Laerdal SimMan Essential User Guide

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SimMan

Essential Bleeding

User Guide

CONTENTS

INTRODUCTION

SimMan Essential Bleeding Patient Simulator

CAUTIONS AND WARNINGS

General Simulator Handling

Anti-virus and Firewalls

File Security and Backup of Data

FEATURES

SimMan Essential Bleeding Overview

General 7

4 Bleeding 24

Replacing and Filling Tibial IO Unit with Blood

Transporting SimMan Essential Bleeding

Unpacking the Patient Simulator

MAINTENANCE

Daily Maintenance

Before Storage or Shipping

Regular Cleaning of Fluid and Blood System

Regular Cleaning of the IV Arm

Installing and Upgrading LLEAP

32 Airway 8

Breathing 9

Circulation 10

Bleeding 10

Sounds 11

Eyes Settings and Configurations 11 and 11

SimMan Essential Bleeding Clothing 11

SETUP

Inserting and Connecting the Batteries

Charging the Batteries 13

Battery 15

Using the Internal Compressor 15

Turning the Internal Compressor OFF Using LLEAP 15

Changing Default Compressor Settings Using LLEAP 15

Air/CO

Blood and Fluid System 16

Connecting 18

Attaching the Left Leg

Attaching the Right Leg

Attaching the Left Arm

Attaching the Right Arm

Replacing Crico Tape / Neck Skin

Replacing Chest Drain Pleura

Replacing Pneumothorax Bladders

Replacing Chest Rise Bladder

Replacing Lung Bladders

Replacing Simulator Skins

Replacing Blood System Filter

Servicing the Patient Simulator

TROUBLESHOOTING

SPARE PARTS AND ACCESSORIES

Simulate Severe Bleeding Using LLEAP 18

Connecting Defibrillation Adapter Plates

Connecting the Blood Pressure Cuff

Calibrating the Blood Pressure Cuff Using LLEAP 22

Connecting the SpO

Changing 23

Changing the Upper Dentures 23

INTRODUCTION

SimMan Essential Bleeding Patient

Simulator

For Clinical Simulation

SimMan Essential Bleeding is a patient simulation system that facilitates training of Basic and Advanced Life Support. This system allows the instructor to effectively assess the learner’s individual and team skills based on realistic clinical situations.

SimMan Essential Bleeding allows observation and recognition of most vital signs. This is achieved through direct interaction with the

Patient Simulator and observation of the Patient Simulator’s status which can also be viewed on the Patient Monitor PC (optional).

The SimMan Essential Bleeding Simulation

System Features Include:

– An advanced configurable airway - allowing simulation of difficult airway management cases.

– Eyes with interchangeable pupils and adjustable blinking function.

– Focus on Quality CPR (QCPR): measurement and feedback according to the 2015 Guidelines.

– Vascular Access (intra-osseous) via the left tibia.

– Internal urine bladder which can be filled with fluid to simulate urine.

– Bleeding and Wound Modules fed from an internal blood reservoir. An external Blood Fill Unit may be connected for extended bleeding cases.

– Automatic Simulation Control based on preprogrammed and validated Patient Cases.

The Main Components of the SimMan Essential

Bleeding

SimMan Essential Bleeding is an adult life-size wireless Patient

Simulator, with internal battery power, internal air compressor and fluid reservoirs. Interventions by learners are registered by the system in the session log, and used for later debriefing.

The Instructor PC controls the simulation. The headset allows the instructor to simulate interactive voice communication between the patient and the learner.

Software available for use with the simulator includes LLEAP for controlling scenarios, SimDesigner for creating and editing scenarios,

SimView server or SessionViewer for debriefing simulation sessions with video capture and a Patient Monitor application.

WLAN Communication

Communication between the SimMan Essential Bleeding Patient

Simulator and the PCs is based on WLAN communication. The

Patient Simulator and PCs can also be connected to a LAN cable network, and WLAN disabled.

CAUTIONS AND WARNINGS

General Simulator Handling

The SimMan Essential Bleeding Patient Simulator should be operated by trained personnel only. Treat the Patient Simulator as you would treat a real patient.

Warning: Do not provide artificial respiration to the Patient

Simulator using oxygen enriched air or flammable gases.

− Do not introduce fluids into or onto the Patient Simulator

(except as directed in the User Guide), as this may damage the

Patient Simulator and it’s components.

− Do not introduce humidified air into the system during ventilation.

− Never perform mouth-to-mouth or mouth-to-nose rescue breathing on the Patient Simulator. The simulator’s airways are not designed for cleaning or disinfection.

− Do not use the Patient Simulator if the internal tubing and cabling is disconnected.

− Never use the Patient Simulator outdoors in wet conditions, as this may pose a shock hazard or damage the simulator.

− Never use the Patient Simulator in temperatures exceeding 40°

C (104°F), as this may cause overheating and shut down.

− Never use the Patient Simulator in temperatures below 4 °C (39

°F), as this may damage the fluid system.

− The Patient Simulator should never be stored in temperatures below -15° C (5° F).

− The Patient Simulator will automatically shut down if the battery temperature exceeds 60°C (140°F).

− Using a defibrillator in temperatures over 35° C (95° F) may cause overheating and shut down.

Warning: Avoid pinch hazards - Do not remove protective bushings from the Patient Simulator’s joints or use it without the external skins.

Warning: Avoid all sharp edges on the Patient Simulator to prevent personal injury.

Do not use the SimMan Essential Bleeding Patient

Simulator if:

− Limbs are not attached to the torso.

− Skins are torn or not properly fastened.

− Internal or external cables, tubes or connectors are damaged.

− There is fluid leakage inside the Patient Simulator torso.

− There are unusual sounds indicating air leakage or mechanical damage.

− There are signs of electrical malfunction, such as an unresponsive

Patient Simulator or unusual smell or smoke.

Hygiene

– To maintain Patient Simulator skins, wash hands before use and place the Patient Simulator on a clean surface.

– Wear gloves as required during simulation scenarios

– After using the Fluid and Blood System, follow the cleaning instructions (see Maintenance ).

– After using the SimMan Essential Bleeding Wound Kit, remove glue residue from the Patient Simulator skin with Manikin Wipes.

– Use only Laerdal Airway Lubricant in the Patient Simulator’s airway. Do not spray airway lubricant into the Patient Simulator.

Lubricate tools only.

Prevent Stains on Patient Simulator Skins

Avoid using colored plastic gloves, as they may cause discoloration of the Patient Simulator skin.

Do not use felt-tipped markers, ink pens, acetone, iodine or other staining medications near the Patient Simulator. Take care not to place the Patient Simulator on newsprint or colored paper. All staining may be permanent.

Transportation and Storage

SimMan Essential Bleeding is heavy; ensure that the Patient Simulator is properly secured during transportation to prevent personal injury or damage to the product.

Antivirus and Firewalls

The SimMan Essential Bleeding Patient Simulator and PCs are not supplied with Antivirus programs. Windows firewall is activated by default. It is the customer’s responsibility to protect the simulation system components from unauthorized access.

The Patient Simulator will revert to factory settings each time the power is switched off.

The customer should install all recommended Windows updates from Microsoft. General security measures should be taken before browsing the internet.

It is recommended that the SimMan Essential Bleeding PCs are used only as Patient Simulator controllers. Downloading other Software programs onto these machines may introduce unexpected errors.

File Security and Backup of Data

The customer is responsible for file security and backup routines for all simulation session data. All use and storage of simulation session data should be in accordance with local rules, regulations or laws and is the sole responsibility of the customer.

FEATURES

SimMan Essential Bleeding Overview

Bleeding Ports

Speakers

ECG Connectors

Defib Connectors

Pulses

Ower

Anel

DC Input 9-24V X, XA

F luid

F ill

Anel

A ir

/CO

Anel

General

Main anatomical features

Dimensions (Patient Simulator only):

1800mm (l) x 550mm (w) chest (5. 90 ft x 1.80 ft)

Weight (Patient Simulator only): 38.5kg (85 lbs)

Weight (with clothes): 40 Kg (88 lbs)

Default male body with interchangeable genitalia pads

Configurable Anatomical Features

Genitalia

The Patient Simulator comes with a neutral genitalia pad as default.

The pad can be changed for a male or female module, both included with the SimMan Essential Bleeding System. See Changing Genitalia

Modules section.

Teeth

Patient Simulator comes with a set of soft teeth as default. These can be exchanged for a hard set of teeth, included with the SimMan

Essential Bleeding System. See Changing the Upper Dentures section .

Trauma Modules/Limbs

Left Leg - amputation and bleeding module (optional accessory).

Left Arm - amputation and bleeding module (optional accessory).

The SimMan Essential Bleeding arm adaptor kit is used to connect the trauma arm modules.

Mobility of joints

Neck: Movement can be on a 3-axis movement of head.

Range of movement can be restricted. See Airway section

Shoulders: 3-axis rotation

Lumbar:

Elbows:

Wrists:

Thumbs:

1-axis

Fixed, no mobility

3-axis rotation

Free mobility

Hip joints: 3-axis rotation

Knees: 1-axis rotation

Ankles: 1-axis rotation

FEATURES

Laerdal Simulation Software

To run a simulation, LLEAP (Laerdal Learning Application) must be started from Laerdal Simulation Home on the Instructor PC.

Laerdal Simulation Home

Laerdal Simulation Home is an application from where LLEAP and other Laerdal programs related to patient simulation can be found and started. Also the help files can be opened from here. Laerdal

Simulation Home is located in the Laerdal Medical folder under the

Windows start menu.

Contact your local Laerdal representative to enquire about other trauma modules compatible with SimMan Essential Bleeding.

Note: Do not remove protective bushings at shoulder or lower back.

These are present to protect users from pinch points.

Software used in a simulation session comprises the following main applications:

− LLEAP (Laerdal Learning Application)

− Voice Conference Application

− Patient Monitor

− SimView Server or Session Viewer

In addition SimDesigner and other applications are also used for designing or preparing a simulation.

LLEAP

LLEAP is the instructor’s application from where the simulation session is run, controlled and monitored. LLEAP can be operated in Automatic or Manual mode. Automatic mode is used for preprogrammed scenarios while Manual mode allows the instructor full manual control of the simulation session. Running simulations in

Manual Mode requires some medical expertise to create clinically sound simulations.

Voice Conference Application (VCA)

The VCA Software allows the instructor to communicate through the simulator during the session. VCA can also be used to communicate with other instructors on a network, and create separate channels where only members can communicate.

Patient Monitor

The Patient Monitor application emulates a typical hospital patient monitor. It is the learner’s console and can be set up and controlled by the instructor, as well as by the learner through on-screen touch menus.

Session Viewer And SimView Server

Session Viewer and SimView Server are applications that record video and patient monitor screen captures during simulation, in addition to providing an interface to debrief your session. After a session is ended, log files generated in LLEAP are transferred and merged with the video files in Session Viewer or SimView Server for the debrief.

Session Viewer typically runs locally on the same computer as used for LLEAP, SimView Server runs on a dedicated server in the local network. During the first start-up of LLEAP, you are prompted to select a debriefing system available on your computer or on a local network. This can be changed later.

Other Applications

There are also other programs that are used in conjunction with the simulation sessions, for example License Manager for handling program licenses and Simulator Firmware & Network Wizard for updating the firmware of the simulators or troubleshooting network problems.

SimDesigner

The SimDesigner application allows you to configure your own preprogrammed scenarios. It can also be used to analyze and print out a graphical representation of a scenario.

SimDesigner must be installed to allow conversion of legacy instructor application files to LLEAP compatible file formats.

For a full overview of all applications and their help files, start LLEAP

Home.

Web Downloads

Visit www.laerdal.com/download to download the latest User Guide and Software.

FEATURES

Use of a malleable stylet is recommended - make sure it does not extend beyond the ET tube.

Recommended styles:

− i-Gel

− Fiberoptic intubation

− Combitube (size small adult is suitable)

− Retrograde intubation

− Needle cricothyrotomy

− Surgical cricothyrotomy

The following Patient Simulator features indicate incorrect tube placement:

− Right main stem intubation – unilateral chest rise

− Stomach distention

− Lack of chest sounds, CO

2 section)

exhalation (see Breathing Features

Airway Features

The airway is anatomically modeled as far as the bronchia.

The airways can be manipulated by a learner:

− Head tilt/Chin lift

− Jaw thrust with articulated jaw

− Cricoid pressure and manipulation

− Suctioning (oral & nasopharyngeal)

If the tongue fallback feature is enabled, head tilt is required to open the airways for mask ventilations. The Patient Simulator may be ventilated by normal and emergency methods:

− Bag-mask ventilation

− Orotracheal intubation

− Nasotracheal intubation

− Transtracheal intubation

Prior to using airway adjuncts, apply a small amount of Laerdal

Airway Lubricant to the equipment. Do not spray lubricant directly into the airway,

The following equipment or methods are suitable to secure the Patient Simulator’s airway:

− Laryngeal mask airways: The airways are designed for use with size #4, but size #5 may also seal correctly.

− Endotracheal tube intubation, Size ID 7.5 - 8.5 is suitable, but using the smaller size reduces wear of the Patient Simulator’s airways.

Configurable Airway Features

Patient Simulator features may be configured to present various airway Scenarios:

− The airway may be closed automatically or manually. There are 2 settings of airway resistance: On/Off

− Tongue edema - multiple levels

− Pharyngeal swelling

− Laryngospasm

− Decreased cervical range of motion

− Trismus

− Teeth - soft upper dentures may be replaced with a hard set of teeth for enhanced realism while practicing intubations.

During simulation, the following conditions can be set:

− Can’t intubate/can ventilate

− Can’t intubate/can’t ventilate

The following information is automatically registered in the

SimMan Essential Bleeding simulation session:

− Detection of proper head position.

− Jaw Thrust

− Pneumothorax decompression

− Ventilations

− Stomach distension

Note: In LLEAP the airway and breathing status for the current simulator is shown in a window. Settings for lung resistance can be made. See LLEAP Help for further information.

FEATURES

Breathing Features

The SimMan Essential Bleeding can simulate spontaneous breathing:

− Bilateral and unilateral chest rise and fall

− There are 2 settings for airway resistance: on - off

− Normal and abnormal breath sounds

− 5 anterior auscultation sites and 6 posterior auscultation sites

− Unilateral, bilateral and lobar breath sounds

− Oxygen saturation and phlethysmogram

− CO

exhalation for use with third-party End-tidal CO

(Requires connection to an external CO

reservoir)

detectors

Warning: Do not ventilate the Patient Simulator with oxygen enriched air or flammable gass.

Caution: Do not ventilate Patient Simulator lungs using humidified air.

Pneumothorax

Tension pneumothorax with needle decompression can be performed at bilateral mid clavicle line, 2nd intercostal space. The Pneumothorax

Bladders may be pierced

+/-10 times, the pressure inside the bladder will drop after repeated puncturing.

A 22 (or smaller) gauge needle is recommended for decompression of the chest.

Using a smaller gauge needle increases the longevity of the

Chest Skin and bladders.

However, a too small gauge prevents automatic detection of the decompression event in the simulation model.

Chest Tube Insertion

Chest tube insertion can be simulated. Exploration and cut can be made at left or right mid-axillary line in the 4th and 5th intercostal space.

Patient Monitor features - Breathing

− SpO

− Airway respiration rate (awRR)

− End-tidal CO

(etCO

)

− End-tidal O

(etO

)

− inO

− pH

Lung specifications

− Max tidal volume: 1.2 liters

− Max tidal volume registered in the LLEAP is 900ml. All volumes higher than 900ml will register as 900ml

− Max airway pressure: 80 cm H

− Simulated stomach inflation starts from approximately 40cm

O airway pressure.

Note: Lungs are not intended for use with PEEP-valves.

Circulation

Cardiac Features

− Extensive ECG library, pulses from 0-220.

− Heart sounds - for every anterior location

− ECG rhythm monitoring (4-connector, 3-lead ECG)

− 12-lead ECG display

− Pacing

− Defibrillation and cardio version using live defibrillators

Defibrillation

− With live defibrillators; energy level and waveform model is registered by the Patient Simulator.

− The energy levels and number of shocks required for automatic conversion are set in each simulation Patient Case.

Defibrillation Studs 3-Lead ECG Studs

FEATURES

Patient Monitor features - Circulation

− ECG (12-lead) and heart rate (HR)

− Pulse

− NBP

− ABP

− PAP

− C.O.

Patient Monitor Features - Temperatures

− TPeri

− Tblood

Note: A variety of settings in the Circulation and Fluids window can be made in LLEAP. See LLEAP Help for further information.

Bleeding

To allow the Patient Simulator to bleed realistically, it has internal reservoirs for simulated blood. See Setup section.

The four bleeding ports and blood flow can be adjusted independently from LLEAP:

− Upper/lower bleeding ports

− Venous/Arterial

− Works with various wound modules and moulage kits

Bleeding Treatment:

− Bandage

− Pressure point

− Tourniquet

− Surgical Clamps

Circulation Features

− BP measured manually by auscultation of Korotkoff sounds

− Carotid, brachial, radial, femoral, dorsalis pedis, and posterior tibialis pulses synchronized with ECG

− Pulse strength variable with BP

− Pulses are synchronized with ECG when the instructor sets the pulse strength manually

− Pulse palpation is detected and logged

Vascular Access:

− IV access (right arm)

− Intraosseous access (tibia)

CPR

− Compliant with 2015 Guidelines

− Compressions generate palpable pulses, blood pressure wave form, and ECG artifacts

− Realistic compression depth and resistance

− Detection of depth, release and frequency of compressions

− Real-time view of Quality of CPR on the Instructor’s PC

Warning: Do not use automated chest compression machines on the Patient Simulator.

Consumables and

Spare Parts:

− Laerdal Artificial Blood

− Fill Units

− Wound modules

− Replacement trauma arm/leg.

Note: A variety of settings in the Circulation and Fluids window can be made in LLEAP. See LLEAP Help for further information.

Sounds

Two types of sounds can be used in a scenario:

– Body sounds

– Vocal Sounds

The sounds can be triggered by the scenario or controlled by the instructor.

Body Sounds

The body sounds are simulated sounds from a human body, like heart, lungs, and bowel sounds. The sounds are integrated and generated in the Patient Simulator and transferred through the integrated speakers.

FEATURES

Vocal Sounds

The vocal sounds are sounds from the throat like coughing, moaning, and crying as well as spoken words. The sounds are integrated in

LLEAP.

In addition, the instructor can communicate through a microphone and the voice is then transferred to the Patient Simulator through the VCA.

Note: A variety of settings for Sounds can be made in LLEAP. See

LLEAP Help for further information

Eyes Settings and Configurations

The calculated Glasgow Coma Scale score for the Patient Case is displayed in LLEAP. The following sources of information helps the learner to judge the state of disability:

Eyes

− Blinking eyelids

− Eyelids: open, closed or partially open

− Eyelids can be opened for examination by the learner

− Set of interchangeable pupils available

Note: A variety of settings for Circulation and Fluids can be made in LLEAP. See LLEAP Help for further information.

Drugs and IV

Drugs and drug concentrations can be registered manually by the instructor in LLEAP.

Patient Monitor Features – Drugs:

– Train-of-Four (TOF)

– in N

O, et N

– Anesthesia agents

– Lab reports

User-Replaceable Items, Spare Parts:

– Intra-muscular Pad

– Tibial IO Pad

Vascular Access (IV and IO) Locations

Intraosseous access with needle insertion is possible through the left tibia. The IO pads may be punctured numerous times before being replaced.

To replace the IO modules, see the Simulation Setup section.

Caution: Do not inject fluids into these pads unless approved IO modules with fluid outlets are in place.

Intra-muscular (IM) Injection

Use the pad placed under the Torso Skin on the right buttock for intramuscular injection training.

SimMan Essential Bleeding

Clothing

Included with the Patient Simulator:

− Shirt, with side zippers

− Trousers, with full-length side zippers

− Boxer shorts underwear

− Belt

Note: For washing instructions see care labels.

Simulated Removal of the Clothes

To simulate cutting with scissors: unzip the zippers placed alongside the seams on both sides.

Inserting and Connecting the

Batteries

Open the torso as described in steps 1 - 4, Opening the Torso .

To remove the batteries, follow the same procedure in reverse.

1 Release the battery clamp by unhooking the clips on either side.

SETUP

4 Connect the corresponding battery cables from the batteries to the torso.

2 Insert both batteries into the battery tray.

After connecting the batteries, connect the Patient Simulator to the external power supply (12V to 24V) while turned OFF.

The batteries will charge if the Patient Simulator is ON and connected to an external power supply in the range of (20V - 24V)

Battery - Cable and Tube Descriptions

Name/Label

Battery 1

Battery 2

Tube/Cable Color Connector Description

Black harness cable Black rectangular connector, 6 lead

3 Snap the battery clamp back into place over the batteries.

The Power Panel

The power panel is found on the right side of the Patient Simulator, under a loose skin flap. Lift the skin flap and pull out the protective cover.

SETUP

Charging the Batteries

Inside the Patient Simulator

1 Connect the Patient Simulator to the external power supply with a power cord and plug that meets local specifications.

2 Plug the power supply into a wall outlet and connect the power cable to the power inlet on the Patient Simulator’s power panel.

To ensure easy access, use the zippered clothing provided with the

SimMan Essential Bleeding Patient Simulator.

DC Input 9-24V X, XA

Power Panel Overview

1 Power ON/OFF button

2 Power status indicator

3 Battery status indicator

4 Charging status indicator

5 LAN network cable connector

6 External power supply connector

Power Status Indicator Description

Indicator

Light Color

Power Status Battery Status Charge Status

Red

Yellow

Power save*

Start up

0% - 20%

20% - 70%

Not charging**

Charging

Green Running 70% - 100% Charge almost complete***

No charge**** No light Off Off

* Blinking light

** One or both batteries missing, overheated, damaged or otherwise not able to charge

*** Not recommended to charge the batteries too long

**** No power input, batteries are charged.

Power Save is activated whenever Patient Simulator is paused.

3 Press the ON button to power on the Patient Simulator.

Note: During start up, the Patient Simulator’s eyes will blink and the power status indicator light will be yellow.

Caution: After Patient Simulator is turned off, wait 20 seconds before restarting. If not, Patient Simulator may not function properly.

External Battery Charging

The battery charger comes with 5 international plugs. Connect the appropriate plug to the charger:

SETUP

Battery Use

− Always use two SimMan Essential Bleeding batteries to power the Patient Simulator.

− Ensure that the batteries are properly connected.

− Charge the batteries regularly.

− Check LEDs on Patient Simulator’s power panel for battery status.

– Charge both batteries before the battery charge drops below

15% or the battery light indicator is red. This can be monitored in the technical status window on the Instructor PC.

– The Patient Simulator will automatically shut down if: battery temperature rises above 60°C (140°F) or the remaining charge falls below 6 % on one of the two batteries.

1 Connect the charger to a power outlet and connect the Patient

Simulator battery to the charger.

View Battery Status in LLEAP

Check the power indicator in the Simulator Status window in LLEAP according to the instructions in LLEAP Help.

Changing Batteries during a Simulation Session:

1 Press <Pause Session> on Instructor PC. Access the batteries as described in Inserting and Connecting the Batteries .

2 Replace one battery at a time to avoid loss of simulation data.

2 The indicator light on the battery charger shows charge status.

3 Battery charging time is approximately 3 hours.

The external battery charger should only be used with SimMan

Essential Bleeding batteries.

Charger Light Showing Battery Sign

Light Code

Standby

Pre-charge

Rapid charge

Maintain

Ready

Wait

Error

Light Color

Yellow

Green

Alternating

Yellow

Characteristic

Steady

Normal Blink

Rapid

Normal Blink

Steady

Alternating

Rapid

Storage and Transportation

− Never store fully charged batteries for longer than a month.

− Never store the batteries inside the Patient Simulator.

− Store batteries in a refrigerator i.e. temperature 0°C - 4°C

(32°F - 40°F).

− The two simulator batteries can be transported in the Patient

Simulator during air freight.

− When transporting spare batteries please contact the airline or freight company for the latest transport regulations.

Battery Maintenance

− On approximately every 30th charge cycle, drain the battery completely before recharging. To drain the batteries run the

Patient Simulator on both batteries until automatic shutdown.

− Expected battery life: 200 charge cycles.

− Replace only with Laerdal SimMan Essential Bleeding batteries.

Battery Warnings

Warning: Do not run the Patient Simulator for more than 1 minute on a single battery.

Warning: If both batteries are removed while the simulation is paused, the Patient Simulator will shut down and simulation data will be lost.

SETUP

Turning the Internal Compressor

OFF Using LLEAP

To switch OFF the internal compressor (to conserve the simulator batteries and reduce wear), do the following:

1 In LLEAP, select the <Tools> menu.

2 From <Simulator Setup>, click <Turn off internal compressor>.

Warning: Dispose of batteries in accordance with local regulations.

Warning: The external battery charger is for indoor use only.

Warning: The batteries should only be charged in temperatures ranging from 0 °C - 40°C (32 °F - 104 °F).

Warning: Inserting and connecting batteries incorrectly, short circuiting or exposure to fluids pose an explosion hazard.

Warning: Do not mistreat, disassemble or attempt to repair the battery.

Changing Default Compressor

Settings Using LLEAP

Change default compressor settings via the Profile Editor.

1 Open the Profile Editor from the <Tools> menu in LLEAP .

2 Select the <Manikin hardware> tab in the Profile Editor.

3 From the compressor setup option, choose <Internal default>,

<External default> or <Remember last setting>.

Warning: Do not use the batteries if they are visibly damaged, malfunctioning or appears to be leaking.

Warning: Take extreme care to avoid direct contact with electrolyte, hot or smoking parts. In case of the above, disconnect and remove the battery when it is judged safe to do so.

Using the Internal Compressor

The SimMan Essential Bleeding Patient Simulator’s chest movements, airway modes and fluid systems are driven by compressed air. The right leg contains a compressor and tank with separate reservoirs for clear and simulated blood fluids.

For extended periods or stationary use, it is recommended to connect to an external source of compressed air. This reduces wear on the internal compressor and extends battery life of the Patient

Simulator.

For instructions on connecting an external compressor and adjusting compressor default settings see Air/CO

Panel section .

Air/CO

Panel

The Air/CO

panel is located on the left side of the torso. To access the panel, lift up the simulator skin flap and remove the protective covering. Connect external Air/CO

Air/Co2 Panel has 2 Connection Ports

SETUP

Blood and Fluid System

The patient simulator has two internal reservoirs, one for blood and one for fluids. SimMan Essential Bleeding is also supplied with two fill units - one Blood Fill Unit for blood and one Fluid Fill Unit for fluids.

SimMan Essential Bleeding Right Leg Fill Panel

The right leg fill panel is located at the top of the right leg near the pelvis. The fill panel contains connectors for filling the blood and fluid reservoirs.

Note: Make sure the patient simulator power is on.

Fill Internal Fluid Reservoir

Connecting External Air and CO

Supply

An internal compressor is located in the right leg of the Patient

Simulator. It is recommended to use an external source of compressed air whenever the Patient Simulator is stationary over extended periods of use.

Connect CO

only if the Patient Simulator is required to exhale

with each ventilation. Exhaled CO

can be detected with a real capnographic device. The Patient Simulator will only exhale CO

2 when a capnograph is registered as being connected to the system.

1 Connect a suitable CO

source to a Laerdal external compressor or regulator panel.

2 Connect a Laerdal double-lumen Air/CO

tube from the external compressor or regulator panel to the Air/CO

inlet on the panel.

For more information on external compressors and regulator panels compatible with SimMan Essential Bleeding, contact your local Laerdal representative

SimMan

Fluid Fill Unit

1 Roll the right leg skin down to expose the fill panel.

2 Connect fluid fill unit tubes to the fluid and air connectors in the right leg panel.

3 Push the fill button on the panel. The button will light up and fluid will flow into the patient simulator.

4 When the flow stops, disconnect the fill unit.

5 Push the fill button on the panel. The light will go out.

Note: Disconnect tubes from the patient simulator before pushing the fill button. Pushing the button before disconnecting the tubes will initiate draining of the tank.

Empty Internal Fluid Reservoir

1 Connect an empty fluid fill unit to fluid connector in the right leg panel.

2 Fluid from the internal reservoir will drain into the bottle.

When the flow stops, disconnect the fluid connector.

Run Patient Simulator with External Fluid

1 Drain the internal reservoir.

Follow instructions for “Empty

Internal Fluid Reservoir”.

2 After draining the internal reservoir, fill the fluid fill unit and connect to the patient simulator.

3 Push the fill button on the panel. The button will light and fluid will flow into the patient simulator.

4 Charge the system for 60 seconds before starting simulation.

Warning: Connecting a full fluid fill unit to a patient simulator with a full internal reservoir will result in system overflow. Fluid will drain out of the right leg. Repeatedly overflowing the system may damage the product.

Fill Internal Blood Reservoir

SETUP

Mixing of Blood and Fluid

SimMan

Blood Fill Unit

SimMan

Blood Fill Uni t

SimMan

Blood Fill Uni t

SimMan

Blood Fill Unit

SimMan

Blood Fill Unit

1 Roll the right leg skin down to expose the fill panel.

2 Connect blood fill unit tubes to the blood and air connectors in the right leg panel.

3 Push the fill button on the panel. The button will light up and

Fluid

Inlet

Activate

Filling

4 When the flow stops, disconnect the fill unit.

5 Push the fill button on the panel. The light will go out.

Note: Disconnect tubes from the patient simulator before pushing the fill button. Pushing the button before disconnecting the tubes will initiate draining of the tank.

To simulate clear fluids and secretions: Fill the Fluid Fill Unit with of de-ionized water (approx 3/4 full) only and tighten the cap.

To mix simulated blood: Fill the Blood Fill Unit with de-ionized water.

Add 5-10 drops of Laerdal Blood colored concentrate, mix and tighten the cap.

Air Out

Activate

Filling

Empty Internal Blood Reservoir

1 Connect an empty blood fill unit to blood connector in the right leg panel.

2 Blood from the internal reservoir will drain into the bottle.

3 When the flow stops, disconnect the blood connector.

SimMan

Blood Fill Uni t

SimMan

Blood Fill Unit

Run Patient Simulator with External Blood

1 Drain the internal reservoir.

Follow instructions for “Empty

Internal Blood Reservoir”.

2 After draining the internal reservoir, fill the blood fill unit and connect to the patient simulator.

3 Push the fill button on the panel. The button will light and blood will flow into the patient simulator.

4 Charge the system for 60 seconds before starting bleeding simulation.

Air Out Blood

Inlet

Fluid

Inlet

Activate

Filling

Warning: Connecting a full blood fill unit to a patient simulator with a full internal reservoir will result in system overflow. Blood will drain out of the right leg. Repeatedly overflowing the system may damage the product.

SimMan

Blood Fill Uni t

Air Out Blood

Inlet

Fluid

Inlet

Activate

Filling

Connecting Wounds Kit

SimMan Essential Bleeding comes with a wounds kit that includes

2 wounds and double-sided tape to attach wounds to the Patient

Simulator skin.

Connect wounds to the bleeding ports on the Patient Simulator torso to simulate a bleeding patient.

1 Select a wound from the wounds kit.

SETUP

Simulate Severe Bleeding Using

LLEAP

Start a Patient Case with Bleeding in LLEAP.

2 Connect the tube from the wound, to the nearest blood port.

There are four blood ports with twist and lock connectors, as illustrated on the right.

− Ensure the area to which the wound will be attached is clean and dry.

− Apply adhesive tape to the back side of the wound.

− Remove the protective liner from the adhesive tape on the wound and fix it in the desired position on the skin.

Removing Wounds

Flush all blood ports and tubes with distilled or de-ionized water while the wounds are still attached. When the fluid runs clear, disconnect the tube from the fluid outlet. After the wound is removed, any tape residue can be cleaned from the Patient Simulator skin with Laerdal Manikin Wipes.

Note: When removing wounds from the blood ports, cover the

Patient Simulator skin with a cloth to prevent staining.

Note: Trauma modules can be purchased separately to replace default limbs to add realism to simulation.

To extend bleeding patient simulations, a scale factor can be used.

Ensure, when the external Blood Fill Unit is empty; replace it with another Blood Fill Unit filled with simulated blood. Repeat this process for as many times as is necessary.

Note: If the external fill unit runs empty during a bleeding scenarios, air will be introduced to the blood system, causing inaccurate reading.

The IV Arm

Follow these instructions when using the IV Arm for SimMan

Essential.

The Patient Simulator must be switched ON when performing the following.

IV Arm with Skin

Filling and Priming port

Priming switch

IV Arm Pad

IV Arm without Skin

Filling and Priming port

Priming switch

Tourniquet area

IV Arm chassis

Drain tube

SETUP

The IV Arm Pad

The new IV Arm Pad is intended to take up to 10 catheter insertions in each of the 3 veins, using a size 20 G catheter. Distribute the insertions of the IV catheter evenly and only in the 3 highlighted areas.

If the IV Pad leaks from any of the insertion points, massage the leak area. Replace the IV Pad if leaking continues.

Filling and Priming the IV System

1 Ensure that the IV Arm is connected to the Patient Simulator and the Patient Simulator power is ON.

2 Ensure that the IV Arm Pad is fitted correctly.

Drain tube

3 Attach a collector bag to the drain tube of the IV Arm. The bag should be placed on the bed beside the Patient Simulator or at the same level, to allow fluid to drain into it.

4 Connect a blood filled syringe (min 40ml) with luer lock to the

Filling and Priming port.

5 Press the priming switch to open the system.

6 Slowly fill the system with simulated blood. Continue this operation until there are no air bubbles coming out through the drain tube. Release the priming switch.

SETUP

Refilling the IV Arm with Blood

1 If the veins do not respond (energize) when the tourniquet is applied it is likely that the system requires refilling with blood.

2 Connect a blood filled syringe and slowly fill with no more than

16ml of blood or until you feel resistance. Remove the Syringe.

7 Continue to slowly fill with no more than 16ml of simulated blood, or until you feel resistance in the syringe.

8 Remove the Syringe. The IV Arm is now ready for use.

Note: It is important that the Arm is filled slowly to prevent damage to the IV Arm Pad causing leaks.

Note: The IV Arm Pad is designed for use with a

20 GA Intravenous Catheter.

Removing and replacing the IV Arm pad

1 Ensure that the Tourniquet Area is not activated i.e. remove the tourniquet.

2 Remove the IV Arm Pad by pulling at the tabs on edge of the IV pad.

The IV Arm is now ready for use.

Cleaning the System

After each session and before storage, clean the IV Arm system:

1 Make sure the collector bag is connected to the drain tube.

2 Connect a syringe filled with Isopropanol 60%-70% to the IV

Catheter. Press the prime switch, and flush the IV Arm system with Isopropanol. Release the prime switch when done.

3 Remove excess blood that may accumulate in the IV Arm chassis.

4 When replacing the IV Arm Pad, ensure that it is pressed firmly into all connection points to provide a watertight seal.

3 Connect a syringe filled with air to the IV Catheter. Press the prime switch, and flush the IV Arm system until only air exits the drain tube. Release the prime switch when done.

5 Fill and prime the system as instructed in the previous section.

Note: Always follow the safety instructions from the defibrillator manufacturer when using the defibrillator on the

Patient Simulator.

During Defibrillation

During live defibrillation, the defibrillator and Patient Simulator may present a shock hazard. All standard safety precautions must be taken when using the defibrillator on the Patient Simulator.

Note: Defibrillation must be performed on the defibrillator

connectors only.

To prevent overheating during defibrillation, do not exceed a defibrillation sequence of 3 shocks in 45 seconds followed by

1 minute of CPR.

After 30 minutes there must be at least 15 minutes pause in defibrillation before starting a new sequence.

Note: Do not repeat this for more than a 4 hour period.

Warnings and Cautions

Warning: Do not spill fluids on the defibrillator connectors.

Wet defibrillator connectors may lead to a shock hazard during defibrillation of the simulator.

Warning: The Patient Simulator must not be in contact with electrically conductive surfaces or objects during defibrillation.

Warning: Do not defibrillate the Patient Simulator when it is OFF or if it is not functioning normally.

Warning: Do not defibrillate the Patient Simulator without the torso skin.

Warning: Do not defibrillate the Patient Simulator in a flammable or oxygen enriched atmosphere.

Warning: The Patient Simulator torso must always be kept dry.

Allow the Patient Simulator to acclimate before defibrillating.

Sudden changes in temperature (moving the Patient Simulator from a cold environment to a warm environment and vice versa) may result in condensation collecting on the base board and pose a shock hazard.

SETUP

Connecting Defibrillation Pads or

Adapter Plates

The Patient Simulator can be defibrillated with semi automatic defibrillators and manual mode defibrillators.

Using Defibrillation Training Cables

The Patient Simulator is fitted with two defibrillator connectors

(Apex and Sternum) for attachment of a Defibrillator Training Cable.

Laerdal can provide adapters that make the Defibrillation Cable fit several defibrillator brands. Designated Training defibrillator pads may also be fitted around the defibrillator connectors to resemble real defibrillator electrodes.

Note: Always follow the safety instructions from the defibrillator manufacturer when using the defibrillator on the

Patient Simulator.

During Defibrillation

During live defibrillation, the defibrillator and Patient Simulator may present a shock hazard. All standard safety precautions must be taken when using the defibrillator on the Patient Simulator.

Note: Defibrillation must be performed on the defibrillator

connectors only.

To prevent overheating during defibrillation, do not exceed a defibrillation sequence of 3 shocks in 45 seconds followed by

1 minute of CPR.

After 30 minutes there must be at least 15 minutes pause in defibrillation before starting a new sequence.

Note: Do not repeat this for more than a 4 hour period.

The defibrillator studs must be fitted in place before using a live defibrillator with defibrillation paddles.

Press the adapter plates firmly into place.