Laerdal ALS Skillmaster
Contents
1. 2 1 4 Airway obstruction Airway obstruction can be induced from the Heartsim 4000 It will cause left right or complete blocking of air ways by shutting the magnetic valves that control air passage to each lung 2 1 5 Opening and closing of airways The airways are opened and closed by two magnetic air way valves located inside the manikin body The opening and closing of these valves are controlled through the following algorithm a If Airway Obstruction is introduced the airways are closed regardless of intubation head tilt or jaw thrust f the airways are not obstructed the ALS Skillmaster will check the next step b If the manikin is intubated and this is indicated by the instructor on the Heartsim 4000 the airways are open regardless of head tilt or jaw thrust C If head tilt or jaw thrust is sufficient the airways are open f head tilt or jaw thrust is not sufficient the airways are closed LAUVIUC MLW YINIIIIQAOLUI 2 1 6 Stomach The manikin is equipped with a stomach which will be distended at inspiratory pressures of more than 25 mm Hg or if the manikin is ventilated after intubation into oesophagus To expel the air after a stomach distention place your hand on top of the manikin s stomach and press downwards 2 1 7 Chest compressions The manikin demonstrates the correct anatomical landmarks for external chest compressions A very fast depression of the sternum with2. External pacemaker training Stomach Arms Volume infusion into left arm Intravenous cannulation sites in right arm Heartsim 4000 is required LQAUVIUC MALY VTINIHIIEPLPLICUOL cece henii en link B Heartsim 4000 This is the instructor s tool to control the training scenario it requires a IBM compatible computer The computer connects to the manikin via the Laerdal Link Box Only one lead goes to the manikin which combines power input and connectivity to the Laerdal Link Box Features are listed below CD ROM ALS training controls via computer keyboard and or remote control Over 2 500 ECG rhythm variations Variable extrasystole rate Choice of different extrasystole types Variable pacemaker threshold external pacemaker training only Control of manikin functions Sounds Breathing Moaning Vomiting Left right or bilateral lung obstruction Pulse strength Activity log Scenario builder ECG sequence builder for your own training scenarios ECG Simulator as a stand alone training tool ECG rhythm recognition quiz VF recognition quiz CPR performance curves and evaluation Link Box 3 4 lead ECG connectors for ECG training power in for the Laerdal ALS Skillmaster manikin Remote Control Interface vi LAUIUCAl MLW YINIIIIQAOLUI 2 System Features 2 1 Manikin Features Laryngospasm The instructor can simulate laryngospasm by using the syr
3. ALS Skillmastar Neck wipulse units Head cpl ALS S amp illmaster Lung plate wilh screws Airway valve housing Airway valve base Upper airway tubes pair Comp venl sensor unil and plate Lunes Stomach plata Esophageal tube with gliomach valve Stomach Stomach pad UMAR col wielestronics Cable ALS to link box Sanitation ki for upper airways teac 29 32 00 29 33 00 29 33 Q1 28 04 00 08 21 10 Q9 21 11 098 21 01 09 21 02 09 21 03 25 20 05 29 1B 30 29 22 00 26 DO 3r 26 30 01 26 305 eb 20 20 Laryrcpaspasm syringe and tube wilhibut Y preca Lower body Trousers Left arm IV hanc IV uppar arm Upper arm repiacemarni pad Hand replacement pac Simulated bload Head Skin amp airways cpl w teeth Directions Ire use Carrying case ALS trainer Accessories Heartsim 4000 cp Remate control Link box Heanrhythm CO ROM Product speciticatiorrs are suec fo change wifrou mala 11 Laerdal ALS Shallmasher 44 rev A Printed in Norway nail Heartsim laerdal no USA and Latin America LAERDAL MEDICAL CORPORATION 167 Myers Corners Road P O Box 1840 Wappingers Falls New York 12590 8840 Telephone 800 431 1055 914 297 7770 Telefax 800 227 1143 914 297 1137 Canada LAERDAL MEDICAL CANADA LTD 70 Ironside Cres Unit 2 Scarborough Ontario M1X 1G4 Tel 1 800 265 9987 416 298 9600 Fax 416 298 8016 United Kingdom LAERDAL MEDICAL LTD Laerdal House Goodmead Road Orpington K
4. connectors only If defibrillation is performed over one or more of the ECG connectors high voltages may be present on the remaining connectors during the shock To prevent overheating do not provide more than three defibrillator discharges max 360 J in a sequence Do not exceed an average of two defibrillator discharges per minute during the training session The manikin must not be in contact with electrically conducting surfaces or objects during defibrillation A flame supporting atmosphere for example with a high content of oxygen should be avoided during defibrillation The manikin chest must be kept dry To prevent chest skin electrode pitting do not apply conductive gel or conductive defibrillation pads intended for patient use Do not use cables or connectors with visible damage Undo load sensor box with cables and ship chest skin with load sensor box for authorized Laerdal service Do not spill fluids over any component inside the manikin torso since this could damage the unit and might also present a possible hazard for the operator If a training session has included administering of drugs into the left arm undo and empty the arm immediately after the training session Do not allow the manikin s skin to come in direct contact with ink or photocopied paper as this can cause permanent stains on the skin Also avoid using coloured plastic gloves when handling the manikin as this may cause discolouration of the manikin
5. recommended as latex gloves may stain the manikin skin 4 1 Proper care of the Laerdal IV Arm 4 1 1 Maintenance tips When withdrawing a catheter from the pad press a cotton or gauze pad over the point of venipuncture This will limit the amount of blood stain on the skin of the pad Use gloves when handling the IV Arm This will reduce the risk of staining the pads To remove stains from simulated blood on the pads wipe the pads in lukewarm water and allow them to dry 4 1 2 Refilling pads with simulated blood The artificial skin and veins are designed to self seal after with drawal of a needle or catheter However since the volume inside the enclosed veins is limited it is sometimes necessary to replace blood that is lost during practice or when flash back is insufficient A 250 ml bottle of simulated blood is enclosed with each Laerdal IV Arm Simply fill a syringe with up to 1 ml of blood and inject it carefully into any vein in the pad This is best done after a successful cannulation before the removal of the cannula to ensure that the blood enters the veins and not the surrounding tissue Be careful not to inject too much blood into the veins at once since this will cause excessive pressure leading to leakage of blood out through previous punctures in the veins Apart from simple refilling this technique can be used to simulate various degrees of blood pressure 4 1 3 Replacing pads To replace a
6. s skin This device generates uses and can radiate radio frequency energy If it is not installed and used in accordance with the instructions it may cause harmful interference to radio communications In that case the user is encouraged to try to correct the interference by Reorienting or relocating the receiving antenna Increasing the distance between the device and receiver Connecting the device into an outlet on a circuit different from that to which the receiver is connected Consulting the dealer or an experienced radio TV technician for help 1 Main Components A The Laerdal Skillmaster ALS Interactive Training System consists of the following main components A ALS Skillmaster Manikin A full Torso male manikin allowing the simulation of Advanced Life Support skills to develop both individual and team skills Features are listed below Head Intubation nasal and oral Head tilt with sensor feedback Jaw thrust with sensor feedback Audible feedback if pressure exerted on the teeth during intubation Laryngospasm simulation Bilateral carotid pulses with normal weak and absent settings Torso Bilateral lungs Auscultation of breath sounds Left right or bilateral lung obstruction Chest compression sensors Precordial thump sensors 3 4 lead ECG monitoring ECG monitoring via defibrillation connectors Defibrillation connectors for AED or Manual defibrillation
7. Laerdal ALS Skillmaster Directions for Use LAUIUC MLW YINIIIIQAOLUI CONTENTS Limited Warranty an curn ERES AREE REPE 2 Cautions and Warnings lille 2 1 Main Components 000 0c eee 3 2 System Features 4 3 Getting Gate 7 4 Maintenance and Repair 055 8 9 Iechhical Data s ide due Pov E REDDE been pee 10 6 Pans Slee sob esate ese ee bower se eee kes 11 Limited Warranty Laerdal Medical warrants to the purchaser that its pro ducts are free from defects in material and workmanship for a period of one 1 year from the date of purchase by the original user During the designated one 1 year period Laerdal Medical will upon receipt of a product found to be defective due to materials or workmanship from the purchaser and notification in writing of the defect at its option repair or replace any parts found to be defective or the entire product Products found to be defective and notification of defects may also be sent to the authorized Laerdal Medical dealer from whom the product was purchased All postage shipping or handling charges shall be the sole responsi bility of the purchaser Laerdal Medical is responsible for the effects of safety reliability and performance of its product s only if service repair readjustment or modification is carried out by Laerdal Medical or persons authorized by Laerdal Medical the electrical installation of the roo
8. a depth of more than 2 mm will be recorded as a precordial thump LQAUIUC MLW VTINIHIIELPLICUOUUI Introduction 2 1 8 ECG monitoring The manikin is equipped with separate defibrillation and ECG monitoring connectors The system provides 3 lead ECG reading lead Il HI Caution These connectors are designed for ECG monito ring only If defibrillation is attempted over any of the ECG connectors it may cause high voltages to be present on one or more of the uncovered connectors during the shock See the Cautions and Warnings section Defibrillation attempt will also damage the internal electronics which may have to be replaced 2 1 9 Defibrillation The manikin is equipped with two defibrillation connectors The ECG signal can also be monitored across these con nectors The instructor can via the Heartsim 4000 use the Ignore Defib function to choose whether or not the defibril lation shall result in conversion to a perfusing rhythm Manual paddle adapters are supplied for use with manual defibrillators Caution Defibrillation must be performed over these two connectors only See the Cautions and Warnings section on page 3 2 1 10 Pacing The manikin can be externally paced via the defibrillation connectors The pacing threshold is variable and is set by the instructor via the Heartsim 4000 2 1 11 Sound The manikin can make 3 sounds controlled by the instructor via the Heartsim 4000 breathing mo
9. aning vomiting 2 1 12 Arms Left Arm In the left arm standard catheters can be positioned in either of the three pre made holes The hole on the back of the hand is sealed and needs to be pierced before first time use This solution has been chosen to provide optimum liquid storage capacity in the arm for users who do not require using this hole Realistic drug dosages can be given The left arm is a hollow reservoir that can collect injected fluid After the training session the arm can be dismounted and emptied through the drain plug located on the back of the shoulder The hole on the wrist allows simulated drawing of samples for blood gas analysis This hole is also sealed when the manikin is new and needs to be pierced before using it for the first time A blood pressure cuff can be positioned on the arm Right Arm The right arm is a Laerdal IV Arm which is also available separately cat No 09 00 21 There are two main IV access areas on the Laerdal IV Arm On the back of the hand and at the antecubital fossa ACF on the upper arm To gain IV access in these two areas specially designed soft pads can be placed in the recesses of these two locations The pads are pre filled with blood and can be used for practice immediately after unpacking and assembly There are two types of pads for the arm one pad to fit onto the back of the hand and one to fit into the ante cubital fossa The hand can be turned 180 deg
10. ent BR6 OHX Tel 01689 876634 Fax 01689 873800 Germany LAERDAL D 81249 M nchen Am Loferfeld 56 Telefon 089 864 20 00 Telefax 089 864 34 84 France LAERDAL MEDICAL FRANCE S A Silic n 5 1 rue des Vergers 69760 Limonest T l 04 72 52 02 52 Fax 04 78 35 38 45 Italy LAERDAL ITALIA S R L Via dei Lapidari 13 40129 Bologna Tel 051 320087 Fax 051 320137 Spain LAERDAL ESPANA S L Manuel Tovar 19 28034 Madrid Tel 91 7291110 Fax 91 7291125 Benelux LAERDAL BENELUX N V Business Park Luchthavenlaan Jan Olieslagerslaan 33 B 1800 Vilvoorde Tel 32 2 253 36 96 Fax 32 2 253 36 90 Australia LAERDAL Pty Ltd ACN 003 817 490 23 Edward Street Huntingdale Victoria 3166 Tel 03 61 3 9569 4055 Toll free 1800 331 565 Fax 03 61 3 9569 4028 Toll free 1800 635 835 Far East LAERDAL Far East Rep Office 7A Dalhousie Lane Singapore 209676 Tel 292 2880 Fax 292 3212 Sweden LAERDAL MEDICAL AB Box 2064 132 02 Saltsj Boo Tel 08 7150300 Fax 08 7471648 Finland LAERDAL OY Vattuniemenranta 2 00210 HELSINKI Puhelin 09 692 77 22 Tilaukset 09 692 76 22 Telekopio 09 692 77 99 Denmark LAERDAL DANMARK Postbox 109 DK 8883 GJERN Tel 80 333 112 Fax 80 333 555 Norway LAERDAL P O Box 377 N 4001 Stavanger Tel 51 51 17 00 Fax 51 52 35 57 e M em
11. ikin Physical dimensions Body without legs and arms Dimensions Weight With legs and arms Dimensions Weight Defibrillation monitor electrodes Max defibrillation voltage Max energy per shock Max average energy per minute Min energy per shock for defibrillation detection on defibrillation electrodes Pacing detection Environmental conditions Temperature Operating Storage Humidity Data 100 240 VAC 50 60 Hz 9 VDC 2A max 80 x 40 cm 31 1 2 in x 15 3 4 in 11 6 kg 25 1 2 Ibs 173 x 55cm 68 1 8 in x 21 5 8 in 15 8 kg 35 Ibs 5000 V 360 J 720 J 2 shocks per minute 10 J 20 200 mA 15 C 35 C 59 F 95 F 0 C 50 C 32 F 122 F 15 90 RH non condensing The serial number of each ALS Skillmaster is imprinted in the bottom plate of the torso on the outer side facing the lower body CE The product is in compliance with essential requirements of council directive 89 366 EEC EMC directive 6 Parts list 08 21 11 09 21 01 09 21 02 09 21 10 09 21 03 29 06 02 ud 2900 11 2001 OT 2901 09 2902 10 29 02 30 2903 10 23 03 30 2906 00 29 06 02 29 06 03 29 06 04 2907 00 29 08 OD 29 08 00 29 10 00 29 11 00 29 12 30 29 12 35 29 31 00 ALS Skillmaster markir Parts Heacd to body coupling wil head fastener and screws Haltainer sat tower body Chast skin ALS no electronics Chast skin wilh 4lead ECG amp loacibax
12. inge next to the head 2 1 1 The head Head tilt f the head tilt angle is greater than 27 degrees and Airway Obstruction is not activated the airway valves will be open 2 1 2 Airways and lungs The manikin contains two lungs with separate volume Jaw thrust lf jaw thrust is performed and Airway detection Maximum volume per lung is 1000 ml Obstruction is not activated the airway valves will be open The system is not developed to perform PEEP controlled ventilation Please note that thorough cleaning of the upper airways as well as changing the lungs is necessary if mouth to mouth or mouth to nose ventilation has been performed on the manikin See sections 4 3 4 5 and 4 6 Carotid pulse When the manikin is used with the Heartsim 4000 a bilateral palpable carotid pulse syn chronous to the simulated ECG is generated the pulse is alterable via the Heartsim 4000 for 3 strengths Normal Weak Absent Care should be taken when palpating the carotid pulse so as not to use excessive force as this will result in no pulse being felt Introduction 2 1 3 Intubation The manikin is intubatable The instructor can indicate that intubation has been performed This will cause the airways to stay open even if the head is tilted less than 27 degrees and jaw thrust is not performed If the manikin is intubated too deeply the tube will pass into the right bronchus and cause only the right lung to be ventilated
13. led with liquid to a point just over the internal ridge Attach stomach and lung connectors to the triple connector of the clean ing pump assembly Put the free tube end into the container Insert the cleaning syringe into the ope ning of the valve Circulate liquid through the airways by pumping the syringe plunger A sodium hypochlorite solution prepared for single class use is an effective and recommended disinfectant This solution should have at least 500 ppm free available chlorine i e gt 22 ml of 2 5 5 0 6 household bleach per 500 ml of water 10 Use this setup to go through the following four steps changing liquid in the container for each new step 1 Use soapy water to remove condensation on interior surfaces 2 Use clean water to remove soap residue 3 Use disinfecting solution Allow airways to remain completely filled for at least 10 minutes 4 Use clean water to remove disinfecting solution After each step lift the face clear of the liquid to allow drainage Allow to dry completely before reconnecting head to manikin 4 6 Cleaning airway valves Disconnect the upper and lower airway tubes from each of the valves Turn the valve houses and lift out of their bases Clean the valve houses using the 4 steps described in section 4 5 and allow to dry completely before placing them back in their bases 5 Technical Supply voltage Supply voltage Link Supply voltage Man
14. m where the product is used complies with pertinent national requirements the product is used in the proper manner in strict compliance with its Directions for use Laerdal Medical shall not be liable under this warranty for incidental or consequential damages or in the event 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 war ranty does not cover batteries fuses normal wear and tear staining discoloration or other cosmetic irregularity which does not impede or degrade product performance Some states in the USA do not allow the exclusion or limi tation of incidental or consequential damages so those limitations or exclusions may not apply to you There are no other express or implied warranties whether of merchantability fitness or purpose or otherwise on the product its parts and accessories Cautions and warnings Do not connect the product to a patient Use of a defibrillator for training purposes represents an operational hazard equivalent to use of a defibrillator on a real patient since it involves the release of high levels of electrical energy into the training manikin Consequently All safety precautions for use of defibrillators must be followed as if the manikin were a patient Consult the user s manual of the defibrillator being used Defibrillation should be performed on the defibrillation
15. pad first use the flat tool enclosed in the pack of the new pad to remove the old pad Snap the new pad into the recess 4 2 Opening the manikin Lift up the edge of the skin on the side of the manikin Unsnap the clips connecting the rib piece to the back porti on When all four clips have been loosened carefully lift up the chest and fold it to the manikin s right side 4 3 Replacing lungs Pull out the stomach WW pad and stomach plate Unsnap the lung straps on either side of the chest plate and lift the chest plate up from its base Introduction Disconnect the plastic tubes from the lower end of the magnetic airway valves Loosen the plastic lungs from the chest plate by pushing the tubes from below upward through the holes in the chest plate Lift off the lungs and pull the tubes through the chest plate Unpack the new lung set and guide the lung straps through the circular hole in the lungs Note the colour marked on the tube and insert the tubes into the holes marked uw with the same colour on the chest plate Snap the lungs in place on the chest plate Check with the illustration to make sure the lungs are correctly positioned and not mounted upside down Connect the ends of the plastic tubes to the lower ends of the air way valves so that the colour markings on the tubes and on the valves match Position the lung plate back into its base Snap the lung stra
16. ps back in place on both sides of the chest plate LUVI UGUI NLY VINHIIELPLICUOUUI 4 4 Replacing stomach Disconnect the lower stomach tube from the lower end of the sto mach valve Undo the stomach bag by push ing the stomach tube from below upward through the hole in the stomach plate Pull the tube up through the stomach plate Unpack the new stomach Insert the tube down through the hole in the stomach plate and reconnect it to the sto mach valve Snap the stomach bag in place on the sto mach plate To reposition the sto p mach plate insert the j peg at the upper end of k the stomach plate into E the slot under the chest plate and then snap the lower end in place over the two steel pins 4 5 Cleaning upper airways The head must be removed in order to clean the upper airways First of all open the manikin as described in section 4 2 Disconnect the upper airway tubes from the airway valves Disconnect the sto mach tube from the thick transparent oesophageal tube LAUIUCAl MLW YINIIIIQAOLUI Introduction Disconnect the thin tube connecting to the Y piece in the neck Disconnect the cables from the sockets marked Head and Head Pulse 2 on the lower box inside the body Gently turn the head around until it releases from the circular soc ket in the torso shell Place the trainer s head face down dia gonally in the plastic sanitation kit container fil
17. rees from palm facing down to palm facing up to obtain the best position for IV access in the hand The shoulder link allows for upwards and sideways move ment of the arm 3 Getting Started 3 1 Assembling the manikin Unpack the manikin and the arms from the case Place the manikin on a surface and attach the arms to the shoulder attachments Make sure that the arms are pushed into place before they are lowered The procedure to put the IV pads in place is the same for both types of pads pur Unpack the pad from its carton Snap the pad into place into the recess in the arm that has the shape correspon ding to the pad Fold up the lower part of the stomach skin and attach the lower body to the two pegs on the torso Fold back the stomach skin and pull up the trouser waistband LUVI UGUI MLW kd MII IG 3 2 Connection to the Heartsim 4000 One lead into the manikin provides all power and data communication Unpack the Heartsim 4000 Link and connect this to the main power and the computer Connect the manikin lead to the Link NB Do not start the Heartsim 4000 program on the computer until all manikin or Link connections have been made LAUIUCAl MLW YINIIIIQAOLUI 4 Maintenance and Repair A cleaning kit for the upper airways is included with the product Spare lower airways a stomach bag anda replacement IV pad of each type are also included Note Wear gloves during cleaning Vinyl gloves are
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