materials section).
To place an out-of-warranty unit under a warranty contract, CAE Healthcare reserves the
right to have the patient simulator inspected by a CAE Healthcare-approved technician at
the customer’s expense. If necessary, the unit would have to be repaired at the customer’s
expense prior to issuance of a warranty contract.
The repairs required as the result of the examination will be quoted on a time and material
basis.
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Care and Maintenance
How to Contact Customer Service
CAE Healthcare Customer Service Headquarters - United States and Latin America
Monday - Friday from 7:00 a.m. to 6:00 p.m. ET
Toll Free
+1 (866) 462-7920
24-hour Hotline
+1 (941) 342-5605
Fax
+1 (941) 342-5600
Email Address: customerservice@caehealthcare.com
Web URL:
www.caehealthcare.com
CAE Healthcare Customer Service - Canada
Monday - Friday from 8:00 a.m. to 5:00 p.m. ET
Toll Free
+1 (877) 223-6273
Email Address: can.service@caehealthcare.com
CAE Healthcare Customer Service - Europe, Middle East and Africa (EMEA)
Monday - Friday from 8:00 a.m. to 5:00 p.m. CET
Phone +49 (0) 6131 4950354
Fax +49 (0) 6131 4950351
Email Address: international.service@caehealthcare.com
CAE Healthcare Customer Service - UK and Ireland
Monday - Friday from 9:00 a.m. to 5:00 p.m. GMT
Phone +44 (0)800-917-1851
Email Address: uk.service@caehealthcare.com
Principal hours of operation exclude holiday and non-business days.
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Care and Maintenance
Contract Period
Warranty contracts are not ordinarily offered for periods of less than one year. However,
multiple-year warranty contracts may be arranged for up to an additional three years.
Discounts are available for purchase of multiple-year contracts.
Limitations of Agreement
Your exclusive remedy for any defective patient simulator is limited to the repair or
replacement of the defective patient simulator.
CAE Healthcare may elect which remedy or combination of remedies to provide at its sole
discretion. CAE Healthcare shall have a reasonable time after determining that a defective
material exists to repair or replace defective material. CAE Healthcare’s replacement material
will be manufactured from new and/or serviceable parts. CAE Healthcare’s agreement
applies to repaired or replaced materials for the balance of the applicable period of the
original warranty or ninety days from the date of shipment of a repaired or replaced material,
whichever is longer. CAE Healthcare warrants its LABOR for 30 days or the balance at the
applicable period of the original warranty, whichever is greater.
CAE Healthcare shall not be liable under this warranty for incidental or consequential
damages, or in the event of any unauthorized repairs or modifications have been made or
attempted, or when the product, or any part thereof, has been damaged by accident, misuse
or abuse. This warranty does not cover normal wear and tear, staining, discoloration or other
cosmetic irregularities that do not impede or degrade product performance. Any damage
or malfunction as a result of the installation of software or hardware, not authorized by CAE
Healthcare, will be repaired under the Time and Materials service plan (see Time and Materials
section).
CAE Healthcare’s warranty does not cover products that have been received improperly
packaged, altered or physically damaged. Products will be inspected upon receipt.
Some states in the USA do not allow the exclusion or limitations of incidental or consequential
damages, so the limitations above may not apply to you. This warranty gives you specific legal
rights and you may also have other rights, which vary from state to state.
Return Materials Authorization (RMA)
No product may be returned directly to CAE Healthcare without first contacting CAE
Healthcare for an RMA number. If it is determined that the product may be defective, you
will be given an RMA number and instructions for product return. An unauthorized return,
e.g., one for which an RMA number has not been issued, will be returned at your expense.
Authorized shipments are to be shipped prepaid to the address on the RMA. Your original box
and packaging materials should be kept for storing or shipping your product. To request an
RMA, please contact Customer Service.
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Care and Maintenance
System Software Upgrade Support
Customers with current warranty contracts are entitled to receive upgrades to applications
software previously purchased. Installation of the system software is the user’s responsibility.
The System Software Upgrades Support includes software upgrades for base software and
purchased optional software modules.
**This does not apply for major upgrades or technological enhancements.**
Pricing Structure
Time and Materials
For those systems not under agreement, service will be provided as required on a Time and
Material basis:
Description
In-House
On-Site
Technical Support
As quoted at time of repair
CAE Healthcare’s prevailing
labor rate with a minimum of
four hours labor
Material
As quoted at time of repair
As quoted at time of repair
Travel
N/A
Priced at CAE Healthcare’s
fully burdened cost plus fee
Principal period of on-site support (customer’s local time) is:
• Monday through Friday, 8:00 AM to 5:00 PM (customer’s time zone)
• Holiday and non-business days excluded
• Support outside the principle period is billed at the premium rate (hourly rate x 1.5)
A minimum of 48 hours notice is required for scheduling an on-site support call. Urgent onsite support with less that 48 hours notice will be charged at the premium hourly rate.
On-site time is described as the time period commencing from arrival at customer site through
departure from customer site.
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Care and Maintenance
Breakdown
After each use, METIman should be properly disassembled and stored in a secure place.
To ensure that METIman remains in good working condition, follow the prescribed CAE
Healthcare breakdown procedures below. These procedures are estimated to take less than 30
minutes.
Breakdown Steps
1
Stop All Running SCEs
2
Clean the Simulator and the Fluid System
3
Shut Down the Software
4
Power off the Simulator
Step 1: Stop All Running SCEs
Stop any running SCEs using the Stop button in the upper right corner of the Müse software
for each SCE.
Step 2: Clean the Simulator and the Fluid System
Refer to the Maintenance Advice on the following pages for detailed instructions.
Step 3: Shut Down the Software
To shut down the Müse software:
1. Click the Account Name in the lower, right-hand corner of the screen. The Logout/
Shutdown dialog box appears.
2. Click Logout to exit the software, or click Shutdown to shut down the computer.
To shut down the TouchPro software (optional):
1. Click the Settings button from the bottom, right-hand corner of the TouchPro screen.
2. From the Settings menu, click Shutdown. A warning box appears asking if you want to
exit.
3. Click Shutdown.
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Care and Maintenance
Step 4: Power Off the Simulator
1. Carefully pull back the skin on METIman’s left hip and hold the power switch for two
seconds. The light on the button begins to blink, indicating shutdown is in progress.
After approximately 30 seconds, the light is off, and shutdown is complete. If the
simulator fails to shut down when the above steps are performed correctly, hold the
power button for five seconds to force the system to power off
2. Carefully put the skin back into place for storage.
Maintenance Advice
Simple care and maintenance helps to ensure that METIman stays in good working condition.
Many problems are caused by inadequate or improper maintenance. Perform a thorough
check of the various components each time the simulator is used. Failure to follow these
guidelines can lead to damage not covered by warranty.
General Simulator Care
Avoid the use of writing instruments and sharp objects near the patient simulator to prevent
unattractive markings on or tears in the skin.
Lubricate airway adjuncts, urinary catheters and chest tubes with silicone spray (NOT a waterbased lubricant) prior to insertion.
A mild detergent and warm water will remove most marks and stains. Gently rub the soiled
area with a soft cloth. Do NOT use ABRASIVE soaps or pads.
Prior to using moulage of any kind, CAE Healthcare suggests the application of a very light
coating of petroleum jelly, followed by a light dusting of baby powder, to the
simulator’s skin. This application makes cleaning the skin easier.
If any of METIman’s fluid systems have been used, flush out the simulator as described in the
following pages. Failure to flush the systems may cause damage to the simulator.
Storage
When in regular use, METIman’s breakdown procedure and general cleanup should be
sufficient to prepare the simulator for storage.
In addition, be certain to follow these instructions:
• Storage temperature should not exceed 122° F (50° C) or fall below 41° F (5° C).
• If a soft-sided simulator case is being used, the simulator should lie flat.
• The simulator should NEVER be stored or shipped with fluids in the system.
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Care and Maintenance
Care of Electronic Equipment
Install any CAE Healthcare software updates as soon as they become available.
Airway Inspection
METIman is equipped with an anatomically accurate airway that supports the practice of
difficult airway management techniques. In the process of performing these techniques
improperly or aggressively, the upper airway can be damaged.
Because damage can occur, occasional visual inspection of the airway is recommended. Using
the light of a laryngoscope blade or a flashlight, visually examine the airway. While tears in
the upper airway resulting from intubation may be obvious, needle holes in the lower trachea
resulting from techniques such as transtracheal jet ventilation may not be readily apparent.
If damage to the airway is found, small cuts or tears may be reparable with silicone adhesive.
However, for permanent repair of damaged simulators, contact CAE Healthcare Customer
Service.
Replacing the Battery
After approximately four hours of use, the simulator’s battery must be removed to be
recharged or replaced with a charged battery.
WARNING : When handling METIman’s batteries, be sure to adhere to all the cautions
and warnings.
To replace the battery:
1. Unzip the chest skin.
Unzipping the Chest Skin
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Care and Maintenance
2. Lift the abdominal insert.
Lifting the Abdominal Insert
3. Remove the abdominal support.
Remove the
abdominal support
Removing the Abdominal Support
4. Release the Velcro battery tie-down.
Release the Velcro
battery tie-down
Releasing the Battery Tie-Down
183
Care and Maintenance
5. Disconnect the battery leads.
Disconnect the
battery leads
Disconnecting the Battery Leads
6. Remove the uncharged battery.
Remove the
uncharged battery
Removing the Battery
7. Insert a charged battery and affix the battery tie-down.
8. Connect the battery leads and replace the abdominal support, ensuring both
ends are secure in the slits.
9. Replace the abdominal insert and chest skin.
Recharging the Battery
The battery should be recharged after approximately four hours of use.
To recharge the battery, disconnect and remove the battery from the simulator and connect to
the external charger provided.
WARNING: When handling METIman’s batteries, be sure to adhere to all the cautions
and warnings
184
Care and Maintenance
Recharging should take approximately four hours.
IMPORTANT: Never recharge the battery while it is connected to METIman.
Draining Condensation from the Simulator
As part of a regular preventive maintenance schedule, condensation should be drained from
the simulator.
Depending on environmental conditions, moisture may condense inside the compressed air
lines and tanks within the simulator. It is recommended that this fluid be drained every 40
hours of operation. In outside, high-humidity conditions, the system should be drained more
frequently.
To drain condensation:
1. Locate the Condensation Drain Hose included with the Inventory Kit.
Condensation Drain Hose
2. Bring the hose and a small bucket to the simulator location.
3. Locate the EXTERNAL AIR port on METIman’s left shoulder.
4. With assistance, place METIman into a supine position.
5. Power on METIman. Do NOT launch the Müse software.
6. Allow 60 seconds for the internal compressor to pressurize the system.
7. Power down METIman.
8. With assistance, raise the left leg 45 degrees.
9. Place the tubing end of the Condensation Drain Hose into the small bucket and
then connect the fitting onto the simulator’s drain connector. There will be a
sudden release of pressure into the bucket. Any condensation within the system
drains with this exhaust.
10. Disconnect the Condensation Drain Hose from the simulator.
185
Care and Maintenance
Cleaning the Simulator and the On-Board Bleeding System
NOTE: A small bucket is recommended to collect wastewater during cleaning and flushing
operations.
To clean and maintain the simulator and On-Board Bleeding system:
1. Remove and clean the wound haptics.
2. Connect the beige-colored “fill” connector from the Trauma Fill Tank to the hip, but
do not connect the white “vent” connection.
3. Open the yellow Pressure Relief knob clockwise on the Trauma Fill Tank or loosen
its Fill Lid so the tank is able to vent during this draining process.
4. With the wound umbilicals in place, put the ends of both wound umbilicals into a
wastewater bucket.
5. From the Müse home screen, click the System Administration button in the top
right of the screen.
6. From the Maintenance screen, click Flush System. The fluid begins to drain.
7. Verify both channels produce a high, steady flow.
8. When fluid stops flowing from either wound umbilical, detach the Fill Tank from
the simulator.
9. When fluid stops flowing from the lower wound umbilical, detach from the
simulator.
10. When fluid stops flowing from the upper wound umbilical, detach from the
simulator.
11. Click Done on the Maintenance screen. The fluids are now drained.
12. Empty the wastewater bucket.
13. Rinse out the Trauma Fill Tank and fill with approximately 1 liter of clean, distilled
water.
14. Pump this fluid into the simulator.
15. Repeat Steps 3 through 7 and 9 through 15 until the fluid exiting the simulator
runs clear.
16. Empty the Fill Tank and dry the wound umbilicals with a towel before storage.
NOTE: It takes two to three minutes for this final flush.
Once a month, it is advised to flush the system with a mix of 50% distilled water
and 50% white vinegar to keep mineral and algae buildup to a minimum. Always
perform the steps for Flushing the Simulator afterward to remove vinegar.
186
Care and Maintenance
Cleaning the Trauma Fill Tank
To prolong the life of the Trauma Fill Tank assembly and the fluid reservoirs, wash and flush the
tank and connections after each use with clean distilled water.
NOTE: A small bucket is recommended to collect wastewater during cleaning and flushing
operations.
Do NOT store liquids in the Trauma Fill Tank. If simulated blood mixtures are stored in the
tank, they may clog the system when they dry and possibly damage the seals, filter and other
components.
1. Remove and rinse the Overflow Bottle.
2. Remove and rinse the Pump Assembly.
3. Rinse the tank to remove all traces of the simulated blood.
4. Pour 480 mL (16 oz) of distilled water into the tank and reinstall the Pump
Assembly. (The Overflow Bottle holds 16 ounces.)
5. Place the Overflow Bottle lid with umbilical attached into the wastewater bucket.
6. Attach the fill (blue-labeled) and vent (yellow-labeled) fittings together at the
other end of the umbilical.
7. Pump the tank 25 times while making sure the wastewater is going into the
bucket.
8. Allow the tank to empty completely (the remaining air pressure will purge the
fluid from the lines.
9. Reinstall the lid onto the Overflow Bottle and place the bottle back onto the tank
assembly.
10. Remove the Pump Assembly and pour any remaining fluid out of the tank. Then,
reinstall the pump.
11. Disconnect the fill and vent fittings from each other and wrap the Trauma Tank
Umbilical around the neck of the tank.
Always depressurize the tank, remove trauma fluid and clean the tank before performing
maintenance. The pump assembly may need periodic lubrication. Call CAE Healthcare
Customer Service for details if the pump loses the ability to create pressure, squeaks loudly or
is difficult to move.
187
Care and Maintenance
Cleaning the In-Line Filter
To clean the in-line filter:
1. Grasp both ends of the in-line filter and twist counterclockwise.
2. Pull apart both ends of the filter to separate.
3. Remove the blue filter cone from the encasement. Do NOT remove the black
rubber seal.
4. Using a 60 mL syringe with distilled water, push fluid from the outside of the blue
filter cone to the inside, removing all debris.
5. Repeat process until all debris is removed.
6. Re-assemble the in-line filter, ensuring the black rubber seal is in place at the base
of the blue filter cone.
The In-Line Filter
188
Care and Maintenance
Troubleshooting the Trauma Fill Tank
Before making any repairs, ALWAYS depressurize the tank, remove all trauma solution and
clean the tank.
Problem
Cause
Solution
Tank can be pressurized, but only
air comes out.
Siphon tube has detached from
insert.
Pressure does not build up. No
fluid is transported to simulator.
(1) Pump assembly not sealed tightly (1) Thoroughly clean pump
into tank or
cylinder gasket or o-ring and
surrounding area and apply a light
(2) Damaged pump cylinder coating of silicone to pump gasket or
gasket or o-ring or
o-ring.
(3) Tank pressure relief valve is set to “open.”
Remove hose from tank and reinsert
siphon tube.
(2) Contact CAE Healthcare for
service.
(3) Turn valve until it returns to a
“sealed” position.
Simulator fill time is too long
(more than 5 minutes).
(1) Not enough strokes applied to create pressure or
(1) Pump 25 to 35 times for best
performance.
(2) The in-line filter is dirty or
(2) Clean filter.
(3) The umbilical is
disconnected at Overflow Bottle or
(3) Reconnect the overflow fitting.
(4) Too much fluid in fill tank.
(4) The Trauma Fill Tank works best
with 1 gallon (3.6 liters) of fluid
inside. If greater amounts of
fluid are used, tank may require
additional pumps as fluid is
transported to simulator.
189
Care and Maintenance
Emptying and Flushing the Chest Tube Reservoir
Removing fluids from the Chest Tube reservoir and the Chest Tube system requires the same
steps.
To empty the Chest Tube reservoir or flush the Chest Tube system, have a chest tube and a
basin to catch fluid in place. Use a syringe to slowly push air through the appropriate CHEST
TUBE port until only air flows through the chest tube.
Flushing the IV Lines
To flush the IV lines:
1. Connect an empty IV bag to the IV DRAIN port.
2. Using a syringe, slowly push air into the IV FILL port. The fluid drains out of the IV
DRAIN port.
3. Continue to push air until empty.
Emptying the Genitourinary Reservoir
To empty the Genitourinary reservoir, have a catheter in place and a basin to catch fluid. Use a
syringe to slowly push air through the GU port until only air flows through the catheter.
Emptying the Head Secretions Lines (Prehospital Only)
To remove fluid from the Head Secretions lines, connect a syringe to the NOSE port and
vacuum out fluid until empty. Repeat this process for the MOUTH and EYES ports.
Emptying the Airway Secretions Reservoir (Nursing Only)
To empty the Airway Secretions reservoir, connect a 60 mL syringe to the AIRWAY FILL port
and vacuum out fluid until empty.
Flushing the Subclavian Catheter (Nursing Only)
When flushing the Subclavian Catheter, the catheter must be in place.
To flush the Subclavian Catheter:
1. Connect an external drain to the IV DRAIN port and place a basin to catch fluid.
2. Using a syringe, slowly push air into the IV FILL port. The fluid drains out of the IV
DRAIN port.
3. Continue to push air until empty.
4. Using the same syringe, push air through the Subclavian Catheter until empty.
190
Care and Maintenance
Handling CO2 Canisters (Prehospital Only)
Careful handling is required in the use of CO2 canisters. Please read and follow all appropriate
cautions and warnings.
Removing CO2 Canisters from the Regulator
The following instructions describe how to safely remove the CO2 canister from the regulator
assembly for replacement or shipping.
CAUTION: If unsure that CO2 canister is empty, eye and hand protection must be worn to
protect from release of freezing gas or liquid.
1. Remove the CO2 regulator assembly from the simulator.
2. While holding the regulator assembly firmly, slowly unscrew the CO2 canister
from the regulator. There is a small relief hole in the side of the regulator from
which any remaining CO2 will bleed. If this should happen, no harm will be done
to system, but it is rather noisy and the rapid release of CO2 gas can freeze the
canister’s surface and cause frostbite to unprotected skin.
3. Continue unscrewing the canister until it is free from the assembly.
191
Care and Maintenance
Important Canister Information
The 16 Gram CO2 Canister with threaded neck is available at most sports equipment retailers
- most often used for bicycle tire inflators. We recommend purchasing Leland brand canisters
(P/N 82122Z), which are also available from CAE Healthcare.
Punctured canisters are considered to be empty. No residue remains in the canister after use.
The steel used is a low carbon type, which rusts if disposed in a landfill. If your community
requires recycling, then place with normal household recycling.
CO2 Canisters are considered by the U.S. Department of Transportation to be “Other Regulated
Materials - Domestic” (ORM-D). Ground shipping containers must be clearly marked with this
label. CO2 Canisters are considered hazardous material when offered for air transportation, so
different rules apply. Contact carrier for details and instructions.
Related CAUTIONS/WARNINGS
CO2 Canister
• Store the CO2 canisters in a dry location between 32° and 104° F (0 to 40°C).
• Do not expose the CO2 canister to heat above 140° F, as rupture may occur.
• Never point the CO2 canister towards your face or someone nearby.
• Use only CAE Healthcare specified CO2 canisters.
CO2 Regulator Assembly
• Care must always be taken when using high-pressure equipment.
• Do not disassemble or alter regulator.
• Dry completely if the regulator becomes wet.
• Discontinue use of this equipment if leakage or visible damage is evident.
Use of Equipment
• Canister end becomes punctured when screwed into regulator base and therefore
should not be removed until empty.
• Unscrewing canister before it is empty will result in sudden release of all high-pressure
gas with a possibility of liquid CO2 spray. Unprotected skin could receive freezing
burns.
• Wear protective gloves and eye protection when removing canister from regulator
assembly.
• Remove CO2 canister from regulator assembly when shipping simulator.
192
Condition Guidelines for Programming METIman
Condition Guidelines for Programming METIman
This card is intended to help you select Müse conditions to achieve desired vital signs
within each programmed state. All four conditions should be programmed into each
state in the order presented below.
• Respiratory: Desaturation
• Cardiovascular: Blood Pressure
• Cardiovascular Heart Rate
• Respiratory: Respiratory Rate
The Müse software is physiologically driven. When using multiple conditions
(e.g., Desaturation + Hypertension + Tachycardia + Tachypnea), physiological
regulatory mechanisms such as the baroreceptor reflex and ventilatory control cause
compensatory changes within parameters. To achieve the desired vital sign, select one
condition level, above (greater) or below (less), to achieve the desired physiological
effect.
Respiratory: Desaturation
Desaturation
Reset
High 90s
98%
96-97%
Mid 90s
Low 90s
High 80s
Mid 80s
Low 80s
High 70s
Mid 70s
Low 70s
Less than 70
94-96%
91-93%
87-90%
84-86%
80-83%
77-80%
74-77%
69-71%
<69%
SpO2 Value
193
Condition Guidelines for Programming METIman
Cardiovascular: Blood Pressure
Hypertension
Reset
Increased
Pre-Borderline
Borderline
Mild
Moderate
Severe
Profound
Extreme
194
110s/70s
120s/80s
130s/80s
140s/90s
150s/90s
160s/100s
170s/100s
190s/110s
220s/120s
Hypotension
Reset
Decreased
Pre-Borderline
Borderline
Mild
Moderate
Severe
Profound
Extreme
110s/70s
100s/70s
100s/60s
90s/50s
80s/40s
70s/40s
60s/30s
50s/30s
40s/30s
Condition Guidelines for Programming METIman
Cardiovascular: Heart Rate
Tachycardia
Reset
Increased
Elevated
Pre-Borderline
Borderline
Intermediate
Mild
Moderate
Severe
Supra
Profound
Extreme
Acute
70s
High 70s
80s
90s
100s
110s
120s
130s
140s
150s
160s
170s
High 170s
Bradycardia
Reset
Decreased
Pre-Borderline
Borderline
Intermediate
Mild
Moderate
Severe
Extreme
Acute
70s
Mid 60s
Low 60s
Mid 50s
Low 50s
High 40s
Mid 40s
Low 40s
Mid 30s
Low 30s
195
Condition Guidelines for Programming METIman
Respiratory: Respiratory Rate
Tachypnea
Reset
Increased
Elevated
Borderline
Intermediate
Mild
Moderate
Severe
Profound
Extreme
196
11
15
18
20
22
25
28
31
33
36
Bradypnea
Reset
Increased
Intermediate
Mild
Moderate
Severe
Profound
Extreme
11
10
9
7
6
5
3
2
Appendix A – Parameter Descriptions
Appendix A – Müse Parameter Descriptions
The Müse software has a number of parameters that control the physiological features of
METIman The parameters are grouped by category: Neurological, Respiratory, Cardiovascular,
Fluids and Sounds. The following is a brief description of each parameter.
Each parameter description lists the default settings for the Stan D. Ardman II and Norma L.
Female patients as well as the ranges, if available, for all patients.
Neurological
METIman can simulate a variety of neurological clinical indicators, such reactive eyes and
convulsions.
Neurological Parameters
Eyes: Pupil Size
Eyes: Blink Speed
Convulsions
ICP
NMB
Temperature: Body
Temperature: Blood
Eyes
Each eye has reactive pupils and eyelids that blink and close.
A-1
Appendix A – Parameter Descriptions
Eyes: Pupil Diameter
These parameters are used to control the diameter of the pupils in the eyes. Each eye has
reactive pupils and functional eyelids that blink.
Currently, there are four pupil options that are used to control the diameter of the pupils in
both eyes: Reactive, Non-Reactive, Pinpoint or Blown.
When the Eyes are set to Reactive, the pupils re-size in response to changes in lighting
condition. If both pupils are set to Reactive, both pupils re-size in a consensual manner.
The Non-Reactive, Pinpoint and Blown settings allow the user to fix one or both pupils to a
specific size. The Non-Reactive setting fixes pupils to a normal size, the Pinpoint setting fixes
pupils in the pinpoint position and the Blown setting fixes pupils in the blown position.
Default: Reactive
Eyes: Blinking
In Auto mode, the eyelids are normally blinking under the following conditions: Minute
Ventilation is greater than 1500 mL, SpO2 is greater than 70% and neuromuscular blockade
(NMB) is less than 30%.
The Blinking and Closed settings allow the user to have one or both eyes either blinking or
closed and override the automatic response.
Default: Auto
The Slow, Normal and Fast parameters control the eyelid blinking frequency. Presently,
blinking frequency is not linked to the physiological models. However, the response can be
done “on the fly” or scripted using the Scenario Designer.
Default: Normal
Convulsions
The Convulsions parameter is used to simulate the presence of convulsions. They are either
ON or OFF.
A-2
Default: Off
Appendix A – Parameter Descriptions
Intracranial Pressure (ICP)
The ICP parameter is used to set the ICP displayed as a numeric value on the TouchPro monitor.
The base value is set at 8 mmHg. This parameter is uninfluenced by physiological models.
Default: 8 mmHg
Range: 0.0 mmHg - 65.0 mmHg
Neuromuscular Blockade (NMB)
The pharmacokinetic and pharmacodynamic models based on the neuromuscular blocking
agents administered and the time course of their injection automatically determines the
degree of NMB. For some educational applications, however, the instructor may wish to set a
fixed degree of neuromuscular blockade that remains stable for an indefinite period. This can
be accomplished using the NMB parameter. The default setting instructs the pharmacologic
models to determine the degree of neuromuscular blockade based upon the drugs injected
and their pharmacologic properties.
When a positive numeric value is assigned to this parameter, the degree of NMB is set to that
level. For example, 80% NMB causes the simulator to set the degree of NMB to 80%, regardless
of the presence (or absence) of neuromuscular blocking drugs. Clinically, the spontaneous tidal
volume is markedly reduced.
Default: Modeled
Range: 0% - 100%
Temperature: Body
The temperature measured at the body surface can be set using this parameter and can be
displayed on the Patient Status Display and TouchPro software.
The body temperature is not linked to the physiologic models. However, changes can be made
“on the fly” or scripted using the Scenario Designer.
Default: 36.5° C
Range: 32.0° C - 42.0° C
A-3
Appendix A – Parameter Descriptions
Temperature: Blood
The arterial blood temperature can be set using the Temperature: Blood parameter. The
arterial blood temperature can then be displayed on the Patient Status Display and TouchPro
software. Note that changes in arterial temperature may alter the shape of the standard
oxyhemoglobin dissociation curve. As temperature increases or pH decreases, more oxygen is
released from hemoglobin and thus the patient’s saturation decreases. The inverse is also true.
Default: 37° C
Range: 32.0° C - 42.0° C
Respiratory Parameters
Respiratory Parameters
Swollen Tongue
Airway Occluder (Prehospital Only)
Laryngospasm (Prehospital Only)
Needle Decompression (Left and Right) (Prehospital Only)
Bronchial Occlusion
Respiratory Rate
A-4
Appendix A – Parameter Descriptions
Respiratory Parameters
SpO2
NMB
Tidal Volume
Intrapleural Volume: Left
Intrapleural Volume: Right
Chest Tube Flow: Left
Chest Tube Flow: Right
Swollen Tongue
This parameter is used to create tongue swelling. The tongue is either Swollen or Not Swollen.
The Not Swollen setting returns the tongue to its normal anatomic state.
Default: Not Swollen
Options: Not Swollen, Swollen
A-5
Appendix A – Parameter Descriptions
Airway Occluder (Prehospital Only)
Using the Airway Occluder parameter, swelling of the posterior oropharynx can be activated
to obstruct the view of the larynx and prevent intubation but allow mask ventilation of the
patient’s lungs, thereby creating a “cannot intubate, can ventilate” scenario.
Default: Off
Laryngospasm (Prehospital Only)
Use the Laryngospasm parameter to simulate a laryngospasm. A laryngospasm actuator
closes the patient’s vocal cords and prevents both ventilation and intubation. When activated
with the Airway Occluder parameter, a “cannot ventilate, cannot intubate” crisis scenario is
achieved.
Default: Off
Needle Decompression (Left and Right) (Prehospital Only)
The Needle Decompression parameter is used to activate the Needle Decompression
hardware in the simulator to relieve a pneumothorax in the simulator. This causes a rush of
air to be heard on successful decompression. The amount of decompression is automatically
subtracted from the Intrapleural Volume set.
Default: Off
Bronchial Occlusion
Turning on the Bronchial Occlusion parameter completely obstructs the right or left bronchi,
simulating a lower airway obstruction (e.g., mucus plug). Improper intubation creates a mainstem occlusion, yielding an inability to ventilate the lungs. However, the right and left bronchi
are not occluded individually.
Default: Off
Respiratory Rate
The Respiratory Rate parameter is used to set the respiratory rate to a given number of
breaths per minute. Once set, arterial oxygen and carbon dioxide values have no effect on the
resulting respiratory rate, but continue to influence other components of the physiological
models. The patient continues to breathe at the set number of breaths per minute, regardless
of the arterial oxygen or carbon dioxide levels.
A-6
Appendix A – Parameter Descriptions
For example, when the respiratory rate is set to 10 breaths per minute, the respiratory rate
remains at 10 breaths per minute, regardless of arterial oxygen or carbon dioxide levels. In such
situations, the patient can only respond to arterial oxygen or carbon dioxide levels by adjusting
the Tidal Volume parameter.
Default: Modeled
Range: 4 breaths per minute - 40 breaths per minute
SpO2
The SpO2 parameter is used to override the normal pulmonary circulation and set the SpO2 at a
fixed numeric value, regardless of the oxygen applied. Resetting to Modeled returns control of
the underlying SpO2 to the physiological models.
Default: Modeled
Range: 0% - 100%
Neuromuscular Blockade (NMB)
The degree of NMB is automatically determined by pharmacokinetic and pharmacodynamic
models, which are based on the neuromuscular blocking agents administered and the time
course of their injection. For some educational applications, however, the instructor may
wish to set a fixed degree of neuromuscular blockade that remains stable for an indefinite
period. This can be accomplished using the NMB parameter. The default value instructs the
pharmacologic models to determine the degree of neuromuscular blockade based on the
drugs injected and their pharmacologic properties.
When a positive numeric any other positive value is assigned to this parameter, the degree of
NMB is set to that level. For example, 80% NMB causes the simulator to set the degree of NMB
to 80%, regardless of the presence (or absence) of neuromuscular blocking drugs. Clinically, the
spontaneous tidal volume is markedly reduced.
Default: Modeled
Range: 0% - 100%
Tidal Volume
The Tidal Volume parameter is used to set the tidal volume to a given volume per breath.
Once Tidal Volume is set to a numeric value, arterial oxygen and carbon dioxide values have no
effect on the tidal volume, but continue to influence other components of the physiological
models.
For example, with the tidal volume set to 600 mL in the adult simulator, the tidal volume
A-7
Appendix A – Parameter Descriptions
remains a constant (set) 600 mL even in the event of falling arterial oxygen levels. In such
situations, the patient can only respond to arterial oxygen or carbon dioxide levels when the
respiratory rate is adjusted.
Default: Modeled
Range: 0 mL- 2500 mL
Intrapleural Volume (Vol): (Left and Right)
The Intrapleural Vol parameters allow intrapleural volume to accumulate, for example, as
happens during pneumothorax, hydrothorax or hemothorax.
To simulate a pneumothorax, set the corresponding Intrapleural Vol to a value greater than 0
mL. Values more than 1500 mL reduce the corresponding lung volume significantly. The breath
sounds are automatically diminished on the appropriate side due to decreased ventilation of the
affected lung.
Default: 0
Range: 0 mL - 2500 mL
Chest Tube Flow: (Left and Right)
The Chest Tube Flow parameter is used with the chest tube feature of the simulator. The Chest
Tube Flow specifies the rate at which fluid can be removed from the simulated pleural space via
a chest tube drainage system. As the chest tube drains, the volume is automatically subtracted
from the set amount of Intrapleural Volume.
Default: 50 mL per minute
Range: 0 mL per minute - 50 mL per minute
Cardiovascular Parameters
Cardiovascular Parameters
Blood Pressure
Heart Rate
Cardiac Rhythm
A-8
Appendix A – Parameter Descriptions
Cardiovascular Parameters
Arterial Catheter
Central Venous Catheter
PA Catheter
PA Balloon
Defib
Pacing Current
Pacing Rate
Pacing Capture Threshold
Cold Fluid Inject
Blood Pressure
The Blood Pressure parameter is used to override the physiological modeling for blood pressure. The systolic and diastolic blood pressures can both be set to fixed numeric values, regardless of interventions performed. Resetting the parameter to Modeled returns control of the
underlying Blood Pressure to the physiological models.
Default: Modeled
Range: Systolic 20 mmHg - 200 mmHg
Diastolic 10 mmHg - 200 mmHg
Heart Rate
The Heart Rate parameter is used to set the heart rate to a given (fixed) number of beats per
minute. Once the heart rate is set to a numeric value, administered drugs or intravascular
volume changes have no effect on the heart rate, but continue to influence other components
of the physiological models. Use this parameter to “fix” or set the heart rate to a specific
number.
Default: Modeled
Range: 30 beats per minute - 220 beats per minute
A-9
Appendix A – Parameter Descriptions
Cardiac Rhythm
The Cardiac Rhythm parameter is used to change the patient’s underlying cardiac rhythm
displayed on the Patient Status Display, TouchPro software or physiological monitor. To change
the cardiac rhythm, click the Cardiac Rhythm parameter and select the desired rhythm from
the available list. If a number appears following the cardiac rhythm on the list, this overrides
the heart rate to the rate indicated.
Default: Modeled
Options: Modeled
Asystole
Atrial Enlargement, Left
Atrial Enlargement, Right
Atrial Fibrillation
Atrial Fibrillation: HR 120
Atrial Fibrillation: HR 80
Atrial Flutter with 2:1 AV Conduction
Atrial Flutter: HR 150
Atrial Tachycardia
AV Block, First-Degree
AV Block, Second-Degree - Mobitz I
AV Block, Second-Degree - Mobitz II
AV Block, Third-Degree
Bundle Branch Block, Incomplete Right
Bundle Branch Block: Left
Bundle Branch Block, Left with PVC 25%
Bundle Branch Block: Right
Hypercalcemia
Hyperkalemia
Hypertrophy, Biventricular
Hypertrophy, Left Ventricular
Hypertrophy, Right Ventricular
Hypocalcemia
Hypokalemia
Hypothermia
Junctional
Junctional: HR 50
Long QT Syndrome
Myocardial Infarction with LBBB
Myocardial Infarction, Anterior
A-10
Appendix A – Parameter Descriptions
Myocardial Infarction, Anterolateral
Myocardial Infarction, Inferior
Myocardial Infarction, Lateral
Myocardial Infarction, Posterior
Myocardial Infarction, Septal
Myocardial Ischemia: Mild
Myocardial Ischemia: Moderate
Myocardial Ischemia: Moderate with PVC 10%
Myocardial Ischemia: Severe
Paroxysmal Junctional Tachycardia
Paroxysmal Junctional Tachycardia: HR 130
Pericarditis
Premature Atrial Contraction
Premature Ventricular Contraction 10%
Premature Ventricular Contraction 25%
Pulseless Electrical Activity
Sinus
Sinus Bradycardia
Sinus Bradycardia: HR 40
Sinus Tachycardia
Sinus Tachycardia: HR 120
ST Elevation with Chest Pain
Torsade de Pointes
Trifascicular Block
Ventricular Fibrillation: Coarse
Ventricular Fibrillation: Fine
Ventricular Tachycardia
Ventricular Tachycardia: Pulseless
Ventricular Tachycardia: HR 151
Ventricular Tachycardia: Pulseless HR 151
Wellen’s Syndrome
WPW Syndrome, Left Lateral Pathway
A-11
Appendix A – Parameter Descriptions
Arterial Catheter
The arterial pressure displayed on the Patient Status Display or TouchPro software is set using
this parameter. A non-pulsatile, “zero” pressure signal is emitted when the Atmosphere
position is selected and can be used to simulate zeroing a pressure transducer. This may also
be used to remove the arterial pressure waveform, if desired. The Left Ventricle position is
useful for simulating cardiac catheterization procedures, or for demonstrating left ventricular
end-diastolic pressure and its relationship to pulmonary artery occlusion (“wedge”) and central
venous pressure.
Default: Peripheral Artery
Options: Atmosphere
Peripheral Artery
Left Ventricle
Central Venous Catheter
The venous pressure displayed on the Patient Status Display or TouchPro software is set
using this parameter. A non-pulsatile, “zero” pressure signal is emitted when the Atmosphere
position is selected and can be used to simulate zeroing a pressure transducer. This may also be
used to remove the central venous pressure waveform, if desired (i.e., beginning of an SCE with
an “unmonitored” patient).
Default: Intrathoracic Vein
Options: Atmosphere
Extrathoracic Vein
Intrathoracic Vein
Pulmonary Artery (PA) Catheter
The pulmonary artery pressure displayed on the Patient Status Display or TouchPro software
is set using this parameter. A non-pulsatile, “zero” pressure signal is emitted when the
Atmosphere position is selected and can be used to simulate zeroing a pressure transducer.
This may also be used to remove the pulmonary artery pressure waveform, if desired (i.e.,
beginning of an SCE with an “unmonitored” patient). The pulmonary artery catheter can be
“floated” into position by sequencing through the right heart positions. This may also be
scripted into a scenario using the Scenario Designer.
Default: Pulmonary Artery
Options: Atmosphere
Intrathoracic Vein
Right Atrium
Right Ventricle
Pulmonary Artery
A-12
Appendix A – Parameter Descriptions
PA Balloon
Inflation of the pulmonary artery catheter balloon is simulated by switching to the Inflated
option of the PA Balloon parameter. The appropriate pulmonary artery occlusion or “wedge”
waveform is then displayed on the Patient Status Display or TouchPro software.
Default: Deflated
Options: Deflated
Inflated
Defibrillation (Defib)
The Defib parameter is used to simulate a specified amount of energy discharged via an
external cardiac defibrillator. Setting this parameter results in the characteristic spike in the
ECG, followed by a return to the pre-defibrillation rhythm. Defib has no direct effect on the
electrical conduction system of the heart. Thus, synchronized cardioversion may be done “on
the fly” or scripted using the Scenario Designer.
Default: 0 Joules
Range: 0 Joules- 360 Joules
Pacing Current
The Pacing Current parameter is used to simulate a specified amount of current discharged
via an external cardiac pacer. Setting this parameter results in the characteristic pacing signal
on the ECG waveform when the pacing current is at or above the capture threshold. Also, see
Pacing Capture Threshold.
Default: 0 mA
Range: 0 mA- 200 mA
Pacing Rate
The Pacing Rate parameter determines the cardiac rate (in beats/minute) when the pacing
current is at or above the pacing capture threshold. Also, see Pacing Current and Pacing
Capture Threshold.
Default: 80 beats per minute
Range: 0 beats per minute - 119 beats per minute
A-13
Appendix A – Parameter Descriptions
Pacing Capture Threshold
The Pacing Capture Threshold parameter determines the minimum pacing current necessary
to pace the heart via an external cardiac pacer. Also see Pacing Current. Pacing current values
below the pacing capture threshold have no effect on the patient’s heart rate.
Default: 50 mA
Range: 0 mA - 119 mA
Cold Fluid Inject
The Cold Fluid Inject parameter is used to simulate the injection of 10 mL iced saline into
the pulmonary artery catheter. The appropriate Thermodilution waveform and cardiac output
measurement are then displayed on the Patient Status Display or TouchPro software.
A-14
Appendix A – Parameter Descriptions
Pulses
The tables below show the defaults and ranges for the pulses and pulse deficits for METIman
Prehospital and METIman Nursing.
METIman Prehospital
Pulse
Default
Range
Left Carotid
On
N/A
Right Carotid
On
N/A
Carotid Deficit
60
0 - 300
Left Brachial
On
N/A
Right Brachial
On
N/A
Brachial Deficit
80
0 - 300
Left Radial
On
N/A
Right Radial
On
N/A
Radial Deficit
90
0 - 300
Left Femoral
On
N/A
Right Femoral
On
N/A
Femoral Deficit
70
0 - 300
Left Popliteal
On
N/A
Right Popliteal
On
N/A
Popliteal Deficit
80
0 - 300
Left Dorsalis Pedis/
Left Posterior Tibial
On
N/A
Right Dorsalis Pedis/
Right Posterior Tibial
On
N/A
Dorsalis Pedis/
Posterior Tibial Deficit
80
0 - 300
A-15
Appendix A – Parameter Descriptions
METIman Nursing
Pulse
Default
Range
Left Carotid
On
N/A
Right Carotid
On
N/A
Carotid Deficit
60
0 - 300
Left Brachial
On
N/A
Right Brachial
On
N/A
Brachial Deficit
80
0 - 300
Left Radial
On
N/A
Right Radial
On
N/A
Radial Deficit
90
0 - 300
Left Femoral
On
N/A
Right Femoral
On
N/A
Femoral Deficit
70
0 - 300
Left Popliteal
On
N/A
Right Popliteal
On
N/A
Popliteal Deficit
80
0 - 300
Left Dorsalis Pedis
On
N/A
Right Dorsalis Pedis
On
N/A
Dorsalis Pedis Deficit
80
0 - 300
Left Posterior Tibial
On
N/A
Right Posterior Tibial
On
N/A
Posterior Tibial Deficit
80
0-300
All pulses, unless altered by an SCE, are enabled by default. To disable a pulse, click the pulse
location on the human form. To enable a pulse, click the pulse location again. Click and hold a
pulse location to adjust the pulse deficit.
A-16
Appendix A – Parameter Descriptions
Fluids
The blood droplet provides a means of controlling the amount of fluid lost by or infused into
the patient. The amount of fluid to be lost or infused and the time frame during which the fluid
loss or infusion takes place can be entered.
Fluid Parameters
Fluid Loss Blood
Fluid Loss Plasma
Colloid Infusion
Crystalloid Infusion
PRBC Infusion
Whole Blood Infusion
Bleeding: Upper
Bleeding: Lower
Fluid Loss Blood
When used, the Fluid Loss Blood parameter reflects a decrease in total blood volume.
Blood loss proportionally decreases both the red blood cell volume and the plasma volume
according to the current hematocrit.
Range: 0 mL - 4000 mL
Fluid Loss Plasma
When used, the Fluid Loss Plasma parameter reflects a decrease in plasma volume. Plasma
loss decreases the plasma volume without changing the red blood cell volume. It refers
collectively and generically to all fluid losses, including evaporative, transcellular, bowel and
third space fluid losses.
Range: 0 mL - 4000 mL
Colloid Infusion
When used, the Colloid Infusion parameter reflects an addition to the plasma volume without
changing the red blood cell volume. Colloids include modified fluid gelatin starch solutions,
dextran and human albumin.
Range: 0 mL - 4000 mL
A-17
Appendix A – Parameter Descriptions
Crystalloid Infusion
When used, the Crystalloid Infusion parameter reflects an addition to the plasma volume
without changing the red blood cell volume. The term crystalloid is used to describe salt
solutions for infusion (i.e., normal saline, dextrose in water and Ringer’s Lactate).
Range: 0 mL - 4000 mL
PRBC Infusion
Packed red blood cells are a preparation of 70% red blood cells and 30% liquid plasma, often
administered in severe anemia to restore adequate levels of hemoglobin and red cells without
overloading the vascular system with excess fluids.
Range: 0 mL - 4000 mL
Whole Blood Infusion
The term whole blood is used to refer to blood that has not been separated into its various
components. It represents a preparation of 40% red blood cells and 60% liquid plasma.
Range: 0 mL - 4000 mL
Bleeding: Upper
The Bleeding: Upper parameter is used to activate the site of bleeding.
Default: Off
Bleeding: Lower
The Bleeding: Lower parameter is used to activate the site of bleeding.
A-18
Default: Off
Appendix A – Parameter Descriptions
Sounds
A variety of simulated sounds are available to enhance realism.
Bowel Sounds
Bowel Sounds
Normal
Hypoactive
Hyperactive
None
Normal, Hypoactive, Hyperactive and absent bowel sounds (None) are selected using this
parameter. Independent control of the type and volume of bowel sounds may be selected in
each anatomical region.
Bowel Sounds Locations
All Bowel Sounds
LUQ Bowel Sounds
RUQ Bowel Sounds
LLQ Bowel Sounds
RLQ Bowel Sounds
To affect the bowel sounds simultaneously in all anatomical regions, select All Bowel Sounds
and the desired sound.
Default: Normal
NOTE: The volume control slider underneath each area may be used to adjust the amplitude of
the sound.
A-19
Appendix A – Parameter Descriptions
Breath Sounds
Normal and abnormal breath sounds are selected using this parameter. Breath sounds are
independently synchronized with ventilation of the left and right lungs. Independent control
of the type and volume of breath sounds may be selected in each anatomical region.
Breath Sounds Locations
All Breath Sounds
Breath Left Upper Sounds
Breath Right Upper Sounds
Breath Left Lower Sounds
Breath Right Lower Sounds
Breath Sounds
Normal
Crackles
Diminished
Gurgling
Pleural Rub
Rhonchi
Wheezing
To affect the breath sounds simultaneously in all anatomical regions, select All Breath Sounds
and the desired sound.
Default: Normal
NOTE: The volume control slider underneath each area may be used to adjust the amplitude of
the sound.
A-20
Appendix A – Parameter Descriptions
Heart Sounds
Normal and abnormal heart sounds are selected using this parameter. Heart sounds are
synchronized with the cardiac cycle.
Heart Sounds
Normal
S3
S4
S3 and S4
Early Systolic Murmur
Mid Systolic Murmur
Late Systolic Murmur
Pan Systolic Murmur
Late Diastolic Murmur
Default: Normal
NOTE: The volume control slider may be used to adjust the amplitude of the sound.
A-21
Appendix A – Parameter Descriptions
Speech Sounds
Speech Sounds include a male or female voice, based on the gender of the active patient, that
can utter pain rating indicators from 0 to 10, various phrases and a series of other utterances.
Unlike Vocal Sounds, Speech Sounds only play once.
Speech Sounds
Loud cough
Soft cough
Short Loud Cough
Short Soft Cough
Scream
Grunt
“Yes”
“No”
“Sometimes”
“Ouch”
“10, 9, 8, 7, 6...”
“My leg hurts”
“My belly hurts”
“My chest is tight”
“I can’t breathe”
“Ow, that hurts”
“0” through “10” - Pain Ratings
“Sharp”
“Pressure”
“Aching”
“Dull”
“Stabbing”
To play a Speech Sound, click the Speech balloon. A list of Speech Sounds appears.
Select the desired sound. The sound plays once, and the list disappears.
To replay the last sound, click the Play button in the Speech balloon.
A-22
Appendix A – Parameter Descriptions
Throat Sounds
The Stridor throat sounds option from the simulator is selected using the Throat Sounds
parameter. The stridor is synchronized with ventilation of both lungs.
Default: None
NOTE: The volume control slider may be used to adjust the amplitude of the sound.
A-23
Appendix A – Parameter Descriptions
Vocal Sounds
To have the simulator emit the various vocal sounds, select the one desired. It immediately
begins to play in a continuous loop until None is selected.
A variety of programmable Vocal Sounds are available. Vocal Sounds are male or female based
on the gender of the active patient.
Vocal Sounds
None
Crying
Gagging
Gasping
Groaning
Long Loud Cough
Long Soft Cough
Wheezing
Mumbling
To select a sound from the Vocal Sounds drop-down menu, click the Sounds button on the
Run screen. The Sounds panel appears.
Click Vocal Sounds and select the type of sound desired from the Vocal Sounds drop-down
menu.
Default: None
NOTE: The volume control slider may be used to adjust the amplitude of the sound.
A-24
Appendix B – Wireless Voice Link
Appendix B - Wireless Voice Link
This information is intended to assist in preparing Wireless Voice Link (WVL) devices for use in
conjunction with METIman.
Cautions and Warnings
This device complies with part 15 of the FCC Rules and with Industry Canada licence-exempt RSS
standard(s). Operation is subject to the following two conditions:
1. This device may not cause interference.
2. This device must accept any interference, including interference that may cause
undesired operation of the device.
Cet appareil est conforme aux normes d’Industrie Canada exempts de licence RSS (s). Son
fonctionnement est soumis aux deux conditions suivantes:
1. Cet appareil ne doit pas provoquer d’interférences.
2. Cet appareil doit accepter toute interférence, y compris les interférences pouvant
provoquer un fonctionnement indésirable de l’appareil.
Any modifications made to this device without the express approval of CAE could void the user’s
authority to operate this equipment.
B-1
Appendix B – Wireless Voice Link
What’s Included
The WVL package includes the following items:
• Wireless Voice Link Handset (1)
• Olympus ME52W Standalone Microphone (1)
• AAA Alkaline Batteries (2)
• Quick Start Guide (1)
How It Works
The WVL is a radio pair that operates in the 2.4 GHz unlicensed radio band. The handset
communicates wirelessly with the base station located inside the simulator. The base station
converts the digitized microphone stream from the handset and outputs it via the base station
to the headphone and line out jacks. The output projects through the head speakers inside the
simulator.
To accommodate multiple WVL pairs in close proximity, each WVL is assigned two RF channels
on which to operate. The RF channels divide up the 2.400 – 2.4835 GHz spectrum in 80 single
frequencies to prevent the WVLs from interfering with each other.
Due to the nature of the unlicensed 2.4 GHz band, there may be other devices such as Wi-Fi,
microwave ovens or Bluetooth® radios operating in the 2.4 GHz band as well. Therefore, two
channels are used to transmit the audio stream redundantly to avoid interference. In case
there is an interference in one channel, the other can be used to extract the audio stream.
To operate correctly, both the handset and base station should be set to the same frequency
using the DIP switches located in the devices. If the interference is too high, the WVL
firmware has the ability to change channels automatically to avoid interruption. This process
occurs simultaneously in both the handset and the base station without the need for user
intervention. The units revert back to the original frequency set on the DIP switches when
both devices are restarted using the power switch.
Recommendations for Use
To receive the best sound quality from the WVL, please note the following recommendations:
• Do not separate the WVL pair with more than two walls.
• Use channels 0 through 11 for the best sound quality.
• Use channels 12 through 31 if more than 12 simulators are present in one area.
B-2
Appendix B – Wireless Voice Link
Wireless Voice Link Devices
There are two unique devices that make up a WVL pair: the handset device and the base
station device. The base station device is located inside the simulator, while the handset
device is battery powered and carried by the user. The handset transmits voice input through
a microphone to the base station receiver, where it is transmitted to the speakers in the
simulator’s head. The two different devices can be identified by their cases.
The handset device has a cover that extends over the length of the antenna.
Figure 1: WVL Handset
The base station device antenna is almost fully exposed.
Figure 2: WVL Base Station
B-3
Appendix B – Wireless Voice Link
Physical Features
The following features are located on the top of the WVL devices:
• Headphone jack: Used to plug in headphones or an iPhone compatible headphone/
microphone combination
• Microphone jack: Used to plug in a standalone microphone
• Red power light: Indicates when the unit is powered on by blinking. Also indicates when
the Mute button is activated by solidly staying on.
• Green connection light: Indicates an RF link connection between the handset and base
station by blinking.
•
Microphone
jack
Red power light
Green connection light
Headphone
jack
Figure 3: WVL Front View
The following features are located on the side of the WVL devices:
• Battery compartment: Houses two AAA batteries and the DIP switch.
• DC power jack: Accommodates a 5VDC/0.2A power source.
• ON/OFF switch: Turns WVL handset power on or off.
• Line out jack: Connects the WVL to the simulator’s audio amplifier.
• Volume/mute dial: Controls microphone gain and microphone mute on the handset. See
Special Handset Settings on page B-9
Battery
compartment
DC Power
Line out
Volume/mute dial (Handset)
Volume/mute dial (Base Station)
ON/OFF switch
Figure 4: WVL Side View
On the WVL handset, the volume/mute dial controls the microphone volume or mutes the
microphone. See Special Handset Settings on page B-9.
On the WVL base station, the dial serves as the volume control for the speakers inside the
simulator. Moving the dial toward the plus sign increases the volume. Moving the dial toward
the minus sign decreases the volume and setting. On the handset, pressing straight down on
the volume dial in the center mutes the microphone.
B-4
Appendix B – Wireless Voice Link
Preparing the Base Station in the Simulator
When using the base station in the simulator, ensure the batteries are removed and the
following items are attached:
• Power cable
• Line out cable
• Serial Connector
The DIP switch is located in the battery compartment of the base station (Figure 5: DIP Switch
Settings).
DIP Switch
Settings
Figure 5: Dip Switch Settings
The serial connector is located on the side of the base station (Figure 6: Serial Connector).
Serial
Connector
Figure 6: Serial Connector on base station
B-5
Appendix B – Wireless Voice Link
The base station should come already connected and installed inside the METIman.
Base Station
Connected and Installed
in METIman
Figure 7: Base Station in METIman
To prepare the base station:
3. Set the base station DIP switch positions 6 and 7 to OFF, and 8 to ON.
4. Turn the power off and on using the power switch on the outside of the base
station to ensure the DIP switch changes take effect.
5. Leave the power switch on the outside of the base station in the on position.
Figure 8: DIP Switch Settings for the Base Station
NOTE: Since the base station receives power from the simulator, the power switch on the
outside of the base station must remain in the ON position. Use this power switch to refresh
DIP switch settings. Do not turn the simulator off and on to refresh the DIP switch settings.
B-6
Appendix B – Wireless Voice Link
Preparing the Handset for Use
To prepare the handset for use:
1. Insert two AAA batteries into the battery compartment.
2. Set the handset DIP switch positions 6 and 7 to OFF and position 8 to ON.
3. Turn the power switch off and back on to ensure the DIP switch changes take
effect.
Figure 9: DIP Switch Settings for the Handset
While DIP switch positions 6 through 8 affect the handset and base station settings, DIP switch
positions 1 through 5 are used to set the radio frequency channel used for communication
between the handset and the base station.
Selecting the Radio Frequency Channel
There are two ways to configure the radio frequency (RF) channel spacing. The first
method reduces channel-to-channel interference, but allows only 12 channels to operate
simultaneously in the same vicinity. The second method increases the number of channels that
can be used simultaneously to 20 channels. However, this method diminishes the channel-tochannel noise immunity.
All of the WVL pairs in the same vicinity must use channels from RF Channel Group 1 or RF
Channel Group 2, and channels must belong to the same group. The DIP switch determines the
initial communication frequencies that the WVL pair use to communicate when the power of
the base station and handset is first turned on. If there is too much interference at the initial
channel, the WVL pair changes frequency automatically and continues operating. The WVL
pair repeats this process automatically as needed and changes frequencies when interference
is too high.
Multiple WVL pairs can be set to the same initial frequency. However, setting different initial
frequencies helps the WVL pairs quickly find a stable operating frequency.
For example, if there are 12 or fewer simulators in the same vicinity, set all of the WVL pairs to
use channel 0 of RF Channel Group 1. To give unique initial RF frequencies, assign each WVL
pair to its own RF channel with the settings found in CH 0 through CH 11.
B-7
Appendix B – Wireless Voice Link
If you have 13 to 20 simulators in the same vicinity, set all of the WVL pairs to use channel 12 of
RF Channel Group 2. To give unique initial RF frequencies, assign each WVL pair to its own RF
channel with the settings found in CH 12 through CH 31.
Figure 10: RF Channel Selection Methods
For a complete list of the initial frequencies associated with the RF Channels, see RF Channel
Initial Operating Frequencies on page B-12.
B-8
Appendix B – Wireless Voice Link
Powering Up the WVL Pair
To power up the WVL pair:
Power on the base station by turning on the simulator. The base station power switch is in the on
position by default.
Power on the handset by setting the power switch to the on position.
The red power light on each unit blinks when the unit is on. Once both units are powered on and
communicating with each other, the green connection light flashes once every second.
If the green connection light fails to blink, ensure both units are set to the same RF channel.
See Selecting the Radio Frequency Channel on page B-6. If you make changes to the DIP switch
settings, toggle the power switches of the handset and base station off and back on to ensure the
changes takes effect.
Using the iPhone/Standalone Microphone
DIP switch position 6 on the handset determines if the iPhone microphone input or the
standalone microphone input is enabled. When DIP switch position 6 is set to the OFF position,
the standalone microphone jack is enabled for the standalone microphone, provided by CAE
Healthcare.
Figure 11: Handset and CAE Healthcare-provided Microphone
To use a microphone compatible with an iPhone (three-pole jack), set DIP switch position 6 to
ON. Please note that an iPhone-compatible microphone is not provided as part of the product
package. Any microphone with a common 3.5 mm input jack can be used with the handset when
DIP switch position 6 is set to ON.
B-9
Appendix B – Wireless Voice Link
Special Handset Settings
Advanced settings for the handset DIP switch are available.
iPhone microphone enable
Base station volume control enable
Noise reduction enable (default)
Noise reduction disable
Microphone gain control enable (default)
Standalone microphone enable (default)
Figure 12: Advanced DIP Switch Settings
DIP switch settings are only refreshed when the handset is powered on. To ensure the DIP
switch changes take effect, turn the power off and back on after making changes.
To enable noise reduction and minimize background noise in high ambient noise
environments, place the position 8 DIP switch in the ON position.
Battery Capacity Indicator
The red power light flashes one time every second when the battery capacity is good. When
the battery capacity is nearly depleted, the red power LED flashes twice in quick succession
every second. This indicates the batteries need to be replaced.
To get the most battery life out of the handset, the handset should be powered down when it
is not in use.
B-10
Appendix B – Wireless Voice Link
Troubleshooting
CAE Healthcare Customer Service is available to help with iStan problems, should they
arise. However, sometimes you can speed up the customer service process by performing
diagnostics before calling, and eliminating some problems on your own with the help of the
following instructions.
Power Problems
The red power light on the handset does not flash when power switch is turned on.
• Check that the batteries are inserted correctly. Install a fresh set of batteries, if needed.
The red power light on my base station is not flashing when the simulator is powered on.
• Check that the cables from the simulator are installed in the base station correctly.
Communication Problems
The simulator and handset are turned on, but the green connection light is not blinking.
• Verify that DIP switch positions 1 through 5 are all set to OFF, which is the default position
set in the simulator base station and handset at the factory. If you have modified this
setting, verify positions 1 through 5 on the handset and the simulator base station are
the same.
• Be sure to turn the power off and back on for the changes to take effect on both the
handset and the base station. Check if the green connection light is flashing after turning
the power off and back on each time to see if communication has been established
between the base station and the handset.
I’m experiencing static or dropouts in the simulator audio output.
• Reduce the range between the base station and the handset. Most likely, the handset
is out of range of the base station, or there may be too many obstacles (walls, windows,
doors) between the handset and the simulator.
Audio Problems
The sound output from the simulator is low when using a microphone on my lapel.
• Increase the microphone gain on the handset by moving the dial towards the plus sign.
DIP switch 7 must be in the OFF position for this to work.
I’m hearing feedback from the microphone when I am close to the simulator.
• Decrease the microphone gain on the handset by moving the dial towards the minus
sign. DIP switch 7 must be in the OFF position for this to work.
B-11
Appendix B – Wireless Voice Link
The sound output from the simulator is too high or too low.
• The volume level is configured at the factory for optimal performance. However, if you
want to adjust the volume level of the base station (located inside the simulator), set the
handset DIP switch 7 to ON. Remember to turn the handset power off and on after each
DIP-switch change. After this step is complete, you will be able to adjust the volume level
of the base station by adjusting the handset volume dial.
The sound output from the simulator is noisy when the speaker is not speaking.
• You can use the noise reduction feature by setting the handset DIP switch position 8 to
ON.
The simulator voice output is cut off when the speaker is speaking quietly.
• In this case, there are three possible options:
- Attempt to talk louder
- Increase the microphone gain
- Disable the noise reduction feature by setting the handset DIP switch 8 to OFF.
B-12
Appendix B – Wireless Voice Link
RF Channel Initial Operating Frequencies
RF Channel
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Frequency 1 (GHz)
2.402
2.405
2.408
2.411
2.414
2.417
2.420
2.423
2.426
2.429
2.432
2.435
2.402
2.404
2.406
2.408
2.410
2.412
2.414
2.416
2.418
2.420
2.422
2.424
2.426
2.428
2.430
2.432
2.434
2.436
2.438
2.440
Frequency 2 (GHz)
2.480
2.477
2.474
2.471
2.468
2.465
2.462
2.459
2.456
2.453
2.450
2.447
2.480
2.478
2.476
2.474
2.472
2.470
2.468
2.466
2.464
2.462
2.460
2.458
2.456
2.454
2.452
2.450
2.448
2.446
2.444
2.442
B-13
Appendix B – Wireless Voice Link
Specifications
Frequency of operation: 2.400 – 2.4835 GHz
Wireless range: 100 ft clear line of sight
RF power output: 0dBm
Batteries: 2 AAA Alkaline, NiCd, NiMH, Lithium
Handset battery life with base station on: 25 hours with alkaline batteries
Handset battery life with base station off: 100 hours with alkaline batteries
DC voltage input: 5 VDC, 0.2A
Line out jack: 3.5 mm
Headphone/iPhone jack: 3.5 mm
Standalone microphone jack: 3.5 mm
Mechanical dimensions with antenna: 6.17” x 2.52” x 0.65”
Mechanical dimensions without antenna: 4.2” x 2.52” x 0.65”
B-14
caehealthcare.com
For more information about CAE Healthcare products, contact your regional sales manager
or the CAE Healthcare distributor in your country, or visit caehealthcare.com.
Tel +1 941-377-5562 or 866-233-6384
For customer service, please contact CAE Healthcare.
Customer Service Headquarters - United States and Latin America
Monday - Friday from 7:00 a.m. to 6:00 p.m. ET
Phone 1-866-462-7920
Email: customerservice@caehealthcare.com
Customer Service - Canada
Monday - Friday from 8:00 a.m. to 5:00 p.m. ET
Phone 1-877-223-6273
Email: can.service@caehealthcare.com
Customer Service - Europe, Middle East, Africa, India, Asia and Australia
Monday - Friday from 8:00 a.m. to 5:00 p.m. CET
Phone +49 (0) 6131 4950354
Email: international.service@caehealthcare.com
Customer Service - United Kingdom and Ireland
Monday - Friday from 9:00 a.m. to 5:00 p.m. GMT
Phone +44 (0)800-917-1851
Email: uk.service@caehealthcare.com
©2012 CAE Healthcare
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