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User Guide Maternal Fetal Simulator

1. ABP Arterial Blood Pressure CO2 Capnogram CVP Central Venous Pressure ECG aVF ECG Lead aVF ECG aVL ECG Lead aVL ECG aVR ECG Lead aVR ECGI ECG Lead ECG II ECG Lead Il ECG Ill ECG Lead Ill ECG V1 ECG Lead V1 ECG V2 ECG Lead V2 ECG V3 ECG Lead V3 ECG V4 ECG Lead V4 ECG V5 ECG Lead V5 ECG V6 ECG Lead V6 PAP Pulmonary Artery Pressure Pleth Optoplethysmograph 327 CAE Fidelis Numeric Widget Displays Display Physiological Variable Alveolar Enflurane Alveolar Enflurane Alveolar Halothane Alveolar Halothane Alveolar Isoflurane Alveolar Isoflurane Alveolar Nitrous Oxide Alveolar Nitrous Oxide Alveolar Sevoflurane Alveolar Sevoflurane BP C O Blood Pressure Cardiac Output Cervix Dilatation Cervix Dilatation CTG FHR Cardiotocography Fetal Heart Rate CVP Central Venous Pressure EtCO2 End Tidal Carbon Dioxide FHR IUP Fetal Heart Rate Intrauterine Pressure FHR TUA Fetal Heart Rate Transabdominal Uterine Activity Hb Hemoglobin Hematocrit Hematocrit HR Heart Rate CR Intracranial Pressure Ischemic Index Ischemic Index MAP Mean Arterial Pressure PACO2 Alveolar Partial Pressure Carbon Dioxide PaCO2 Arterial Partial Pressure Carbon Dioxide PAO2 Alveolar Partial Pressure Oxygen PaO2 Arterial Partial Pressure Oxygen PAP Pulmonary Artery Pressure PCWP Pulmonary Capillary Wedge Press
2. The Mannequin Setup Screen Prepartum and Latent Phase 352 ZW CAE Healthcare Muse Mannequin Setup Screens Mannequin Setup Screen for an Active Phase Breech SCE Once an active phase breech SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Mise software Mannequin Setup Active Phase Active phase Breech Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Remove rotation ring 4 Install fetus support tub and let the 7 Install prepartum abdomen placenta pouch rest over it 5 Attach umbilical cord to delivery fetus 2 Use delivery birth canal 3 Install uterine funnel with delivery cervix 6 Install delivery fetus Presentation Breech Station 3 Cancel Continue The Mannequin Setup Screen Active Phase Breech Presentation NOTE Active Phase means non delivery 353 M se Mannequin Setup Screens CAE Fidelis Lucina Mannequin Setup Screen for an Active Phase Vertex SCE Once an active phase SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Muse software Mannequin Setup Active Phase Active phase Vertex Make sure the mannequin is setup as follows BIRTHING MECHANISM
3. 338 Recommendations for Use M 338 Wireless Voice Link Devices me 339 xxiv ZW CAE Healthcare Table Of Contents Physical Features yada oni DERE ERREUR DAR CLERO 340 Preparing the Base Station in the Simulator eere rere eere ener entren enun 341 Preparing the Handset for Use scissssisessesssssscessescsssncensensvsovesosnsvsonsennsdsesenaenasdsasnnessoaseesonees 342 Selecting the Radio Frequency Channel 4 eeereeee eere eerte eene enean ntn tnanao 342 Powering Up the WVL Pall uuasvecveeccd mene necd a pn oen Viro ndn n o Rn en nA 343 Using the iPhone Standalone Microphone eere entere eene tn tnn nnn 343 Special Handset Settings 4 uoi rcp PAR RR RUD MM RUD A FER EKUUA ERREUR NIRE CAU DAR EO DRAE 344 Battery Capacity IMGiC ates soci issaswasnassvaswandsasenneieavssessiassemisnsnsispnatsuismisnnatnsnipsaivessnisdnniesinusin 345 Hl m assess 345 Power Problems REN RE aimee eee nai 345 Audio Mets LE oes sckcsescczcraqacsenstnsaverseaseatestscncocuectorarsenenawtinic ectscgesuanstesaavnrern namin 345 RF Channel Initial Operating Frequencies cscssssssssssssssssssssssssssssssssssssssesssssssesssseeses 347 Fidelis Lucina Medication Information csssccssssssssssssssssssssssessessssesnssesnesesseseesers 349 M se Mannequin Setup Screens 4 creer een
4. IQ 288 Bronchial Resistance Factor Left and Right sssssssssssscsesesssssssesssssssesssssssesessseessessesssccsssecssneesses 288 Pizirgspr me P MP 288 Fraction of Inspired Enflutalle iua causae metta iagu dial breeds tnlehitusi san edat t RR 289 Alveolar Halo IA BO uoce sicat aseo Qa pep edt ea carpi ER asistini ha ied didi 289 ZW CAE Healthcare Table Of Contents Fraction OF Inspired Halothane o tin dO GR Er DERI PED RR HERE MR DUREE 289 Alveolar So OB icio cos cpessalcatancdctcgve acess cetsacecheu a aeaanabontas adie R ru mar cR ribns 290 Fraction of Inspired eof Falle iso ida ag SEES IERI RUUDL FOU ERE LIQURH UU VOD OR ERN BEARE RA 290 Alveolar Nitrous ORB cni bv IRR rt Ion dU on RN IB EUM A QURE DB o Ub Pu SUPCR UNE 290 Fraction of Inspired Nitrous OXICE oa osa odori tamea n ERR D GN xe RO nta d ona OR donantur 29 Alveolar Sevoflurane sso tpe tmdeed nsi en pmet eb RD RIED NR BEEN PAL EET 29 Fraction of Inspired SevVorDUTafibas ose nda dd tna RUP QR RR REPRE ERES HI DE 29 Cardiovascular Basic Parameters 4 1 eeeeee eese ee eee teens teta tata stats inen ea tasas nuo 292 Blood PIOSSUEE conet p ITEENU POIs UEPEAR V URS M ERU dO He Am RUSE 292 Heart Rale RR E M 292 Heart Rate F AU EMINET PH CT TTE 293 Cardiac RAYT cis 293 itle T 295 Central Venous Catheter suos telis iR rini epd irure o a ru
5. Monday through Friday 8 00 AM to 5 00 PM customer s time zone Holiday and non business days excluded Support outside principal period is billed at the premium rate hourly rate x 1 5 A minimum of 48 hours notice is required for scheduling an on site support call Urgent on site support with less than 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 How to Contact Customer Service For customer service please contact CAE Healthcare 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 customerservice caehealthcare com Website 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 can service caehealthcare com 241 Care and Maintenance CAE Fidelis CAE Healthcare Customer Service Europe Middle East and Africa Monday Friday from 8 00 a m to 5 00 p m CET Phone 49 0 6131 4950354 Fax 49 0 6131 4950351 Email international service caehealthcare com CAE Healthcare 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
6. Once the mannequin and the Instructor Workstation are both powered on they automatically establish a wireless connection and when the Internet Explorer browser is opened the M se software launches If the auto connect does not occur perform the following steps a Click or tap on the Wireless Network icon in the task bar b Select the simulator wireless network The network is called mfsxxx and the password is caeadmin the password is case sensitive c Click or tap the Connect button The wireless connection is established The M se software can now be launched using Internet Explorer For more information on starting the application see the Using M se section of this user guide 16 ZW CAE Healthcare Setup Step 6 Connect a TouchPro Workstation to the Wireless Network Optional The CAE Healthcare TouchPro workstation comes pre configured for use with the simulator If you wish to supply your own computer to run the TouchPro software the computer must meet the system requirements and must join the simulator network prior to use The simulator and Instructor Workstation form a local area network with static IP addresses To incorporate an additional computer to run TouchPro the computer s network properties must be configured to join the simulator network Contact the system administrator for your institution or CAE Healthcare Customer Service to configure the network properties if necessary NOTE Th
7. RF Channel Frequency 1 GHz Frequency 2 GHz 0 2 402 2 480 1 2 405 2 477 2 2 408 2 474 3 2 411 2 471 4 2 414 2 468 5 2 417 2 465 6 2 420 2 462 7 2 423 2 459 8 2 426 2 456 9 2 429 2 453 10 2 432 2 450 11 2 435 2 447 12 2 402 2 480 13 2 404 2 478 14 2 406 2 476 15 2 408 2 474 16 2 410 2 472 17 2 412 2 470 18 2 414 2 468 19 2 416 2 466 20 2 418 2 464 21 2 420 2 462 22 2 422 2 460 23 2 424 2 458 24 2 426 2 456 25 2 428 2 454 26 2 430 2 452 27 2 432 2 450 347 Wireless Voice Link CAE Fidelis Lucina RF Channel Frequency 1 GHz Frequency 2 GHz 348 CAE Healthcare FIDELIS LUCINA MEDICATION INFORMATION The following table details the new medications available for administration in the M se software specific to the Fidelis Lucina simulator Each medication is listed along with whether the medication affects the patient s physiology modeled or log only the medication category and the application of the medication Medication Mode M Modeled Category L Log only Fidelis Lucina Simulator Application Atosiban M Tocolytics Used to supress preterm labor Does not have U S FDA approval Betamethasone L Corticosteroids For preterm delivery Used to stimulate fetal lung maturity Carboprost L Uterine Used in management of postpartum tromethamine stimulants hemorrhage PPH due to uterine atony Dinoprostone L Cervical Used to r
8. The Language icon The Info icon The M se Login Screen The icons in the bottom left corner of the screen provide access to additional information about the software Clicking the Info icon to access the Info menu From the Info menu users can select from the following options o Select About to access information about the M se software version the type of simulator and the serial number e Select User Guide to download the user guide English version To access the User Guide in other languages please visit www caehealthcare com and click the Support link o Select Support for CAE Healthcare Support contact information Click the globe shaped Language icon in the bottom left corner to change the language of the M se software 3 On the Login screen enter the Username and Password in the appropriate fields to access M se 62 ZW CAE Healthcare Using M se The system default Username is admin and the default Password is admin Username Password The M se Login Fields M se opens to the Home page Navigating the Home Page From the Home page users can run create edit search for and print SCEs The Home page can be accessed by clicking the Home button in the upper right corner of the M se software or on any screen without a Home button by clicking the Return button in the upper left or right corner of the screen The Account Profile The System Administration button butt
9. The Early Deceleration Magnitude parameter determines the magnitude of the early decelerations in the fetal heart rate signal The selectable options are None Mild Moderate and Severe Default None 307 M se Parameter Descriptions CAE Fidelis ucina Late Deceleration Amplification Factor Fetal heart rate FHR late decelerations associated with uterine contractions UCs are attributed to reductions in oxygen supply from the mother The Late Deceleration Amplification Factor parameter allows for greater control over the amplitude of late decelerations in conditions where they would be expected notably for the fetal patient with placental insufficiency In addition use of this parameter allows the instructor to demonstrate late decelerations for the normal fetus in the cases of maternal hypotension and uterine hyperactivity The Late Deceleration Amplification Factor is a multiplicative factor applied to the oxygen distribution in the fetus Values above 1 0 speed up the propagation of reduced oxygen levels from the placenta to the fetal arteries Default 1 0 Range 1 0 5 0 Shoulder Dystocia The Shoulder Dystocia parameter needs to be set to Enabled to activate the condition of Shoulder Dystocia When Enabled fetal descent will be interrupted when the fetal head has been delivered and restituted Now in shoulder dystocia condition will be logged in the event log and the numeric station indicator in the Graphic widget wi
10. The abdomen latch post The mannequin torso hole The Abdomen Placement The abdomen is ready for use IMPORTANT Use only the lift straps attached to the abdomen to lift and remove the abdomen from the mannequin s torso The lift straps The Abdomen Removal CAE Healthcare Configuring the Mannequin Non Gravid Non Pregnant Abdomen IMPORTANT Ensure the birthing mechanism on the mannequin is at the highest position and the Leopold Tub is installed for support 1 Locate the speaker system cable inside the abdomen shell The Speaker cable The Non Gravid Abdomen Speaker Cable 2 Plug the cable into the corresponding connection inside the mannequin s torso The Abdomen Speaker Connection 41 3 Latch the abdomen shell into the mannequin s torso and ensure the speaker cable is not pinched or constricted The abdomen latch post The mannequin torso hole The Abdomen Placement The abdomen is ready for use IMPORTANT Use only the lift straps attached to the abdomen to lift and remove the abdomen from the mannequin torso The lift straps The Abdomen Removal 42 CAE Healthcare Configuring the Mannequin Disconnecting the Umbilical Cord To disconnect the umbilical cord from placenta push down on the gray disconnection ring and pull the blue tubing out of the connection port The gray disconnection ring The Umbilical Cord Pla
11. removing the rotation ring Do not place pressure or any object on the rotation ring support arms while the rotation ring is removed 21 Configuring the Mannequin CAE Fidelis Lucina Installing the Static Cervix Prepartum and Latent Cervix Installation To install a static cervix for a prepartum and latent SCE 1 Remove the uterine funnel with delivery cervix by lifting the part up and out of the mannequin s pelvis The uterine funnel The delivery cervix The Uterine Funnel with Delivery Cervix Removal 2 Install the prepartum birth canal NOTE The prepartum birth canal is installed within the standard birth canal To install the prepartum birth canal a Using the cottonseed oil provided lightly lubricate the inside of the standard birth canal the labia the perineum and the vaginal labia of the prepartum birth canal 22 CAE Healthcare b Place the prepartum birth canal inside the mannequin s torso and pull the perineum section out through the standard birth canal The labia The Prepartum Birth Canal c Tuck the skin shorts over the extended flaps To install the static cervix lubricate the anterior part of the selected cervix and insert at the posterior end of the prepartum birth canal with the arrow pointing upward The static cervix The Prepartum Birth Canal and Static Cervix 23 Installing the Backplate Prepartum and Latent Backplate Installation To install the backplate fo
12. CAE Healthcare Setup Step 3 Power on the Fetus To power on the fetus a Priorto powering on the simulator ensure the fetus has fully charged batteries For more information on charging the fetus see the Care and Maintenance section of this user guide b Locate and press the power button on the back of the fetus The Power button The Back of the Fetus A green light will begin blinking in the umbilical indicating the fetus is powering up When the umbilical light begins alternating between green and orange the fetus is powered on and communicating with the maternal mannequin When the umbilical light is a solid green the fetus is running with good battery NOTE When the umbilical light is a solid orange the battery life for fetus is less than one hour The Power indicator light The Front of the Fetus IMPORTANT Each fetus is specifically configured to connect to its designated maternal mannequin The last three digits of the maternal mannequin s serial number are located on the back of the matching fetus under the skin below the USB power port If there are multiple units keep each fetus with its designated maternal mannequin at all times For more information on charging the fetus batteries see the Care and Maintenance section of this user guide Step 4 Power on the Instructor Workstation To power on the instructor workstation a Place the Laptop or Tablet Instructor Workstat
13. The Audio Setup Window 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 173 Using the TouchPro Patient Monitor CAE Fidelis Lucina 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 The Close button ht E Lp lll o nA I tir ies Pans M j Li V V 3 aI n 4 y VA M JA L J m y Ada PARSI StS SES pee PS Y SD d y 4 A H E z 4 A d JL sie ioe The Print button A 12 Lead ECG Report The report can be printed or saved by clicking the Print button in the bottom right corner of the 12 lead 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 orientation 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 Macintosh or Windows 174 ZW CAE Healthcare Using the TouchPro Patient Monitor To save the report to a PDF file on a Macintosh Instructor Workstation 1 From the 12 lead ECG report screen click the P
14. The Scenario Designer 125 Using M se CAE Fidelis Lucina Scenario Designer Views The Scenario Designer has two views the Graphical view and the List view The Graphical view allows users to map out scenario states The List view places the states and transitions into a linear format The Graphical x Scenario kg D ez New State gt Collapse All Yi Expand All The List View button View button The Scenario Designer View Buttons Click the Graphical view button to utilize the Graphical View A Normal Delivery ad Lo New State b Collapse AN Y Expand All ei The An Collapse expanded State state button The Graphical View From the Graphical View double click on any state to expand it and view all its components Click the Collapse State button to collapse an expanded state Click the List view button to utilize the List view The List View From the List View click the Expand Contract arrow to the left of any state to expand it and view all its components Click the arrow again to collapse the state 126 ZW CAE Healthcare Using Muse Adding Scenario States When beginning to create a new scenario the canvas is blank Scenario states can be created by dragging and dropping conditions from their respective menus on the right side of the Scenario Designer to the canvas Drag and drop a condition onto the canvas to create a state 4 Cardiovascu Q BP Hypoten
15. nasisS 9 Step 1 Place Mannequin in the Work Area ee eee eene erento eoe rnonuo 10 Step 2 Power on the Maternal Mannequin eee eee eren eere roto rn eet tnonoe 11 Step 3 Poweron the Fetus me 13 Step 4 Power on the Instructor Workstation csssscsscsssssssssscsssssssssssessessessessassssessessasens 14 Step 5a Connect to the Wireless Network Laptop Instructor Workstation Macintosh 15 Step 5b Connect to the Wireless Network Laptop or Tablet Instructor Workstation Windows 16 Step 6 Connect a TouchPro Workstation to the Wireless Network Optional 17 Configuring The Mannequin eere eere eene ener reete roe otn etas tn ena ena tanta enata 19 Ij mee 20 Removing the Rotation Ring siciscssssecsessssovsossessconseeseasnsonsenseasnscosenoesssnsesenowsesasensesenseaseoonsenses 20 Installing the Static Cevik aod vina igi gl vedono donne orba band dl n 22 Pr partum atid Latent Cervix Inst llatigii iuusucoscosci sott Eee titor e UD Et Petr noeh 22 Hr nud rim 24 Prepartum and Latent Backplate Installation eese terne nntnnnnnnnnnn 24 Installing the Support Tubs P 25 Loading the Fetus un 25 Prepartum and Latera shen ptt pd Pado
16. Apply the desired conditions interventions and parameters 2 Click the Event Recorder button at the bottom of the M se screen 4 0 Event Recorder The Event Recorder Button 102 ZW CAE Healthcare Using M se The Event Recorder appears displaying all events that have occurred since the start of the SCE Qo Event Recorder Whole Blood Infusion 17 mL hr Events Bag Valve Mask 75 FiO2 The Edit button l The Save State puron Save State Edit desc 2 1 The Clear button The Event Recorder WARNING The Clear button deletes all recorded events This action cannot be undone 3 Review the list of events If you wish to remove any events from the state to be saved a Click Edit A Delete button appears next to each recorded event Event Recorder Whole Blood inrait 17 Events miie r Delete buttons Bag Valve Mask 75 FiO2 The Done button The Save State button c Save State Done The Event Recorder b Click the Delete button next to each event to be removed The events are removed from the Event Recorder c Click Done 103 Using M se CAE Fidelis Luna The Delete buttons are hidden 4 Click Save State The New State Name window appears New State Name The Save button The New State Name Window 5 Enter a state name 6 Click Save The state is saved to the State Library and can be accessed via the Scen
17. Cancel Continue The Mannequin Setup Window In the Mannequin Setup window instructions appear for setting up the mannequin for the selected SCE For detailed information on mannequin configuration see the Configuring the Mannequin section of this user guide IMPORTANT You MUST set up the mannequin as directed in the Mannequin Setup window before clicking Continue Failure to do so may result in damage to the mannequin and undesired behavior during simulation Ensure the mannequin is set up correctly and then click Continue The Run screen appears 70 ZW CAE Healthcare Using Muse Prior to continuing with the simulation wait a moment until the fetus is positioned at the desired station and position When the Position Station widget displays actual value instead of dashes the simulation may begin The Play Delivery button The labor clock SCE time controls The Stop button The Patient Records button Scenarios Physiological Condition display widgets ee E m M T PU Y S Medications and Em _ i ein uin Interventions PEEL palettes Event Logs aaa 2 2 The Event Recorder jb Trection Feedback M CHR Mentor The Run Screen NOTE The labor clock and Play Delivery button only appear on SCEs that use the vaginal delivery operating mode From the Run screen users can manage the SCE perform interventions view physiological status and events sav
18. Installing the Uterine Funnel with Dynamic Cervix The uterine funnel with dynamic cervix is used for active and delivery SCE configurations To install the uterine funnel with dynamic cervix slide the uterine funnel with delivery cervix into the grooves located on each side of the mannequin s pelvis The uterine funnel The dynamic cervix The Uterine Funnel with Dynamic Cervix Installed NOTE Lightly lubricate the dynamic cervix with the cottonseed oil provided to ensure the fetus will pass through without damaging the cervix The uterine funnel with dynamic cervix is now ready for use 28 ZW CAE Healthcare Configuring the Mannequin Loading the Fetus Delivery NOTE Prior to loading the fetus ensure that the descent mechanism is properly returned to the Home position Failure to do so will require the user to reload the fetus To manually return the rotation ring to the Home position 1 Press the upward arrow button on the Gripper button pad The Gripper Button Pad 2 Hold for three seconds after the rotation ring reaches the top of the descent mechanism and wait until the rotation ring rotates to the Home position 3 Ensure there are no kinks in the yellow tubing on the rotation ring NOTE If the SCE does not require loading a fetus ensure the descent mechanism is retracted to the most superior position prior to running the SCE Vaginal Delivery Breech To load the delivery fetus for a vaginal
19. Step 3 Power Off the SIMULATION acci a OR RUD HR RR REA RERO REUNIR CR 244 Step 4 Power Off the Fetus Loue and eri p dez ER SER ROS RUNS UA RN ORUHAEUN Uer UAR PURA A QUEM UR RUD 244 Maintenance oii cR 245 General Sim lat r Caressant RR in Hina puc Hd Rete ay 245 Storing the Simulatorin ebs 245 Caring for Electronic EQUIDR BHE cisco OT TH Hu P RR UR ROUEN A D P DR RR 246 Inspecting TREAT mb o E ardua etd aer ento D dl qu EE 246 Charging the Batteries 1er rcr bxo gib bte Has bipEr perinde Do bU AR 246 Charging the Fetus Bates unes tirado MORE REO precor UG Red RR CORR hen b n 249 Cleaning the Internal eg EE AEST TREO 250 Draining Condensation from the Simulator seen titan evite 256 Replacing the Standard BirtliCarial iaceo triti ebat Hetero wie teret 258 Respiratory DSA UE ALIN andes pc red hood PER bv o CE an CU no p cuim eR ad 271 Cardiovascular Blood PROS se ocooia DERE RASEN RE REDIERE RH RR DARUM UR UR NDEAE 272 Cardiovascular Heart CSI 273 Respiratory Respiratory Rate icons coste tncoMab di uti Dr RUN GEH eo dreba deed ten GOD NEUE 274 M se Parameter Descriptions fe 275 Neurological Parameters iooosssec uitiis tire nini ree i Rer Re RUPEE TH OX AS PE SEVE dU ROE 275 Eyes Pupil CODTIOL scusa t tedden eas rd eH pne COD D PR RI DEAN 275 Eyes BIO cxssusiseecruswesindencinvssinsotnn tr potrai onc PE P rtr pti lon cents po bec RR 276 Eyes Blink Speed aoa UE RERUM RATION E CDD DOG a
20. The Mise Start Screen appears I ToucliPro Patient Monitor TouchPro GS The Miise Start Screen 163 Using the TouchPro Patient Monitor CAE Fidelis Lucina 2 Select the TouchPro Patient Monitor icon When TouchPro Patient Monitor software launches the simulated patient monitor appears br min The TouchPro Display NOTE The capnogram waveform is not displayed on the TouchPro Patient Monitor software from the Instructor Workstation Capnogram information can be found on the clinical patient monitor if one is connected to the simulator 164 ZW CAE Healthcare Using the TouchPro Patient Monitor Modifying the TouchPro Patient Monitor Display The layout of the waveforms and numeric data shown on the software can be customized The software can show up to six waveforms plus an additional four numeric readouts Selecting a Preconfigured Layout There are six preconfigured CAE Healthcare Layouts Labor and Delivery preconfigured with a waveform and numeric readouts for ECG LEad Il and numeric readouts for SpO NIBP HR and body temperature ICU Arterial Line Only preconfigured with waveform and numeric readouts for ECG Lead II ECG Lead V ABP Pleth and a numeric readout for Body Temperature EMS ED Telemetry preconfigured with a waveform and numeric readout for ECG Lead Il and numeric readouts for SpO gt and noninvasive blood pressure NIBP ICU OR No CVP preconfigured with wavef
21. 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 344 ZW CAE Healthcare Wireless Voice Link 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 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 e 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 e Check that the cables from the simulator are installed in the base station correctly Audio Problems The sound output from the simulator is low when using a microphone on my lapel Increase the microphone gain
22. when clicked exports the data to a CSV file that can be stored on an external device The Clear All Logs option will delete all logs associated with the SCE 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 page The System Administration Button The System Administration screen is displayed The System Administration Screen Content Management To access the Content Management options from the System Administration screen click Content Management 139 UsngM se CAs luna From the Content Management options users can manage learning modules SCEs Base Patients Scenarios Conditions Patient Records and Vocalization List The Content Management button The Content Management options The System Administration Screen Learning Modules From the Learning Modules panel learning modules can be installed or deleted When the Content Management button is selected the Learning Modules panel appears by default If another panel has been selected return to the Learning Modules panel by clicking the Learning Modules link The Learning Modules link The Learning Modules panel The Install Learning Module button The Remove button The Learning Modules Panel To install a learnin
23. 90s 80s 40s 160s 100s 70s 40s 170s 100s 60s 30s 190s 110s 50s 30s 220s 120s 40s 30s 272 ZW CAE Healthcare Condition Guidelines for Programming Cardiovascular Heart Rate Tachycardia STET I8 Te E 70s 70s High 70s Mid 60s 80s Low 60s Mid 50s 90s 100s Low 50s 110s High 40s Mid 40s 120s 130s Low 40s 140s Mid 30s 150s Low 30s 160s 170s High 170s 273 Condition Guidelines for Programming CAE Fidelis p Lucina Respiratory Respiratory Rate Tachypnea Bradypnea 274 ZW CAE Healthcare Mise Parameter Descriptions MUSE PARAMETER DESCRIPTIONS Neurological Parameters The maternal fetal simulator can simulate a variety of neurological clinical indicators Neurological Parameters Eyes Pupil Control The pupil control 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 three pupil options that are used to control the diameter of the pupils in both eyes Pinpoint Blown or a Fixed Pupil Size 3 mm to 8 mm Default 5 mm 275 M se Parameter Descriptions CAE Fidelis ucina Eyes Blinking In Auto mode the eyes are normally blinking However the eyes will automatically clo
24. ABDOMEN 1 Remove rotation ring 4 Install fetus support tub and let the 7 Install prepartum abdomen 2 Use delivery birth canal placenta pouch rest over it 5 Attach umbilical cord to delivery fetus 3 Install uterine funnel with delivery cervix 6 Install delivery fetus Presentation Vertex Station 3 Cancel Continue The Mannequin Setup Screen Active Phase Vertex Presentation 354 ZW CAE Healthcare Muse Mannequin Setup Screens Mannequin Setup Screen for a Vaginal Delivery Breech Left Sacrum SCE Once a vaginal delivery breech left sacrum SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Muse software Mannequin Setup Vaginal Delivery Vaginal Delivery Breech left sacrum loading Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Install rotation ring 4 Power on delivery fetus and lubricate 7 Connect umbilical cord to placenta 2 Use standard birth canal lubricate 5 Attach umbilical cord to delivery fetus 8 Insert intact placenta in placenta pouch 3 Install uterine funnel with delivery cervix 6 Install delivery fetus Attach pouch to pelvis lubricate Presentation Breech 9 Install delivery abdomen connect speakers Loading Position Left Sacrum Transverse and palpable contraction system Cancel IN
25. Continue The Mannequin Setup Screen Vaginal Delivery Breech Left Sacrum Presentation 355 M se Mannequin Setup Screens CAE Fidelis Lucina Mannequin Setup Screen for a Vaginal Delivery Breech Right Sacrum SCE Once a vaginal delivery breech right sacrum SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the M se software Mannequin Setup Vaginal Delivery Vaginal Delivery Breech right sacrum loading Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 4 1 Install rotation ring 4 Power on delivery fetus and lubricate 7 Connect umbilical cord to placenta 2 Use standard birth canal lubricate 5 Attach umbilical cord to delivery fetus 8 Insert intact placenta in placenta pouch 3 Install uterine funnel with delivery cervix 6 Install delivery fetus Attach pouch to pelvis lubricate Presentation Breech 9 Install delivery abdomen connect speakers Loading Position Right Sacrum Transverse and palpable contraction system Cancel N Continue The Mannequin Setup Screen Vaginal Delivery Breech Right Sacrum Presentation 356 ZW CAE Healthcare Muse Mannequin Setup Screens Mannequin Setup Screen for a Vaginal Delivery Vertex SCE Once a vaginal delivery vertex SCE is selected the mannequin must be manually configured prior
26. Frequengy iicet le cnbes Duda pa ebur dett bn aet tee inde 320 Patient Baseline Parameters iiu ossis ica ni RENE Y IU R HRUEIRRE QU NM CX ERE TUN EIS IR EDU INR dE 320 Operating Mode sacrae ERR N GN REDE 320 Delivery Paused on RUN ase osten OX REOR Lu RU EDU FOCLERR tan nen o ROO ORI RE REUS AERA 321 Pastpaftuni Included scettr entra bake ni tog p DOE washes eat en npe Fo kid 321 ERI cie uvae ORO EEE EA E E whch chee dente a awed an eR DdInM den d 322 iz 2n me T TE 322 Initial Statio e 322 Vertex ROtAtION YB ccdsccesascctniesseasainicoasteianreainveslalareuendaudalaneiiniestornseliabinalnadiuntecaarm 323 xxiii Table Of Contents CAE Fidelis Lucina Breech Siri RC 323 Cond Prolapse doo ERROR RHET ERREUR DR GNO MERI HON DE 323 Warp T T ee 323 Placenta CONICUITIIOIN Meemm ETC E H 324 Postpartum Initial Uterine State 1 aortic irae itin tire obtinere toy erret 324 Postpartum Basic Parameters aissssscsssccssussisencessusenssoianesaassorensvasincanevevadinsasevevsannesansenstnates 325 Uterine Massage Mer 325 Resolve Boggy UIS Rt Er rrOU FRI UR OR ton EA Cd Rn t Ei ROPA 326 Inverted Uterus Can Be Revelteu i sooo pep teri mnl ahi D o beh 326 Postpartum Additional Parameters 4 eceeeee eere eere entere treten eno tn sensns enata 326 Materiali Hel Ou acosc
27. Monitor The CTG Monitor Settings menu appears fr CTG Qu Alarm Suspension Time Qu Audio Setup The CTG Monitor Settings Menu 2 From the Settings menu click MNIBP Cycling The MNIBP Cycling window appears Manual MNIBP E T 2 mins 3 mins 5 mins 10 mins 15 mins 30 mins 60 mins Custom Cycling The Manual NIBP Window 3 From the MNIBP Cycling window select the desired interval for the cycling 4 Click Start 191 Using the TouchPro CTG Monitor CAE Fidelis Lucina The MNIBP Cycling window closes and the selected cycling interval is applied Custom cycling is also available by selecting the Custom Cycling option from the MNIBP Cycling window To display the patient s current MNIBP click the Manual MNIBP button FHR UA MNIBP 148 7 ie pedi ie 3 bpm MSpO2 98 6 5 US mmHg TOCO A Ea N Med Lhi IN en S S A eta ree IIIA ear tna TERLER PE a PERII ARAARA The Manual MNIBP d button The CTG Monitor Display The current MNIBP is displayed NOTE Manual MNIBP can be used at any time during cycling However this turns off auto cycling Resetting Tocography Noise The tocography information displayed on the CTG Monitor can be adjusted to represent TOCO probe error This is accomplished in M se using the TOCO Offset parameter accessed from the CTG Configuration Settings To eliminate probe error and restore TOCO Offset to the default zero value from the
28. Monitor press the Close button in the upper right corner of the medication Monitor window Resetting a Medication To reset a medication from the Medication Monitor click the Reset button on the Medication Monitor The Reset Medication dialog box appears asking you to confirm that you wish to reset the medication Reset Medication Reset the medication rocuronium The Reset button The Reset Medication Dialog Box The medication is cleared from the model and from the Medication Monitor With continuous infusions the amount infused goes back to zero but the infusion continues To stop the infusion you must select the medication from the medication library and set the infusion rate to zero 108 ZW CAE Healthcare Using Mise Returning to the Home Page To exit the SCE and return to the Home page click the Return button in the upper left of the run screen SER Return The Return Button The SCE continues running and the Home page appears To return to the SCE from the Home page click the Continue button in the SCE summary panel of the running SCE Abruptio Placentae Secondary to Cocaine Abuse Print SCE Alishia Stower 23 years old de Add To Favorites 66 0 kg Stannette Momtobe Vaginal Delivery Overview The learners will admit to the Labor and Delivery Unit and then care for a 23 year old gravida 1 para 0 woman in apparent distress She is accompanied by a disheveled man of sim
29. NSS MANU LOEO 276 Reactive DUDAS uoo e pida m rtp ona apt n br P Pra eU DOC CGU 276 Light Reactivity SPOR ssscescavssestssvexenes hate ORTOS QE OUT rt veo vocetur lisa EM 276 SCIZUEES P 276 Intracranial Pressure ICP seen retener tttm torto tette tonis 277 Neuromuscular Blockade NMB cessere tnter ntn niece 277 Temperature Body scacsucissscnevisncaesiisnnsrsensdnciessinilei Dp EREXU BU P Y RO use duismnaweanismumeiusiensin 27 Temperatur BIG Gusescoe oO D OA ptdien nb hop dme AUOD DOR RR ND PDA EAE 27 Respiratory Basic Parameters wscccsecoesccssssissscascossdaseivancesisusssseasssnsceiseseesviveassceashsauiasavastiars 278 Bronchial Occlusion Left and Right ssssssssscssssssssscsssssssscssnsssssccssnscsssscesnscsssscesnscssesessnscesasesssess 278 Respiratory Palast inar adi ap OR RR A OY ad A OR Rad de rU 278 xix Table Of Contents CAE Fidelis Lucina Respiratory Rate EdELUE aententia didit on d DD DEDE LE CU M CU ERA OR CR A RR ONE 279 EUM H 279 NER N P P E 279 Neuromuscular Blockade NMB esent ttntnntnnente teens 280 Tidal I Mer NURE Na 280 Intrapleural Volume Vol Left and Right eere nnn tnnnnnnn 280 Fraction f Inspired 02 FIOR castas abun tr ER QR RE RUM ERR DAVE EDI DME 281 Respirato
30. Proceed To Postpartum after the baby is marked as delivered do not stop the SCE However it is necessary to reconfigure the mannequin for postpartum configuration prior to proceeding This process may be completed before installing the blood tank or after installing the blood tank depending on which filling method is chosen internal or external For more information on selecting an SCE see the Using M se section of this user guide For more information on processes such as priming the genitourinary system epidural site or IV system see Using Lucina section of this user guide PREPARTUM Removing the Rotation Ring To remove the rotation ring from inside the mannequin s torso 1 Unfasten the yellow air compression tube at the baffle by pressing the metal release clip The Mannequin s Torso Rotation Ring Compressor Connection 20 ZW CAE Healthcare Configuring the Mannequin 2 Unfasten the clips on each side of the ring a Push the top of the clip out to unsnap b Push slightly down to unclip the bottom of the clip The rotation ring clip The Mannequin s Torso Rotation Ring Side Clip 3 Lift the ring out of the torso and place the rotation ring in a secure location for later use The Mannequin s Torso Rotation Ring Removed The mannequin s torso is empty and ready for the next piece of equipment to be installed CAUTION Avoid contact with any other part of the mannequin while
31. RE RU ER E pd EB ca and edu 295 Pulmonary Artery PA Catheter coss od perti tu IS RERO UD ROC EE UR UIN CORR UO NEQNE ODE RUE 296 Pulmonary Artery PA Balloon zucca dirti ivit teur pna S EROR Ue Pu PL Fa Bo PREX ER 296 Defibrillation Defib eese rennen ntntnntnne ntt en sentence 296 cni C 297 Pacing ID TS RENE 297 Pacing Capture TRrBSBDIG s cdidit addo eM HP D Prnt RCM EDU RARE dus 297 i fia TIS Tn RR 297 Cardiovascular Additional Parameters esee esee eere entente ente tnan enano 298 Baroreceptor Maximum PIBSSUEG oa ousatc arena nO R cod REEL e con LC 298 Baroreceptor Minimum PI Sstife ui ccce rsa estis t tee btt piu tte cade 299 Left Ventricle Contractility Fattor uaccusacisasicce qai aoa epi DERI MER GERE HU Reb etr Ub ped 299 Right Ventricle Contractility Fact os aeo HERES RU QU MERE en ARR Er RH HR RE 300 Systemic Vascular Resistance FaCtOr csscsesosusssossssnnsseonsosonscsosvorennsounnsconessannerdbassannsssbuoosnneonssecndosendssoe 300 Venous Capacity Factor sto peeteseaete ceases castes densi acit Rana sett dade ota ai sc ctn aa unt 300 Systemic Arteries Compliance Paetol coser deron hoa o ono En a RO ARDOR Prada 301 Pulmonary Arteries Compliance FattpE i iuassosa soon oneri too sette Sese RO ERI bett vb orga 301 Pulmonary Vasculature Resistance FactOr ssscssssssssscssssssssscssessssscsssnssesscsssnscesssessnsesssscesnscessseessess 301 Venous
32. S SpO shunt fraction Shunt Fraction Allows direct laryngos None required None required copy oral intubation and use of specialty airway devices Senses if ET tube is correctly inserted Normal tidal breath None required but None required ing and pathophysio adjustable logical conditions such as atelectasis pneu VIEW Respiratory mothorax asthma and COPD PARAMETER S Respi ratory Rate Respira tory Rate Factor etc Tracheal pathophysio None required but None required logic conditions such adjustable as pneumothorax VIEW Respiratory PARAMETER S Chest Wall Compliance Factor Tracheal intubation None required None required results in bilateral chest excursion and breath sounds Endo bronchial intubation results in unilateral chest excursion and breath sounds 206 ZW CAE Healthcare Using Lucina Respiratory Features Anatomy Physiology son Description Software Control Manual Control and Clinical Signs Venous Blood Gases PvO and PvCO are continuously calcu lated and displayed when selected for the Patient Status Display None required Realistic Upper Airway The upper airway of Lucina is designed to allow for intubation and laryngoscopy Oral intubation can be performed using a variety of airway devices including LMAs endotracheal tubes and oropharyngeal airways Sensors detect right mainstem intubation and the a
33. SCE Library appears The Learning Modules icon EK Learning Modules Preconfigured SCEs 1 0 The Learning Modules menu E SCEs The SCEs icon The Close Library button ds Close Library fe New SCE The SCE Library The Learning Modules menu is open by default The Learning Modules menu lists Base SCEs Preconfigured SCEs and all installed learning applications Click the desired learning application name to access its SCEs or click Base SCEs or Preconfigured SCEs The selected SCEs appear Clicking the SCEs icon reveals the SCEs menu which lists all user created SCEs Clicking the Learning Modules icon again reveals the Learning Modules menu To open an SCE click the name of the SCE Click Close Library to exit the SCE Library Base SCEs Base SCEs are fundamental SCEs with no scenarios and no progression of events Each base SCE is designed to provide facilitators with a baseline to run simulations on the fly or as a physiological baseline from which to design their own SCEs To access a base SCE from the SCE Library choose Learning Modules then click Base SCEs The base SCEs are displayed and available for selection 66 ZW CAE Healthcare Using Muse Preconfigured SCEs Preconfigured SCEs are training tools with scenarios and multiple states They are intended to be used for learner education and training To access a preconfigured SCE from the SCE Library choose Learning Modules th
34. Scenario Designer views The New State button is used to add new states Once created states are displayed on the Scenario Designer canvas Editing a Scenario To edit a scenario 1 From the SCE Editor under the Pre Loaded Scenarios heading click the Add Scenario button Pre Loaded Scenarios 4 Add Scenario The Add Scenario button The Pre Loaded Scenarios Heading 124 ZW CAE Healthcare Using Mise The Choose Scenario dialog box appears Scenarios 63 Name Last Modified Anaphylactoid Syndrome of Pregnancy 2013 09 04 09 30 12 Anaphylaxis 2013 09 10 11 16 35 Hyperemesis Gravidarum 2013 09 04 09 30 12 Scenarios Postpartum Hemorrhage Two Hours After Delivery 2013 09 04 09 30 12 Preeclampsia 2013 09 04 09 30 12 The Add The Search button Add New Q x field The Choose Scenario Dialog Box 2 Select a saved scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 3 Click Add The scenario is added to the SCE and is listed on the SCE Editor beneath the Pre Loaded Scenarios heading 4 Click the scenario s name under the Pre Loaded Scenarios heading The Scenario Designer appears displaying the selected scenario m gt muse Abruptio Placentae Secondary to Cocaine Abuse k boy Eee me deem state y Collapse all w Expand alt ALL CONDITIONS Cardiovascular nemore Meorokpa Respiratory Laterventions
35. 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 position of the standard oxyhemoglobin dissociation curve shift 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 277 M se Parameter Descriptions CAE Fidelis Lucina Respiratory Basic Parameters Respiratory Parameters Bronchial Occlusion Left and Right Turning on the Bronchial Occlusion parameter completely obstructs the right or left bronchi simulating a lower airway obstruction e g mucus plug Right and left bronchi can be 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 For example when the respiratory rate is set to 10 breaths per minute the respiratory rate remains at 10 breaths per minute reg
36. The medication selected also appears in the Medication Monitor OR 86 ZW CAE Healthcare Using Mise b Choose a route of administration to administer a custom dose Morphine s Intraosseous IO The custom 4 dose options Intramuscular IM leg only 1mgIV 2 5 mg IV 5 mg IV 10 mg IV 15 mg IV 20 mg IV 1 mg IO 2 5 mg IO 5 mg IO 10 mg IO 15 mg IO 20 mg IO 5 mg IM log only 10 mg IM log only The Medication Dose Menu The Custom Dose Administration menu appears Morphine s Intravenous Iv The 7 Administer button Presenter The Custom Dose Administration Menu 5 Enter the desired dose and click the Administer button The dose is applied and appears in the patient s physiology The medication selected also appears in the Medication Monitor NOTE Not all medications affect the patient s physiology but all are logged 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 87 UsngM se CAERidels luna that are made accessible in the Interventions palette for quick application Quick Links can also be created for the Conditions and Medications palettes To apply an intervention using the Quick Links in the Intervention palette click an Intervention Qu
37. The Set Alarm button button Set Color Set Alarm The Numeric Widget Options Panel Choose the desired option from the list and the widget changes to reflect the new selection 74 ZW CAE Healthcare Using M se From the numeric widget menu the Set Color button can be used to change the display color of the widget and the Set Alarm button can be used to change the alarm settings for the selected widget NOTE The information displayed on the CTG and Graphic widgets cannot be changed The Numeric Widget options that have two parameters displayed FHR IUP and FHR TUA cannot be changed The Event Logs During an SCE all software operations sensed by the simulator or entered manually e g virtual defibrillation setting a physiological parameter value are recorded by an event entry that appears on the screen The event entry notes what occurred and the time it happened Contraction Duration was set to 61 sec 00 34 11 Contraction Frequency was set to 5 ctx 10 min 00 33 55 Delivery progression has 00 33 46 resumed Scenario A Normal 00 00 00 Delivery started 00 00 00 SCE was started The Event Logs Displaying Patient Records Patient records can be uploaded to M se and displayed in the TouchPro software while an SCE is running To display an uploaded patient record 1 From the M se Run screen click the Patient Records button The Patient Records Button 75 Using M
38. Upon opening an SCE in the Muse software the Mannequin Setup screen automatically appears to assist users in the configuration of the mannequin and necessary equipment setup for the individual type of SCE The Mannequin Setup screen can also be accessed from the SCE Information drop down menu by clicking the SCE Title and Patient name in the upper left corner of the Mise Run screen The SCE Information drop down menu The SCE Title and Patient Name The Run Screen For more details on configuring the mannequin in accordance with the Mannequin Setup screen see the Configuring the Mannequin section in the user guide 351 M se Mannequin Setup Screens CAE Fidelis Lucina Mannequin Setup Screen for a Prepartum SCE Once a prepartum amp latent phase SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the M se software Mannequin Setup Prepartum amp Latent Phase Leopold maneuver or cervix evaluation Vertex Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN wm O 9 gt Li J 1 Remove rotation ring 4 Install Leopold tub 6 Install prepartum abdomen 2 Install prepartum birth canal 5 Rest placenta pouch over Leopold tub and install as needed Leopold fetus 3 Install static cervix Closed Presentation Vertex cancel Continue
39. ZW CAE Healthcare Muse Parameter Descriptions 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 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 saline into the pulmonary artery PA catheter The appropriate Thermodilution waveform and cardiac output measurement are then displayed on the Patient Status Display or TouchPro software 297 M se Parameter Descriptions CAE Fidelis Lucina Cardiovascular Additional Parameters Cardiovascular Parameters Additional Barorece
40. any of the electrical components other than changing the batteries Always use the supplied power adapter to charge or run simulator from AC 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 xi Cautions and Warnings CAE Fidelis ucina General Use Warnings Please observe the following warnings when using the Fidelis Lucina simulator 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 Donot operate the MFS 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 Bleeding System DO NOT modify the tank or any assembly component ALWAYS protect eyes skin and clothing against accidental exposure ALWAYS read and follow instructions for creating trauma fluids e g blood NEVER fill the tank with more than 2 liters 0 5 gallons of fluid e After use ALWAYS drain the tank DO NOT store liquids in the tank Transport Prior to using the stretcher packed with the shipping container th
41. appears 2 In the New Account Creation panel enter the user s personal data and choose a password 3 Assign the user to a group by selecting a group from the Group menu NOTE A user can only be assigned to one group 4 Click Create The new user is created and the New Account Creation panel disappears Editing a User To edit a user s information or privileges 148 ZW CAE Healthcare Using Mise 1 On the User Accounts panel select the user to edit 2 Click Edit The user fields become editable 3 Make the desired changes 4 Click Save Deleting a User To permanently delete a user from the User Accounts panel select a user and click Delete When the User Deletion Warning box appears click Yes The user account and the data associated with it are deleted However the administrative user deleting the account becomes the owner of any SCEs scenarios or patients created by the user being deleted i e the SCEs scenarios and patients created by the deleted user are moved to the deleting user s account Groups Users are assigned to groups to define access privileges To access the Groups panel from the System Administration screen click Groups The Groups panel appears The Groups ta b Groups Privileges The Groups panel The New button The ries The Save HER button The Groups Panel NOTE Groups functions are available only to users with the User Management or System Management privile
42. are changed by clicking in the relevant field and entering a new value in place of the existing one or using a slider to move through the range of parameter values until the desired numeric value is established Once a measured value is set that value overrides the physiologically modeled parameter value To return to a physiologically modeled value switch the slider in the parameter dialog from Override to Modeled Discrete Parameters Discrete parameters enable users to select one of two or more options 82 CAE Healthcare Using M se Discrete parameters are changed by choosing the appropriate option using a drop down menu or toggle switch In the image below the Patient Pushing parameter is shown The Patient Pushing parameter is set using a discrete parameter switch that toggles between Off and On r The toggle switch Patient Pushing Off The Patient Pushing Parameter Once the parameter has been set it is reflected in the patient s physiology Some parameters such as Reactive Pupils have two toggle switches one for the left side of the mannequin and one for the right The left toggle The right toggle switch switch Ye Reactive pupils Yes The Reactive Pupils Parameter When the Apply to Both Eyes parameter is set to On any change made to the left or right side is also automatically applied to the other side Apply To Both Eyes Oo The Apply to Both Eyes Pa
43. audio settings 1 Click the Settings button in the bottom right corner of the screen fF Settings The Settings Button 188 ZW CAE Healthcare Using the TouchPro CTG Monitor The CTG Monitor Settings menu appears fr CTG Qu Alarm Suspension Time Qu Audio Sodio The Audio Setup button MNIBP Cycling The CTG Monitor Settings Menu 2 Click the Audio Setup button The Audio Setup window appears Audio Setup The Close button Beep Sound Doppler Sound The Audio Setup Window 3 Select the desired alarm sound 4 Click the Close button The window closes and the selected alarm sound is applied 189 Using the TouchPro CTG Monitor CAE Fidelis Lucina Muting CTG Alarms All CTG alarms can be muted by clicking the Mute button in the bottom left corner of the CTG Monitor The Mute Button When all alarms are muted they remain muted until the user manually un mutes them by clicking the Mute button again MNIBP Cycling and Manual MNIBP When maternal non invasive blood pressure MNIBP is displayed the MNIBP can be updated at specified intervals using MNIBP Cycling or the current MNIBP can be displayed immediately using the Manual MNIBP button To set MNIBP cycling to update the MNIBP at regular intervals 1 Click the Settings button in the bottom right corner of the CTG Monitor display The Settings Button 190 ZW CAE Healthcare Using the TouchPro CTG
44. b cda and ddon Ra QU IN 25 Active ST RR E naa iai 26 DGLIVONY Et T 26 Installing the Rotation R ng uasnsnaedk erit d vera a Re D EROR EY ZH GEH UAR 26 Installing the Uterine Funnel with Dynamic Cervix eene eere enne 28 RIDE leet 29 Vaginal Delivery DOBBE II ooo eu togre tir REORUM RE hag tmb Rom rodeo 29 Vaginal Delivery VBITBX o esq osi RPM Prbn a Erba mb anS EGO brop at dno Ert cbtnd C RR DD 32 xiv ZW CAE Healthcare Table Of Contents Installing tne PIaCelbdo ode Add i PRA RR A nO EDDA CR CO POR Ln b DU RD QD EL 35 Vaginal Delivery Placenta Pouch Placement ssssssssssssscsssecsssssssnscssssesssscssssecsssccesseseseceessecessceessneesss 37 Installing the ADAOMOM 38 Delivery Abdomen Installation C jcveniosteaneieranaperdanis aie inamiidieudeinivanbeiumcad 38 Non Gravid Non Pregnant Abdomen c sssscssesssssscssssssssssssnscsssssssnscesssessnscssasecsssecessecssscesssecssssess 4 Disconnecting the Umbilical Cord ssssscsssssssssscsssssessssssssssssssssesssssssssessessessesessessesseces 43 Postpartum me 44 Filling the Blood Talks rre RHDRARHATRERNAN GIU DR RG QUERER ORO RARE UK 44 Internal FII neon prie Ft Rpt FUN Sen ribR RUIT pn DU pi Gd OR ARR RC 44 External FING ca cocci d READ REANO DER RURP QNS neat UA ed WD KTO NN RUM UMOR UN 45 In
45. 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 ECGI ECG II ECG III ECG V1 ECG V2 ECG V3 ECG V4 ECG V5 ECG V6 ECG aVL ECG aVR ECG aVF Pleth Capnogram Blank Set Alarm Set Color Set Scale The Wave Vital Selection Menu 2 Select the desired waveform or numeric The new waveform or numeric is reflected on the screen From the Wave Vital Selection menu the alarm color and scale can be set for the waveform using the Set Alarm Set Color and Set Scale buttons From the Numeric Vital Selection menu the color and alarm for the numeric can also be established using the Set Color and Set Alarm buttons 167 Using the TouchPro Patient Monitor CAE Fidelis Lucina 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 The Add Waveform An empty and Remove waveform Waveform field buttons The TouchPro Display 2 Click the Add Waveform button in the location above which you want the empty waveform to appear An empty waveform field appears 168 JZ CAE Healthcare Using the T
46. compliances chest wall compliance bronchial resistances the presence of artificial airways in the simulator and the inspired gas mixture When the PaCO Set point is set to a new value the physiological controls adjust the simulator s respiratory pattern in an attempt to attain the desired set point For example when the set point is raised from 40 to 50 mmHg there is a transitory decrease in respiratory rate and tidal volume as the physiological controls attempt to drive the PaCO toward 50 mmHg When the PaCO reaches the new set point the simulator s respiratory rate and tidal volume should return to normal values Default 40 mmHg Range 20 0 mmHg 70 0 mmHg 284 ZW CAE Healthcare Muse Parameter Descriptions PaO Set point The PaO Set point parameter is a set point for PaO When PaO is below the set point value progressive stimulation of spontaneous minute ventilation occurs Both tidal volume and respiratory rate rise which under appropriate conditions results in PaO moving closer to the set point Factors that influence this control effort include baseline tidal volume baseline respiratory rate respiratory gain O5 consumption respiratory quotient lung compliances chest wall compliance bronchial resistances the presence of artificial airways in the simulator and the inspired gas mixture Minute ventilation is not affected for PaO above the set point For example if PaO Set point is set to 100 mmHg and P
47. conditions and notices contained herein Consequently please be sure to read the terms of this License carefully If you do not accept these terms conditions and other provisions in their entirety without modification of any sort 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 Embedded 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 Embedded Software and the Data solely for the operation and mainten
48. customize the specific needs of a wide variety of education environments Supplemental Static Cervices Kit The supplemental static cervices kit contains a set of cervices in addition to the essential static cervices kit The supplemental static cervices kit includes Closed without effacement and not permeable by one finger firm posterior e Closed 70 effaced and permeable by one finger medium posterior 2 cm dilated and 80 effaced soft intermediate 3cm dilated and 80 effaced soft intermediate 5 cm dilated and 90 effaced soft anterior Operation Supplemental Accessories The operation supplemental accessories are available to enhance the realism of the simulation experience The following supplemental accessories are available for individual purchase e Revertable Uterus All Four Position kit Protective abdomen shell o All four position support straps Hands free electrical therapy kit Zoll Hands free electrical therapy kit Physio Quick Combo e Hands free electrical therapy kit Philips AED Spanner e Wall air kit Required when using the facility supply source and facility wall adapter ZW CAE Healthcare Equipment Overview Additional Equipment Some items are available for purchase as additional equipment Arm skin Delivery birth canal including perineum and vulva Delivery fetus Hand skin left or right Leopold fetus Lubricant spray cottonseed oil Non Gravid Abdom
49. delivery in a breech presentation 1 Ensure the rotation ring from inside the mannequin s torso is installed and returned to the Home position 2 Ensure the delivery uterine funnel with dynamic cervix is installed 3 Ensure the fetus is powered on indicated by the illuminated power light in the umbilical opening on the front of the fetus 4 Ensure the umbilical cord is connected to the fetus 29 Configuring the Mannequin CAE Fidelis ucina To attach the umbilical cord to the fetus push one of the blue ends of the cord into the umbilical opening on the fetus The blue tubing The Umbilical Cord Attached to the Fetus 5 Lubricate the fetus buttocks legs and lower torso using cottonseed oil DO NOT lubricate under the fetus arms IMPORTANT Wipe off remove any lubrication from the fetus head 6 Insert the fetus by placing the buttocks of the fetus into the birth canal cervix with legs bent towards the fetus chest The Fetus in the Rotation Ring Breech Presentation 30 ZW CAE Healthcare Configuring the Mannequin 7 Insert the head into the rotation ring approximately 0 5 cm past the two dimples near the top of the ear this allows the ring to line up with dimples when inflated The ear dimples The Fetus in the Rotation Ring Breech Presentation NOTE For Left Sacrum breech presentation the fetal head should be facing the mother s right side when placed into the rotati
50. ehe shi pet ERE QU Sb INS QUT NI Ee HER UNRRUD ERR NN VUE MINER MEN Qna 2 Equipment Overvie Mee 3 Standard Eduipment uuo ddaexdrvod eR ERU ENDUNAUA RU LU PAROLA RADAR ORA AMD RR DA 3 Full Body Wireless Mannequin sssscsssscssssssssscssssssssssssnssessccssnscsssscssnsessesessnsecsasecsnsecsssecsnscesssecssssessss 3 Laptop Instructor Workstation c sssesssssscssscsssscsssscsssccssnscssuscesnscssssccsnsccessecsssccessesesuceesuecesseessucessseesee 3 Touch ro Workstations RS HM HA ca contains Ir d SEHR nc E OR DU RT QU DORMI 4 Power Adapters and Cords 2 cussdobostientd eio Ao diat RARE o Mo bo Dr PR rcnt 4 GOWN MEN enamine mca muna NEEE IA RE eR Ea aiii 4 Prepartum Early Labor NL s gita sacs ecaupepnsah ascanscdedessatsveniecasavpensoamees SQ DRE BAR ue Ea RU 4 Vaginal Delivery ME ccu ttr Oates D a AGE EO DO PDC DA OON n tnu EA 5 LEE Or LIT LLLA ERR RN RIA 5 xiii Table Of Contents CAE Fidelis Lucina ACCESSONES T M M 5 Optional EOD BME Scott ER PR PD RED ERROR NEC REP GL EH DL D UD RD 6 Supplemental Static Cervices Kit s lt ssiscsscsssossesensessnnscennnesataesusveisonsoenassonescobesedbos taupssbbvasoniesennodtansonsuosboneies 6 Operation Supplemental Accessories io dos aon RUE UTEM CHER HOUR V prO CE EO YF HEU prO 6 Additional EQuipMeNt epson rapiVaxnd nain aao ORAR RE RERORAA Ha Ronan nar on in n 7 D 9 Pirat me
51. 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 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 MEPGTC 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 substanti
52. in the presence of an unfavorable oxygen supply demand ratio or how rapidly it resolves when myocardial oxygenation becomes favorable By decreasing the averaging time i e value toward 0 5 ischemia has a faster onset if there is a poor oxygen supply to the heart or a faster resolution with favorable oxygenation Increasing the averaging time i e value toward 0 99 means ischemia takes longer to develop or longer to resolve Use this parameter to speed up the recovery from the model driven death spiral By setting the parameter to 0 5 a patient pulls out of the death spiral at a faster rate than with a setting of 0 99 However the favorable conditions i e better oxygenation and or lower heart rate must exist before the number is made smaller If not the patient s descent increases at a faster rate Default 0 99 Range 0 50 1 00 304 ZW CAE Healthcare M se Parameter Descriptions Aortic Valve Resistance Factor The Aortic Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the aortic valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through the aortic valve Default 1 Range 1 1000 Mitral Valve Resistance Factor The Mitral Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the mitral valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through t
53. information is intended to assist in preparing Wireless Voice Link WVL devices for use in conjunction with Fidelis Lucina 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 interf rences 2 Cet appareil doit accepter toute interf rence y compris les interf rences pouvant provoquer un fonctionnement ind sirable 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 337 Wireless Voice Link CAE Fidelis Lucina What s Included The WVL package includes the following items e 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 out
54. of the software or the Trash is emptied 133 UsngM se CA Fidelis luna Saving the Scenario At any time during scenario creation or modification the scenario can be saved To save a scenario 1 Click the Scenario button in the upper left of the Scenario Designer The Scenario drop down menu appears Rename New State The Scenario Drop Down Menu 2 To save the most recent version of a modified scenario click Save OR To save a modified scenario as a new scenario leaving the original scenario intact a Click Save As When Save As is clicked the Save Scenario dialog box appears The Enter Scenario name The Save field button The Save Scenario Dialog Box b Enter the name for the scenario in the Enter scenario name field c Click Save NOTE When naming a scenario the scenario name CANNOT exceed 128 characters Additionally scenario file names CANNOT contain any special characters such as V lt gt 134 ZW CAE Healthcare Using Muse Emptying the Trash To empty the Trash click the Trash icon in the lower left corner of the Scenario Designer mise Abruptio Placentae Secondary to Cocaine Abuse k Emme GE Ere state by cotteose at wi txan an The Scenario Designer The Trash List appears Cardiac Rhythm Set Heart Rate Tachycardia The Empty Trash button The Trash List 135 UsngM se CA Fidelis luna Click Empty Trash to empty the Trash If y
55. 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 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 345 Wireless Voice Link CAE Fidelis Lucina The sound output from the simulator is noisy when the speaker is not speaking Youcan 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 e In this case there are three possible options o Attempt to talk louder Increase the microphone gain e Disable the noise reduction feature by setting the handset DIP switch 8 to OFF 346 CAE Healthcare RF Channel Initial Operating Frequencies
56. order to run the various SCEs Prior to beginning a configuration users must select a SCE in the Muse software NOTE To avoid any unexpected behavior users must click the Stop button in the Muse software to end an SCE is that is currently running prior to selecting a new SCE and configuring the mannequin The table below outlines which processes are necessary to properly configuring the mannequin for each type of SCE Process Prepartum Active Vaginal Vaginal Postpartum amp Latent Non Vertex Breech Boggy Contracted Delivery Uterus Installing the Rotation No No Yes Yes No Ring Removing the Rotation Yes Yes No No Yes Ring Installing the Support Tub Yes Yes No No No Filling the Blood Tank No No No No Yes Installing the Blood Tank No No No No Yes Installing the No No No No Yes Boggy Contracted Uterus Installing the Prepartum Yes No No No No Birth Canal Installing the Static Cervix Yes No No No No Installing the Backplate Yes No No No Yes Installing the Retention Yes No No No No Plate Installing the Uterine No Yes Yes Yes No Funnel with Dynamic Cervix Installing the Placenta No Yes Yes Yes No Loading the Fetus Yes Yes Yes Yes No Installing the Prepartum Yes Yes No No Yes Abdomen Installing the Delivery No No Yes Yes No Abdomen Configuring the Mannequin CAE Fidelis Lucina When in the Vaginal Delivery Operating Mode if the user selects
57. plasma within the circulation Total Blood Volume The volume of blood i e Red Blood Cell Volume Plasma Volume within the circulation Blood Volume Loss The amount or rate of decrease in the total blood volume A given amount or rate of blood loss proportionally decreases both the Red Blood Cell Volume and the Plasma Volume according to the current hematocrit Plasma Volume Loss The amount or rate of decrease in the plasma volume A given amount or rate of plasma loss decreases the plasma volume without changing the red blood cell volume Plasma Volume Loss refers collectively and generically to all plasma fluid losses including evaporative transcellular e g ascites pleural effusion bowel and third space losses Hematocrit The ratio of Red Blood Cell Volume to Total Blood Volume expressed as a percentage 223 Using Lucina CAE Fidelis Lucina The Genitourinary System The simulator allows for the insertion of a 14 Fr urinary catheter and excretion of urine The genitourinary GU system must be primed prior to use IMPORTANT Use only clear distilled water distilled water tinted with food coloring or distilled water mixed with white vinegar 50 50 inside the mannequin Administration of any other type of fluid is NOT supported and may damage the system Be sure to clean the system before storing the mannequin For more information on cleaning the GU system see Cleaning the Genitourinary System in the Care
58. port The UTERUS The uterus pneumatic port inflation port The Uterus Inflation Port and UTERUS Pneumatic Port 13 Disconnect the BLOOD UTERUS port from the uterus bleed port The uterus bleed port The BLOOD UTERUS port The Uterus Bleed Port and BLOOD UTERUS Port 14 Ensure all fluid is removed from within the vaginal canal 15 Wipe the external area particularly the buttocks and under the skin surrounding the vaginal opening The food color will stain more readily if left on for an extended period 16 Remove the uterus by folding the labia and perineum flaps closed together and pushing the external genitalia up through the birth canal into the mannequin s torso 252 ZW CAE Healthcare Care and Maintenance 17 Hold the labia and perineum closed and slowly lift the uterus out from inside the abdomen 18 Ensure that no left over fluid spills inside the abdomen IMPORTANT If any fluid gets inside the mannequin follow these cleaning instructions immediately to prevent damage to the simulator a Ensure the abdomen is installed on the torso whenever the mannequin is positioned upright o Elevate the torso en Lean the mannequin forward Qa Unzip the torso skin zipper e Open the skin on the back to expose the area under the buttocks Th Clean the area where fluid is located g Reattach the skin and return the mannequin to supine position h Clean any remaining liq
59. reset their passwords meti admin Email admin amp meti com Profile Information ID admin First Name meti The Profile tae fadi o Information link mE passes ves Password Reset Th e Profi e Profile Preferences Information New Password Confirm Password pa n e The Account Profile Screen To change profile information enter the new information in the appropriate fields and click Update Profile when finished To reset a password enter the new password in the New Password field and re enter the new password in the Confirm Password field Click Change Password when finished IMPORTANT It you change your username or password you MUST use the new username and or password upon your next login You cannot access the system with the old username or password once it has been changed 158 ZW CAE Healthcare Using Mise Favorite SCEs To access the Favorite SCEs panel click Favorite SCEs from the Account Profile screen All of the logged in user s favorite SCEs appear in the Favorite SCEs panel meti admin Email admin meti com Favorite SCEs ID admin Hyperemesis Gravidarum Profile Information The The ae Favorite Favorite SCEs panel SCEs link Medication Preferences Profile Preferences The Add Favorites button The Account Profile 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 F
60. 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 Embedded 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 MEPGIC 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 End User License Agreement CAE Fidelis Lucina 9 5 Notices Notices or communications pertaining to this Agreement must be given in writing and delivered to the addressee as i
61. the Placental Perfusion Factor parameter The effect of this parameter is independent of uterine contractions Default 1 0 Range 0 1 0 314 CAE Healthcare M se Parameter Descriptions Cardiotocograph CTG Configuration Parameters CTG Configuration Parameters The following parameters control the operation of the emulated Cardiotocograph CTG The effect of a change is immediate and global if there is more than one instance running all change 315 M se Parameter Descriptions CAE Fidelis ucina FHR Probe The FHR Probe parameter determines the type of probe used for fetal heart rate monitoring Possible selection includes Disconnected No probe is currently connected The UA widget will display a to indicate there is no probe and there will be no UA graph generated US An external probe is in use FECG An internal probe is in use Default US UA Probe The UA Probe parameter determines the type of probe used for uterine activity Possible selection includes 316 Disconnected No probe is currently connected The FHR widget will display a to indicate there is no probe and there will be no FHR graph generated TOCO An external probe is in use Noisy measurement IUP An internal probe is in use Accurate measurement Default TOCO ZW CAE Healthcare M se Parameter Descriptions MHR Probe The MHR Probe parameter indicates if the emulated CTG has the capability t
62. the SCE file is saved Click Export to export an SCE to an external device The SCE file extension is sce 141 Using M se CAERidels Luna Base Patients From the Content Management options click Base Patients to access the Base Patients panel The Base Patients panel appears The Base Patients link The Import Patient button The Base Patients Panel All Patients are listed in the Base Patients panel From the Base Patients panel users can rename review delete and export Patients they have created by clicking the respective buttons next to each Patient Click Import Patient to import a Patient file from an external device or the hard drive location where the SCE file is saved Use the Rename button next to a patient to give the patient a different name or the Delete button to delete the patient The Export button next to each patient can be used to export the Patient file to an external device The Patient file extension is pat NOTE Preconfigured CAE Healthcare Base Patients have a lock symbol in the upper left corner of the picture and CANNOT be renamed deleted or exported 142 ZW CAE Healthcare Using Mise Scenarios From the Content Management options click Scenarios to access the Scenarios panel The Scenarios panel appears The Scenarios lin k Patient Records The Create The Import New Scenario Scenario button X button The Scenarios Panel All Scenari
63. 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 I IMO Battery Line out compartment EO y DC Power i Volume mute dial ON OFF switch WVL Side View On the WVL handset the volume mute dial controls the microphone volume or mutes the microphone 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 340 ZW CAE Healthcare 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 e Line out cable The DIP switch is located in the battery compartment of the base station Figure 5 DIP Switch Settings DIP switch settings Dip Switch Settings The base station should come already connected and installed inside the simulator To prepare the base station 1 Set t
64. tion and oxygen administration Oxygen administration input by the instructor None required VIEW Respiratory PARAMETER S Frac tion of Inspired O PaO PaCO and pH are continuously cal culated and displayed when selected for the Patient Status Display None required but adjustable None required VIEW Respiratory PARAMETER S O5 Consumption CO Production Factor Allows for jaw thrust when sensors in the lower jaw are grasped in a clinically appropri ate manner This action is recorded in the events log None required None required Completely obstructs right and or left main stem bronchi simulat ing a lower airway obstruction e g mucus plug This yields an inability to ventilate the lungs Synchronized with ventilation spontane ous or mechanical Excursion depth pro portional to tidal vol ume VIEW Respiratory None required PARAMETER S Bron chial Occlusion None required None required 205 CAE Fidelis Respiratory Features Anatomy Physiology and Clinical Signs Description Software Control Manual Control The simulator exhales None required None required air exhibiting synchro nized chest move ment Oxyhemoglobin satu None required but None required ration SpO gt automat adjustable ically correlates with the oxygen concentra VIEW Respiratory tion in the lungs and the intrapulmonary PARAMETER
65. to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Mise software Mannequin Setup Vaginal Delivery Vaginal Delivery Vertex Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Install rotation ring 4 Power on delivery fetus and lubricate 7 Connect umbilical cord to placenta 2 Use standard birth canal lubricate 5 Attach umbilical cord to delivery fetus 8 Insert intact placenta in placenta pouch Attach pouch to pelvis 9 Install delivery abdomen connect speakers Loading Position Occiput posterior face up and palpable contraction system 3 Install uterine funnel with delivery cervix 6 Install delivery fetus lubricate Presentation Vertex Cancel Continue The Mannequin Setup Screen Vaginal Delivery Vertex Presentation 357 M se Mannequin Setup Screens CAE Fidelis Lucina Mannequin Setup Screen for a Cesarean Breech SCE Once a Cesarean breech SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Mise software Mannequin Setup Cesarean Section Cesarean Section Breech Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Remove rotation ring 3 Install placenta pouch 7 Install delivery abdomen connect speakers 2
66. volume remains a constant set 600 mL even in the event of falling arterial oxygen levels In such situations the patient can only respond to arterial oxygen or carbon dioxide levels when the respiratory rate is adjusted Default Modeled Range 0 mL 2500 mL Tidal Volume Factor The Tidal Volume Factor along with the Respiratory Rate Factor parameter is used to change the baseline tidal volume before the control of breathing and drug influences are taken into account A value of 2 doubles the baseline tidal volume A value of 0 5 decreases the baseline tidal volume by 5096 Default 1 Range 0 10 4 00 TIP First decrease the respiratory gain factor to reduce the influence of the respiratory control mechanism on the respiratory rate and tidal volume pH Shift The pH Shift parameter is used to create a metabolic acidosis or metabolic alkalosis under script control The default pH value displayed on the Patient Status Display or TouchPro software is dependent on respiratory arterial CO values Under default conditions PaCO 40 mmHg the pH is approximately 7 4 Rising arterial CO produces a subsequent drop in pH while falling arterial CO levels result in rising pH values To simulate pH changes with metabolic changes acidosis or alkalosis the pH Shift value is a mathematical addition to or subtraction from the displayed pH value to that which is desired Default 0 Range 0 50 0 50 283 M se Parameter D
67. 2 F 50 C or fall below 39 F 4 C If a soft sided simulator case is being used the simulator should lay flat on its back The simulator should NEVER be stored or shipped with fluids in the system 245 Care and Maintenance CAE Fidelis ucina Caring for Electronic Equipment Do NOT use any of the computer components associated with this system for any other use Do NOT connect the computer components to any network of any kind Install any CAE Healthcare software updates as soon as they become available Inspecting the Airway The maternal mannequin is equipped with an anatomically accurate airway that supports the practice of various airway management techniques In the process of performing these techniques improperly or aggressively the upper airway can be damaged While such damage may be readily apparent manifested as a leak in the breathing circuit when the simulator is connected to a ventilator it may not be obvious during spontaneous or bag and mask ventilation Because damage can occur occasional visual inspection of the airway is recommended Using the light of a laryngoscope blade or a flashlight visually examine both the upper and lower airway While tears in the upper airway resulting from intubation may be obvious needle holes in the lower bronchus may not be readily apparent If damage to the airway is found small cuts or tears may be reparable However for permanent repair of damaged simulators co
68. 2196 Range 096 10096 Respiratory Additional Parameters Respiratory Parameters Additional 281 M se Parameter Descriptions CAE Fidelis Lucina Respiratory Parameters Additional Respiratory Rate The Respiratory Rate parameter is used to set the respiratory rate to a given number of breaths per minute Once set arterial oxygen and carbon dioxide values have no effect on the resulting respiratory rate but continue to influence other components of the physiological models The patient continues to breathe at the set number of breaths per minute regardless of the arterial oxygen or carbon dioxide levels For example when the respiratory rate is set to 10 breaths per minute the respiratory rate remains at 10 breaths per minute regardless of arterial oxygen or carbon dioxide levels In such situations the patient can only respond to arterial oxygen or carbon dioxide levels by adjusting the Tidal Volume parameter Default Modeled Range 4 breaths per minute 40 breaths per minute 282 ZW CAE Healthcare Muse Parameter Descriptions 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
69. 3 Sti jm im Hx ogy CAE Heatthca CER Maternal Fetal Simulator User Guide 2015 CAE Healthcare 905K470052 v2 1 ZW CAE Healthcare End User License Agreement CAE HEALTHCARE END USER LICENSE AGREEMENT END USER LICENSE FOR CAE HEALTHCARE MEDICAL EDUCATION PRODUCTS THE PRODUCT S THIS IS ALEGAL 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 if the Product is labeled as designed and manufactured in Canada CAE Healthcare Inc a Canadian corporation having its principal place of in Montreal Oc Canada otherwise from CAE Healthcare USA Inc a United States company having a place of business in San Jose California USA This purchase of the Product is subject to the CAE Healthcare Medical Education Products General Terms and Conditions the MEPGTC and this End User License agreement License This License governs the grant of licenses for the software in object code only embedded in the Product the Embedded Software as well as all related Product documentation and information the Data supplied by CAE Healthcare either with or separately from the Product which items as indicated in the MEPGTC are not sold but licensed Acceptance of these terms and conditions must be without modification of any of the terms
70. CTG Monitor display click the TOCO Zero button in the lower left corner of the CTG display 192 ZW CAE Healthcare Using the TouchPro CTG Monitor Viewing the CTG Strip The lower portion of the CTG Monitor display shows a CTG strip This strip represents the paper strip that would be generated by a real CTG monitor 98 36 5 UA D MNIBP 7 E SENI ETR US mmHg TOCO 148 The CTG strip navigation buttons The CTG strip The CTG Monitor Display To view CTG strip history use the CTG strip navigation buttons located in the lower left corner of the CTG strip The Play button The Rewind button The Fast Forward button The Skip Back button The Skip Forward button The Skip to End The Back to button Beginning button The CTG Strip Navigation Buttons The Back to Beginning button skips back to the very beginning of the strip The Skip Back button skips back one screen The Rewind button moves the strip steadily backward so the user can view the strip as it moves along the monitor 193 Using the TouchPro CTG Monitor CAE Fidelis Lucina The Play button causes the strip to move along the monitor at a normal speed beginning from the currently displayed portion of the strip NOTE The Play button becomes a Pause button when the strip is running The Fast Forward button moves the strip steadily forward so the user can view the strip as it moves along the monitor The Skip Forwa
71. 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 MEPGTC 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 SPTGC LIABILITY IF ANY SHALL BE SOLELY FOR DIRECT DAMAGES NOT TO EXCEED ON A CUMULATIVE BASIS THE AMOUNT PAID BY LICENSEE FOR THE PRODUCT ZW CAE Healthcare End User License Agreement 8 GOVERNING LAW 8 1 Save and except for Products designed and manufactured in Canada this License is governed by the internal substantive laws of the State of California applicable to agreements to be made and to be performed solely within California without giving effect to any conflicts or choice of laws principles that otherwise might be applicable For those Products desig
72. E 233 UA Synchronized Vocal CI aoo im URERNQUEA TOIT U BUDE UPS UNA QUADR HOD NIU OH ODER 234 Neonate Cry Selection usse eoa iur bo ptem Orel ourecris CORR DUen APRI BUR RRXU ERE 235 Fetal Heart Sound Location snieni 236 Bowel Sounds Non Gravid Only ssiccersseussassecssssaveavosessasvieeehsneevsvsnucssnsseiesbveodasnineerinvibennyeiveiecesoasnedeiont 237 Care and Maintenance m 239 CAE Healthcare Assurance Programs esssesssososososososseocososssssosessososososososososososssseosessssosssse 239 General IM OMAtON NER OO 239 Units Qut OT PRG acier DE ease alga os daa ec oh oan 239 lids em M aS Penton enone ect Preset 239 nci qaaa e 239 Return Materials Authorization RMA essere tnter tentent 240 Maning TOR LIT TAS RR EHE RUE DURO E 240 System Software Upgrade Support esee eee ee eene ee eene ene ee treten nest e tato ats 241 Time and Materials MER 241 How to Contact Customer ServiCe sessessesossessesosesesosososososososoeosossesosesesssososssosososososososssssoe 241 For customer service please contact CAE Healthcare eee 241 BreakdOWN 243 Step T Clean the Simulator and Fluid SySTOnIS ocosieira vineis QU Perpiniani 243 xviii ZW CAE Healthcare Table Of Contents Step 2 Shut Down the SOM Wale ainsi EO RO DRE Fo tH hb o UB ORA ORA RD O 243
73. E Healthcare Care and Maintenance 3 Connect the blue line to the mannequin BLOOD FILL port and the yellow line to the BLOOD VENT port The _ BLOOD FILL port VENT port The Battery Compartment and Ports 4 Ensure the yellow pressure relief knob on the trauma fill tank is closed and pressurize the tank When enough pressure has built up about 25 to 35 strokes there will be a sharp release and any remaining liquid will be flushed in the overflow bottle 5 Release pressure in the trauma fill tank by turning the yellow knob 6 Disconnect tank and empty and clean the overflow bottle Cleaning the Epidural System To clean the epidural system 1 Remove the split septum adapter from the epidural port and connect an empty 50 mL syringe to the luer fitting 2 Withdraw fluid air until a vacuum is formed If only clear fluid was injected into the epidural system the cleaning procedure is complete If colored fluid was injected into the epidural system a Fill a syringe with 50 mL clear distilled water b Connect the syringe to the epidural port and slowly push clear distilled water into the epidural port c Slowly withdraw the syringe until no water or air comes out 255 Care and Maintenance CAE Fidelis ucina d Disconnect the syringe from the port and discard the water 3 Place the split septum adapter back on the luer fitting Cleaning the Genitourinary System To clean the genitourinary system 1 E
74. E iius pof REA RRROA HE GDD AN A EAM C RE D OE VR ROPA EUR UE 136 Administrative TODS e P 138 HISTO eR IEEE D NR 138 System Administratii NP TRI RE Te 139 P eIBg m 157 Using The TouchPro Patient Monitor eee ee enero enean auno 163 Accessing the TouchPro Patient Monitor Software eere eee eene tnne 163 Modifying the TouchPro Patient Monitor Display e eeene eere 165 Selecting a Preconfig red LayOutsissssssessessancesveveions sonssasnsenssvenensstausosonndsannsendoseannsostvesconsveonsseonnsvensenve 165 Changing a Waveform or Numeric Display sssscssssssssssssesssssecssesssssssssssesssnssssscessnscsssecssnscssseessnscs 167 PORTIBIERIEITSD DNE 168 Adding a Numeric Display ssutucscceeuswivsestvostveerorsusconis oq RRR T bruts piel be nhu D RH uc 170 Moving a Waveform or Numeric Display usan conne pred Gon bi Fn ny 171 ZW CAE Healthcare Table Of Contents SIENTE 172 DU MA M 173 V2 Leech rcp 174 NIBP Cycling and Manual NIBP e 177 E A E E E 179 Configuring the TouchPro Software esesesssososesosososseosososssseosessososesososososososossssessessssesesse 180 Changing the TouchPro Language eene ee ene enne eene ren
75. EE Stannette Momtobe years old Base Stannette Momtobe Change Picture The Save button t The Profile Editor 2 Set the Patient s name age gender and weight by filling in the appropriate fields 3 Clickthe Change Picture button to change the patient s picture optional 4 Click Save 114 ZW CAE Healthcare NOTE The Upload Picture button which is only available in the SCE Development version of the Muse software can be used to add new photos to the library of patient pictures IMPORTANT No part of the patient s profile can contain any special characters such as V lt gt Using M se Setting a Patient s Baseline The patient baseline is the patient s initial physiology at the beginning of an SCE To set the Patient s Baseline 1 From the SCE Editor click Baseline The Baseline button Untitled SCE if domnm The SCE Editor Screen The Patient Baseline screen appears muse arate p mese 9 Patient Baseline Operating Mote yapu Comey P g Pestperum Lncoted m 9 y ana Gs an E js Y E e JEAN o o Broers amw oenar i V mas carn Ml Wa Rats towel T The eZ ne Complete ve 9 M button The Patient Baseline Screen 115 UsngM se CAs Luna 2 Set the Patient s baseline physiology by modifying the desired parameters 3 Click Complete When the SCE begins the Patient physiology reflects
76. EEE NER a 307 Patient DUSTITAD cocoa dco voa RR en to poda bra Brod dde RU Vn an NOI 307 Early Deceleration Magtitude ussuu cssc erts eed ebat MON UNE SEP Rte Ir HEP rt ere AR 307 Late Deceleration Amplification Factor xs ssessssenecsessstenvscasnssoceesvnvessnssosasnsconsoninecobsssaensyaonsssensesonboveobse 308 Should r DUST CI ssena rn AE RR EON E OERE n E 308 Shoulder Dystocia Resolution csississsssscsvvnssdanceconeveosacdonsdaven essswinentsoxisscoda ins seasaspnvnun donsdenenonsieoioeveeenee 308 Extraction of Posterior Arm s uoa capes casserole DERE B QA UE RU es n DARE NRI MEUS 309 Arrested Labor sarsii b ton Fa debe mUR DX PRORA NISI NS PUT I QUERI na eae di PAD 309 Arrested Labor Trigger Stablgl uos esiroldspease nnda eto rn Qvae te nd dnd bd PD HER PEU 310 Arrested Labor Resolved by Traction sssscacsssicscosssesssesunsavsvesvoneoeessacenwcrrwasnsnvesinvsaehsavansaceeseasveeanssendesase 310 Traction Force Required to Resolve Arrested Labor eee tennnttnnn 310 Manual Release of the Baby sisi toot te M DR lance PUDUE TR QE RAE RUE o SER ONU UAR RU RAEG 310 Fetal and Labor Additional Parameters 4 eee esee eee entente tatnen nnn 311 Matermal POSITI ceastecon tr Ren nO d o nuc Rond hen Rd ode GARUDA bei SE 311 Contraction Resting HONE siscsncsatrcrncnsaincnhacetiootennanindnisnwsmenivuntansadacaminntassn 312 Contraction Frequency Variabillty u us cista Pee b eter petiere ola b N
77. ER 312 Contraction Amplitude Vall aD EY io qi o ox ta POR GUAE rd bt eine Cur HR DE 312 xxii ZW CAE Healthcare Table Of Contents JN 0 c P 312 TOCO Amplitude CoA SCRRUS BUR NOR UA QURE HE R E ERU EHE 312 FAR he OI acca EURO E REO UM a UD au E M D DA MU NM MEE 312 FHR Variability Coefficient essiensa Er RUN EHE EDU EU MU FO PNEU MU 313 Umbilical Cond Compressibility Factor suoni oti a QURE D EA OY RO Forth ORAE honte 313 FHR Acceleration Amplitude critt DR reb hd Pado ER NOEL HEU choneanenssebie FRA 313 FHR Acceleration NEBIVO ascia Bde ho e c RAD REA 313 bp iriure T C 313 Placental Perfusion FOUDUE oeuvre rom D ba boc tp itt tarta dae Edu ao IM 314 Umbilical Flow FIEBURS uocat rris Loo oninlvbc tnde LO RR on BG vec LUE Kd SUD oneris 314 Cardiotocograph CTG Configuration Parameters eere eene rennen 315 FAR Probe 316 VA Md me T C Q 316 ENDE iara tun Ra DU EACH Ra PURO D rU dn DRE 317 MSPUS Probe cance chase UR ERR EODD E RD cea Du eect 317 MNIBP Probe ssissisiiisisisrissririraiisnriiiarinie ii i 318 Temp PrOD E erena E EEA E NE AEA AE 318 FHR Signal LOSS ia tait nene ar GR A UNDO RO a Nn 319 UA Signal Los Sinisorsa a RA d 319 TOCO OTST m 319 Ln EST PL RR ER S 319 MHR Overrides FHR RR E 319 MSPO2 Printing Bars Dos NT T 319 MNIBP Printing
78. 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 2596 Bundle Branch Block Right Hypercalcemia 293 294 M se Parameter Descriptions CAE Fidelis Lucina Hyperkalemia Hypertrophy Biventricular Hypertrophy Left Ventricular Hypertrophy Right Ventricular Hypocalcemia Hypokalemia Junctional Junctional HR 50 Long QT Syndrome Myocardial Infarction with LBBB Myocardial Infarction Anterior 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 PVCs 1096 Myocardial Ischemia Severe Paroxysmal Junctional Tachycardia Paroxysmal Junctional Tachycardia HR 130 Pericarditis Premature Atrial Contraction Premature Ventricular Contraction 1096 Premature Ventricular Contraction 2596 Pulseless Electrical Activity Sinus Sinus Bradycardia Sinus Bradycardia HR 40 Sinus Tachycardia Sinus Tachycardia HR 120 ZW CAE Healthcare M se Parameter Descriptions 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 Tachycardi
79. NIBP port located on either side of the mannequin s torso The LEFT NIBP port The Battery Compartment and Ports Non invasive blood pressure may now be taken using the return to flow technique 5 Store the modified blood pressure cuff with the mannequin Korotkoff Sounds Korotkoff sounds can be auscultated on either arm To auscultate Korotkoff sounds 1 Wrap the sphygmomanometer cuff around the arm on the same side as the connected NIBP port 2 Place the stethoscope just above the brachial pulse 3 Pump up the blood pressure cuff and let the cuff pressure drop slowly by opening the valve on the bulb slightly 4 Monitor the pressure displayed on the cuff gauge All five phases should be recognized Phasel Clear repetitive tapping sounds Systolic e Phase Il Longer beats with some swishing sounds e Phase Ill Crisp more intense rhythm sounds e Phase IV Muffled less distinct sounds Phase V Sounds disappear completely Diastolic 216 ZW CAE Healthcare Using Lucina Defibrillation and Cardioversion Lucina 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 However use of a defibrillator for training purposes represents an operational hazard equivalent to use of a defibrillator on a real patient Consequently ALL SAFET
80. PR Monitor Live Data View 101 Using M se CAE Fidelis Lucina Click the CPR Summary button to display the summary view Hand Position Chest Compression Depth Variability in Chest Compression Compression Depth in fh Compression Rate min llo or F Chest Recoil 0 9 Compression Fraction 96 Compression Rate Compression Depth Average Compression Depth Variability Compression Recoil 0 Compression Fraction CPR Monitor Ventilation Ventilation Volume Ventilation Rate I E Ratio Minute Ventilation Alveolar Ventilation CPR Summary Ventilation min Patient Vitals mi 9 Blood Pressure CePP breaths min core Sp02 EtCO2 Ventilation Volume Average Ventilation Rate I E Average The CPR Monitor Summary View Click the CPR Live Data button to return to the live data view mmHg mmHg mmHg CPR Live Data L min breaths min m The Close button The CPR Live Data button The CPR Monitor displays several statistics including current hand position compression and ventilation rates compression depth ventilation volume and compression ventilation ratio CPR data is recorded in the Event Logs To close the CPR Monitor click the Close button Using the Event Recorder to Save States The Event Recorder can be used to save conditions interventions and parameter changes as states To save a state using the Event Recorder 1
81. Parameter Descriptions Postpartum Basic Parameters Postpartum Parameters Basic Uterine Massage The Uterine Massage parameter determines the effect of massage on the postpartum boggy contracted uterus Possible choices are Ineffective Massage of the uterus does not cause it to contract Effective With Effective successful compression of the uterus will fully contract the boggy uterus Five effective compressions are required before contraction occurs The feel of the uterus will not change for the first four massages i e the uterus stays fully boggy for massages one through four With the fifth massage the uterus fully contracts over approximately 90 seconds and the message Boggy uterus was declared resolved appears in the event log A single massage compression consists of pressing holding and releasing the uterus With each successful massage the message Uterine compression was applied is logged in the event log independent of uterus mode Effective or Recurring atony In order to completely contract the uterus one must execute five successful compressions in Effective or Recurring atony mode Additionally when Vaginal Bleeding Severity is active Mild Moderate Severe or Profuse each massage will produce a gush of blood in addition to the bleeding enabled by the vaginal bleeding severity parameter see Vaginal Bleeding in the Using Fidelis Lucina section of this guide This gush of blood occurs every t
82. Patient Profile and content determining settings and programming scenarios 112 ZW CAE Healthcare Using Mise The SCE Editor The SCE Editor can be used to review preconfigured SCEs and to create or edit custom SCEs To access the SCE Editor click the Review button in the SCE Summary Panel or create a new SCE The SCE title mise Nervous System Depression by Narcotics Given to the Mother on Et E3 The Return button peak r The View as ioan m PDF button g nce The Run button Content Pes TT tom nO Management H Patient profile SCE Configuration as Fae Ea Fa Bsa a Fee es Es ee i um 7 CTG data Preloaded Sewn Scenarios The SCE Editor The buttons in the upper right corner of the SCE Editor provide options for running the SCE generating a printable PDF or returning to the Home page The Content Management SCE Configuration and Preloaded Scenarios links in the left side panel and the CTG Data are used to review the SCE content and configuration view CTG data and view scenarios applied to the SCE 113 Using M se CAE Fidelis Lucina Editing a Patient s Profile To edit the Patient Profile 1 From the SCE Editor in the Profile section click Edit Untitled SCE ko G The Edit button The SCE Editor Screen The Profile Editor appears The Change Picture button ETE ETE Z
83. Return Resistance Factor iussscninso agekp aX do d FD e ROROES ERG PL HYPER b Ober pehi uale Rit 302 xxi Table Of Contents CAE Fidelis Lucina Baroreceptor Gain Overall Factor sacos dokn Ip PED HERE EMO GORERUR RA ERR oe 302 Baroreceptor Gain Cardiac Fatto oae p RR UHR RD RR RUE UAR Urb RR RORIS DRE 302 Baroreceptor Gain Peripheral Factor sssssssscsssssssessssscsssssssscesssesssssesssccsssscessscssssesssscesssecsssessss 303 Chest Compression EMGACY vods FORO Ht Een print rRNR NEIN f RD 303 Tamponade VolUME Cocco Gio CAEDE KO DDR LO MAR OQ FORMAT Dec n ERR CEREO UI E Dad 303 Ischemic Index Sensitivity uus erect act DR Heb hd Pad RE EE NOEL HEU chimeananss UR PRO 304 Ischemic index Averaging ioco ORA UD HERRERA RA TRA n DRE 304 Aortic Valve Resistance Factor sacos ae bora io aa pe npe nd Ua KS GU Rd debilis 305 Mitral Valve Reststalite FaELOE us unco Pvt tod ep eC Reed bu get ip PRU e s 305 Pulmonic Valve Resistance Factor ao cosuisa sto oen BUCO ve SE SUD oni 305 Fetal and Labor Basic Parameters esee esee eeee eere tees te enean stain tantas tn tas tn ineo 306 Rate glor e 306 Fetal STATE caesos opp eon RON NS UE TRE URSUS EI s s bap aaas 306 Contraction FregUen Y ideo a Parte RES teo dup HORA RR irri tetris aE 307 Contraction Amplitude oido RON RRQUH EA DORKHRN RO PUN TOD ERU RURRAQR CHRON TN HOD AGED RIRUA 307 Contraction Durat e occippE PORE IER EN FUROR OD S OO RU DN
84. SCE and is listed on the SCE Editor beneath the Pre Loaded Scenarios heading Developing Scenarios The Scenario Designer allows users to create and edit scenarios To access the Scenario Designer create a new scenario or choose an existing scenario to edit Creating a New Scenario To create a new scenario 1 From the SCE Editor under the Pre Loaded Scenarios heading click the Add Scenario button Pre Loaded Scenarios The Add Add Scenario Scenario button The Pre Loaded Scenarios Heading The Choose Scenario dialog box appears Scenarios Name Last Modified Anaphylactoid Syndrome of Pregnancy 2013 09 04 09 30 12 Anaphylaxis 2013 09 10 11 16 35 Hyperemesis Gravidarum 2013 09 04 09 30 12 Postpartum Hemorrhage Two Hours After Delivery 2013 09 04 09 30 12 2013 09 04 09 30 12 Preeclampsia The New button The Choose Scenario Dialog Box 2 Click New The Scenario Designer appears displaying the new untitled scenario 123 Using M se CAERidels Luna From the Scenario Designer scenario states can be added modified and deleted Untitled Scenario The Scenario button sem je ewe state py Collapse alt cw Expand alt ALL CONDITIONS Cardiovascular The View buttons Canvas The New State button The Scenario Designer The Scenario button is used to manage states and save the scenario The View buttons toggle between
85. SCEs that are currently running and is only available when at least one SCE is running Recent tab Lists all the recently run or edited SCEs e Favorites tab Lists all SCEs that have been selected as favorites and is only displayed after favorites have been selected To add a favorite SCE to your profile click the Add to Favorites button at the top of any SCE on the Home page Managing favorites is achieved in the Account Profile portion of the software All tab Lists all SCEs including user created SCEs and all SCEs from available learning modules ZW CAE Healthcare Using Mise The Lock icon indicates a locked SCE Locked SCEs are installed by CAE Healthcare and cannot be deleted The Lock ealthy Adult Female icon Norma L Female A Locked SCE To search for an installed SCE enter part of the name of an SCE in the Search field and click the Search button Click the page arrows to view additional pages of installed SCEs Click any SCE to select it Once an SCE is selected it appears in the SCE Summary panel To run an SCE click Run in the SCE Summary panel to execute the SCE To open the SCE Library click the Open Library button To create a new SCE click the New SCE button 65 UsngM se CA Fidelis Luna The SCE Library The SCE Library lists all SCEs available on your workstation Access SCEs from your library by clicking the Open Library button at the bottom of the SCE Selection panel The
86. Settings menu appears 2 From the Settings menu click the Language Selection button The Language Selection window appears 3 From the Language Selection window select a language Language Selection English US German French France Spanish Spain Chinese Traditional Chinese Simplified Polish Russian l Cancel Accept The Language Selection Window 4 Click Accept The TouchPro software changes to the selected language 181 Using the TouchPro Patient Monitor CAE Fidelis Lucina Exiting the TouchPro Software To exit TouchPro 1 Click the Settings button from the bottom right corner of the TouchPro screen The Settings Button The Settings menu appears 2 From the Settings menu click Shutdown A warning box appears asking if you want to exit 3 Click Shutdown TouchPro shuts down and the Muse Start Screen appears 182 ZW CAE Healthcare Using the TouchPro CTG Monitor USING THE TOUCHPRO CTG MONITOR SOFTWARE The TouchPro CTG Monitor software enables users to monitor fetal heart rate and uterine contractions The software can be used from the Instructor Workstation or on another computer provided the computer has joined the simulator s wireless network The parameters displayed on the TouchPro CTG Monitor are determined by the TouchPro CTG Configuration settings selected for the running SCE from the Muse Run screen From the TouchPro CTG Configuration settings user
87. SpO2 in the upper 90s on room air The learner is expected to deliver and examine the placenta Learning Objectives Recognizes the normal progression of the active phase of labor and the second stage of labor gt Rooze noma fetal heart rate Ten items and nomi uteris conticiinn ieouenc The Run The SCE Summary Panel The View as PDF button can be used to generate a printable PDF of the selected SCE The Add to Favorites button adds the SCE to your Favorites list Clicking the Review button accesses the SCE Editor which can be used to review and edit SCEs Select the Run button to run the SCE 68 ZW CAE Healthcare Using Mise Printing SCEs To print an SCE 1 From the Home page select the SCE to print The SCE summary panel appears I Deliv i A Normal Delivery B View as Por The View as Paula Jimenez ge 27 years old S PDF button 70 0 kg Paula Jimenez Operating Mode Vaginal Delivery Overview The patient is a 27 year old primigravida who was admitted in labor four hours ago at 40 weeks gestation Mother s blood group is O positive Group B streptococcus at 36 weeks was negative This SCE consists of three states that are transitioned manually at the facilitator s discretion In State 1 Initial Assessment the patient demonstrates a HR in the 80s BP in the 110s 70s RR in the mid 20s and SpO2 in the upper 90s on room air and a temperature of 37 0C Vaginal examination on admission revealed that the ce
88. Traction No us im Traction Force Required to Resolve 10 4 Arrested Labor Y The State Parameters Screen Click the various organs to change the views and then select the desired parameter Once a parameter has been selected it appears in the State Parameters panel on the right side of the screen Add as many parameters as needed Added parameters appear consecutively within the state Drag and drop to reorder as needed Click Complete to save and exit the State Parameters screen or click Back to exit without saving NOTE If the physiology of any of the parameters conflicts the M se software reflects the physiology of the last parameter entered Adding Transitions To add a transition the scenario must have both an original state and a state that results from the transition To add a transition 1 Click the Create button in the original state Contraction Frequency 6 ctx 10 min Respiratory Rate Factor 2 over 15 sec The Create button A State 129 Using M se CAE Fidelis Lucina The Transitions Menu appears listing all available transition variable types Close Assessment Intervention Medications Physiology Scenario Vitals Fetal Childbirth The Transitions Menu 2 Select the desired variable type For example if a transition based on the administration of medication is desired select Medications and then select the desired medication from the list Once a medication is
89. Use standard birth canal If so desired install and palpable contraction system a static cervix requires the prepartum birth 4 Attach umbilical cord to delivery fetus and canal placenta Place intact placenta and cord into pouch 5 Power on delivery fetus and lubricate 6 Install delivery fetus in desired position over placenta pouch Presentation Breech Cancel Continue The Mannequin Setup Screen Cesarean Breech Presentation 358 ZW CAE Healthcare Muse Mannequin Setup Screens Mannequin Setup Screen for a Cesarean Vertex SCE Once a Cesarean vertex SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the Mise software Mannequin Setup Cesarean Section Cesarean Section Vertex Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Remove rotation ring 3 Install placenta pouch 7 Install delivery abdomen connect speakers and palpable contraction system 2 Use standard birth canal If so desired install a static cervix requires the prepartum birth 4 Attach umbilical cord to delivery fetus and canal placenta Place intact placenta and cord into pouch 5 Power on delivery fetus and lubricate 6 Install delivery fetus in desired position over placenta pouch Presentation Vertex Cancel Continue J The Manne
90. W x 4 5 D 48cm x 15cm x 11 5cm Instructor Workstation 95 H x 12 78 W x 8 94 D 2 4cm x 32 5cm x 22 7cm Weight Mannequin Simulator 111lbs 50 kg Fetus Simulator 5 5 Ibs 2 5 kg Instructor Workstation 4 5lbs 2 1kg 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 noncondensing Instructor Workstation Operation 50 F to 95 F 10 C to 35 C Storage 13 F to 113 F 24 C to 45 C Relative Humidity 0 to 90 noncondensing Maximum Altitude Instructor Workstation Maximum operating altitude 10 000 ft Maximum storage altitude 15 000 ft Maximum shipping altitude 35 000 ft Specifications CAE Fidelis Lucina Power Mannequin Simulator AC Input AC 100 240VAC 50 60Hz Consumption Maximum 150W Charging 100W charged Typical 40W Internal Batteries 14 4V 90 watt hour lithium ion rechargeable Run Time 4 hours Typical Fetus Simulator Run Time 7 hours Typical Instructor Workstation AC Input AC 100 240VAC 50 60Hz Consumption Maximum 85W Charging Internal Battery 10 8V 60 watt hour lithium polymer rechargeable Run Time 2 to 4 hours Typical TouchPro Computer Please see the product s user guide for power specifications Communications Simulator Network Wired 10 100 Ethernet or Wireless IEEE 802 119 Wireless Voice 537 MHz to 819MHz Country Speci
91. Whole Blood Infusion Vaginal Bleeding Severity The Fluids View 219 Anatomy Physiology Description Software Control CAE Fidelis Manual Control and Clinical Signs The simulator can exhibit vaginal bleeding ata rate controlled by the instructor VIEW Fluids PARAMETER S Vaginal Bleeding Severity See Vaginal Bleeding on the following pages The software can simulate blood loss causing appropriate physiological changes in the patient VIEW Fluids PARAMETER S Fluid Loss Blood Fluid Loss Plasma None required The simulator supports urinary catheterization When catheterized the simulator can produce urinary output of 50 mL None required See Urinary Catheterization on the following pages The simulator s right and None required See IV Access on the fol left hands and arms pro lowing pages vide intravenous access locations Bolus injections can be Administered IV Up to 300 mL of administered utilizing standard syringes while continuous IV infusions can be administered using infusion devices Injections can be admin istered in the IV hands and arms bilaterally at the dorsal metacarpal basilic median ante brachial ante cubital fossa and median cubital locations medications must be set by the instructor Medications are administered via the Medications palette administered IV fluid are collected in reclaim bags located in t
92. Y 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 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 Avoid touching any nearby ECG posts To prevent overheating DO NOT provide more than three 3 defibrillation discharges in a sequence per minute during the training session maximum 200 joules with biphasic defibrillation and 360 joules with a monophasic defibrillation Avoid a large number of consecutive discharges as may damage the simulator Leave at least 30 minutes recovery period after a sequence of more than nine consecutive discharges Do NOT provide more than nine consecutive discharges over three minutes without recovering for 30 minute before the next discharge as it may damage the simulator 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 vaginal bleeding features To prevent pitting of the chest ski
93. a Pulseless HR 151 Wellen s Syndrome WPW Syndrome Left Lateral Pathway 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 e g beginning of an SCE with an unmonitored patient Default Right Atrium Options Atmosphere Extrathoracic Vein Intrathoracic Vein Right Atrium 295 M se Parameter Descriptions CAE Fidelis ucina Pulmonary Artery PA Catheter The pulmonary artery pressure displayed on the Patient Status Display or TouchPro software i
94. aO drops to 90 mmHg ventilatory stimulation occurs When the PaO reaches the new set point the simulator s respiratory rate and tidal volume are again controlled to maintain PaCO at the PaCO set point Also see PaCO Set point Default 100 00 mmHg Range 20 0 mmHg 100 0 mmHg to E Ratio 1 X The I to E Ratio 1 X parameter sets the inspiratory expiratory I E ratio for spontaneous ventilation At the default setting the time for exhalation is twice that of inhalation Default 2 Range 0 5 7 0 PetCO PaCO Factor The PetCO PaCO Factor adjusts the end tidal CO relative to the PaCO gt At the default value of 1 PetCO very closely approximates PaCO When PetCO PaCO Factor is set at a value of 2 PetCO is approximately one half of PaCO gt PetCO depends on CO production and alveolar ventilation Because the alveolar dead space is not modeled physically in the hardware the responses to changes in mechanical ventilation settings may not be exact The use of the Onset feature e 9 onset over a 1 minute period is recommended for this parameter Default 1 Range 0 9 10 0 285 M se Parameter Descriptions CAE Fidelis ucina Respiratory Gain Factor The Respiratory Gain Factor determines how strong an influence arterial CO levels have on the simulated patient s tidal volume and respiratory rate Under default conditions value 1 when arterial CO levels rise the patient s respiratory rate
95. ach it to the rectal plug NOTE CAE Healthcare recommends placing the mannequin in McRoberts position to perform this procedure Install the Backplate without the Cervix Retention Plate NOTE Ensure the arrows on the top of the plate point towards the mannequin s feet 53 Configuring the Mannequin CAE Fidelis Lucina Installing the Postpartum Invertible Uterus NOTE The postpartum invertible uterus is soft and has a reversion lock collar in the cervical area unlike the Boggy Contracted uterus The invertible uterus is placed inside the abdominal cavity over the placenta pouch on the blood tank and has two connections A manual pneumatic connection to inflate the uterus and help with inversion syringe attachment Areversion lock collar pneumatic line connection that prevents reversion when desired yellow Gripper line The Invertible Uterus NOTE For ease of installation it is recommended that the uterus be inverted prior to installing in the mannequin However the uterus may be inverted after installing in the mannequin To configure and install the invertible uterus 54 CAE Healthcare Configuring the Mannequin 1 Connect the provided 140 mL syringe to the air tube on the uterus NOTE Leave the syringe attached during preparation and installation The air tube The Syringe Air Tube Connection 2 Depress and pull the syringe plunger until uterus inflates to a rounded shape ap
96. ackaging When unpacking the mannequin for the first time careful use of box cutters protects both the packaging and the product Step 1 Place Mannequin in the Work Area Select a work area with enough room for all equipment providing ample space for easy access to the simulator At least a 10 x 12 3 meter x 4 meter work area is recommended for movement of learners and positioning of components around the simulator The CAE Fidelis Lucina Maternal Fetal Simulator Maternal Mannequin The maternal mannequin and the Instructor Workstation may all be operated from their batteries allowing for wireless use In a lab environment make sure that a multi plug AC power outlet exists within the workspace to recharge the simulator and its powered components Before placing the simulator on a surface be certain that surface can easily support 200 pounds NEVER lift the simulator by the LIMBS Leverage the torso of the simulator and support the head while lifting Ensure the abdomen is installed on the torso whenever the mannequin is positioned upright Do not use a surgical cap on the mannequin as overheating may occur Prior to using the stretcher packed with the shipping container the mannequin must be wrapped in a sheet Failure to wrap the mannequin in a sheet may result in permanent damage to the mannequin skin CAE is not responsible for damage to the mannequin skin if the mannequin is not wrapped in a sheet while using the st
97. al Catheter Central Venous Catheter PA Catheter None required Systemic blood pres sure can be measured using the return to flow technique Korot koff sounds can also be auscultated None required See Blood Pressure for information on modi fied blood pressure cuff 210 JW CAE Healthcare Anatomy Physiology and Clinical Signs Myocardial Ischemia Palpable Pulses Cardiovascular Features Description Software Control Myocardial oxygen supply and demand automatically influ ence the cardiac rhythm yielding response to hypox emia Carotid brachial radial and dorsalis pedis pulses can be palpated bilaterally and are syn chronous with the car diac cycle A pulse deficit automatically occurs if the systolic arterial blood pressure falls below specified thresholds The inten sity of the pulse reflects current physi ology or can be set to absent weak normal or bounding Note that carotid pulses do not have intensity levels None required None required Using Lucina EVO m elilice 211 Using Lucina CAE Fidelis Lucina Pulses Eight pulse locations are activated through sensors by touch e Carotid 2 e Brachial 2 Radial 2 e Dorsalis Pedis 2 Pulse palpation is recorded in the Events Log Pulses are visible and can be controlled from any physiological view All pulses unless altered b
98. al cord to fetus and placenta Place placenta inside pouch 3 Place the delivery fetus on top of the placenta pouch 4 Cover with the prepartum abdomen 25 Configuring the Mannequin CAE Fidelis Lucina Delivery Installing the Rotation Ring The rotation ring must be installed prior to running a delivery SCE To install the rotation ring inside the mannequin s torso 1 Align the rotation ring tab located on the side opposite of the CAE Fidelis logo with the rotation ring groove inside the mannequin s torso The rotation ring tab The rotation ring groove The Rotation Ring 26 ZW CAE Healthcare Configuring the Mannequin 2 Secure the clips on each side of the rotation ring a Ensure the side connections are fully inserted and aligned b Latch the bottom of the clip to the rotation ring c Push the top of the clip in to securely fasten The rotation ring clip The side connection The Mannequin s Torso Rotation Ring Clip 3 Connect the yellow compression tubing on the rotation ring to the compressor connection on the baffle The Mannequin s Torso Rotation Ring Compressor Connection 4 Use the upward arrow on the gripper button pad located on either side of the mannequin s torso to move the rotation ring to the highest Home position in the mannequin s torso The rotation ring is now ready for installing a fetus 27 CAE Fidelis Lucina Configuring the Mannequin
99. al 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 End User License Agreement CAE Fidelis ucina 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 preven
100. al until reaching the final position At the final position the fetus is released from birthing mechanism and is ready to be manually delivered 308 ZW CAE Healthcare M se Parameter Descriptions The Rotation of Posterior Shoulder option activates the automatic resolution of shoulder dystocia upon detection of proper rotation of the posterior shoulder Upon detection Posterior shoulder rotation maneuver was performed and Shoulder dystocia condition resolved will be logged in the event log Once shoulder dystocia is resolved the fetus is released from the birthing mechanism and can be manually delivered Proper rotation of the posterior shoulder requires that the posterior shoulder is rotated at least 35 Improper rotation of the posterior shoulder is prevented For example if after restitution the fetus is in LOT position automatic resolution of shoulder dystocia requires that the posterior shoulder is rotated clockwise at least 35 In LOT position rotating the posterior shoulder counter clockwise is prevented The Rotation of Anterior Shoulder option activates the automatic resolution of shoulder dystocia upon detection of proper rotation of the anterior shoulder Upon detection Anterior shoulder rotation maneuver was performed and Shoulder dystocia condition resolved will be logged in the event log Once shoulder dystocia is resolved the fetus is released from the birthing mechanism and can be manually delivered P
101. ance CAE Fidelis Lucina 5 Twist and fully insert the rectal plug back of lower torso NOTE Lift mannequin to one side for access to plug The rectal plug The Mannequin Torso Back 6 Insert the birth canal top grooves into the left and right sides of mannequin NOTE Gently stretch the mannequin skin away from the torso to allow room for birth canal insertion The top grooves y 2 T E j M The Birth Canal Top Grooves 266 ZW CAE Healthcare Care and Maintenance 7 Insert the bladder into the inside bottom of birth canal ensure bladder lays flat The bladder The Mannequin Torso 8 Align and insert the GU tank and tubing left side of mannequin torso Ensure tubing is fully inserted into birth canal The GU tank The GU tube inside birth canal The GU Tank and Tube NOTE GU tube outline is for reference only The GU tube is inserted into the top left side of the birth canal and runs down and through the birth canal to the exterior GU opening 267 Care and Maintenance CAE Fidelis Lucina TIP Lubricate exterior of tubing to help ensure full insertion into birth canal The GU Tank Tube Insertion NOTE The end of the GU tubing should be visible from exterior of birth canal at vaginal opening The GU tube The Birth Canal Exterior View 268 CAE Healthcare Care and Maintenance 9 Align the GU tank to the mannequin torso and insert screw The GU
102. ance of the Product and the use of the Product solely as an educational tool End User License Agreement CAE Fidelis ucina 2 LICENSE 2 1 In consideration of Licensee s agreement and compliance with the terms and conditions contained in the MEPGTC and in this License CAE Healthcare grants to Licensee and Licensee accepts a personal non exclusive non transferable license to use the Embedded 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 Embedded Software is a trade secret of CAE Healthcare and only CAE Healthcare shall have the right to alter maintain enhance or otherwise modify the Embedded Software 2 3 Without limiting the foregoing or any other terms in this License Licensee shall and shall ensure that any person authorized to access the Product which are limited
103. and Maintenance section Priming the Genitourinary System Prior to catheterizing the simulator the genitourinary GU system must be primed To prime the GU system 1 Fill a syringe with distilled water and clinically appropriate food coloring if desired 2 Connect the syringe to the GU filling tool 3 Plug the GU filling tool into the Urinary port colored yellow located on the torso baffle inside the mannequin 4 Slowly push in the distilled water until fluid drains into the overflow reservoir on the GU filling tool approximately 70 mL 10 mL 5 Disconnect the GU filling tool from the Urinary port 6 Store the GU filling tool in a secure location for future use For more information on draining and cleaning the GU system see Cleaning the Genitourinary System in the Care and Maintenance section Inserting a Urinary Catheter Once the GU system has been primed catheterize the simulator using a standard 14 Fr urinary catheter lubricated with cottonseed oil spray When the catheter is inserted simulated urine begins to flow until the internal bladder is empty NOTE The urinary catheter needs to be inserted approximately 4 1 2 to achieve urine flow 224 ZW CAE Healthcare Using Lucina Medication and Fluid Administration Lucina supports pharmacological interventions through pre programmed pharmacokinetic and pharmacodynamic parameters that are established for more than 50 intravenous drugs Sta
104. and blood pressure Use this parameter to raise or lower the cardiac output Default 1 Range 0 10 10 00 299 M se Parameter Descriptions CAE Fidelis ucina Right Ventricle Contractility Factor The Right Ventricle Contractility Factor parameter adjusts the contractility of the right ventricle and has a direct effect on pulmonary artery pressure and an inverse effect on central venous pressure Use this parameter to raise or lower pulmonary artery pressure PAP or to change the central venous pressure CVP Default 1 Range 0 10 10 00 Systemic Vascular Resistance Factor The Systemic Vascular Resistance Factor parameter adjusts the baseline systemic vascular resistance Raising the value increases the systemic vascular resistance while lowering the value decreases the vascular resistance Raising the parameter value is analogous to increasing the resistance to blood flow through the systemic vasculature Under such conditions the arterial blood pressure ABP increases and the heart rate may decrease due to feedback from the physiological control mechanisms Default 1 Range 0 10 10 00 Venous Capacity Factor The Venous Capacity Factor parameter adjusts the volume of blood contained in the unstretched venous system without an increase in venous pressure Raising the value decreases the venous capacitance vasodilatation and decreased vascular tone while lowering the value increases the venous capacitance vasoco
105. and decrease in arterial blood pressures The heart rate increases due to feedback from the physiological control mechanisms in an attempt to maintain adequate blood pressures Default 1 Range 0 10 100 00 Baroreceptor Gain Overall Factor The Baroreceptor Gain Overall Factor parameter adjusts the influence of mean arterial pressure MAP on heart rate contractility systemic vascular resistance and venous capacity Use this parameter to adjust how vigorously the heart and vasculature respond to blood pressure changes The degree of increase in heart rate or vascular response is influenced by the baroreceptor gain overall factor For example when blood pressure falls the heart rate increases the arteries increase their vascular tone resistance and there is less pooling of the blood in the venous system all in an attempt to maintain adequate blood pressure A baroreceptor gain overall factor value of less than 1 corresponds to baroreceptor depression A baroreceptor gain overall factor value greater than 1 leads to a stronger response to MAP changes Default 1 Range 0 00 100 00 Baroreceptor Gain Cardiac Factor The Baroreceptor Gain Cardiac Factor parameter selectively adjusts the influence of mean arterial pressure MAP on the heart rate and contractility influencing how much the heart rate increases or decreases with changes in blood pressure Use this parameter to adjust how vigorously the heart responds to blo
106. and groups Content Management Users with the Content Management privilege can create and manage all SCEs Creating a New Group To create a new Group 1 From the Groups panel click New The Group Name field appears 2 Enter the name of the Group in the Group Name field 3 Click Create Group The group appears in the Groups panel Privileges can now be selected 4 Select the privilege s to be assigned to the Group 5 Click Save Deleting a Group Groups can be deleted when they are no longer needed Once a Group is deleted all users who were affiliated with the Group are moved to the Deactivated Users Group To permanently delete a Group select the group to be deleted from the Groups panel and click Delete When the Group Deletion warning box appears click Yes 151 Using M se Providing Access to Content Only CAE Fidelis Lucina To provide users with the ability to create and manage SCEs but not the ability to manage users or groups 1 Create a new group called Content Only 2 Assign the group the Content Management privilege Do NOT assign any other privileges to the group 3 On the User Accounts tab create or edit the desired users placing each user in the Content Only group System Settings From the System Settings panel users can manage the System Configuration Data Management Product Licensing Language CTG Configuration and Performance Metrics of the M se software To access the Sys
107. and tidal volume show a transitory increase in an attempt to return the patient to the physiological control CO set point If the Respiratory Gain Factor is increased to more than 1 the patient has a more pronounced response while values less than 1 correspond to a blunted response Default 1 Range 0 00 10 00 Respiratory Quotient Respiratory Quotient is the rate of carbon dioxide production divided by the rate of oxygen consumption Changes to the Respiratory Quotient parameter alter the rate of carbon dioxide production relative to the rate of oxygen consumption Default 0 8 Range 0 70 1 10 Volume Rate Control Factor Ventilatory responses to increased arterial carbon dioxide or decreased arterial oxygen may take the form of increased tidal volume increased respiratory rate or both The Volume Rate Control Factor determines these relative changes At a value of 1 increased and decreased ventilatory drive affect tidal volume and respiratory rate equally When the Volume Rate Control Factor is greater than 1 increased or decreased minute ventilation is predominantly achieved by changes in tidal volume When the Volume Rate Control Factor is less than 1 ventilatory changes are affected primarily by changes in respiratory rate For example set the Volume Rate Control Factor to 0 1 and increase the shunt fraction to 0 4 to decrease the arterial O5 The patient responds to falling arterial oxygen levels with increased minute ve
108. anguage selection To access the User Guide in other languages please visit www caehealthcare com and click the Support link 154 ZW CAE Healthcare Using M se Cardiotocograph CTG Configuration To configure the emulated CTG paper strip displayed on the CTG monitor 1 From the System Settings panel under the Cardiotocograph CTG Configurations heading Click CTG Settings The CTG Configurations dialog box appears 2 From the dialog box select a Paper Type Paper Speed and Paper Theme 3 Click Accept The CTG strip is configured to the selected settings Performance Metrics Acceptable limits for fetal traction and key CPR parameters can be set from the System Settings panel To set the maximum acceptable fetal traction 1 From the System Settings panel under the Performance Metrics heading Click Fetal Traction The Traction Threshold dialog box appears 2 From the dialog box enter a threshold value 3 Click OK The traction threshold is set To set CPR thresholds 1 From the System Settings panel under the Performance Metrics heading click CPR 155 Using M se CAE Fidelis Lucina The CPR Settings window appears CPR Settings Training Target Values Chest Recoil s Low High 90 to Compression B Rate per min 100 i 2 120 60 150 prr m Chest Compression Depth 2 E in Ventilation Low High Volume liters s 0 35 le 0 70 j 2 Physiological D
109. ar nitrous oxide Using this parameter bypasses pharmacokinetics real and instructor specified inspired fractions venous content lung perfusion and ventilation This parameter can be used to focus on cardiorespiratory effects pharmacodynamics NOTE Muse does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default 0 0096 Range 0 0096 80 096 290 ZW CAE Healthcare M se Parameter Descriptions Fraction of Inspired Nitrous Oxide The Fraction of Inspired Nitrous Oxide parameter is used to simulate the amount of nitrous oxide set in the anesthetic vaporizer and is used to calculate alveolar nitrous oxide This parameter has a faster effect on physiology than anesthesia machine settings because mixing in the breathing circuit is not simulated NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default 096 Range 0 0096 80 096 Alveolar Sevoflurane The Alveolar Sevoflurane parameter is used to simulate the presence of sevoflurane in the alveolar space without using real anesthetic vapors The sevoflurane percentage is input to the drug models to achieve the expected pharmacodynamic effects e g respiratory depression Using this parameter bypasses pharmacokinetics real and instructor specified inspired fractions venous content lung perfusion and ventilation This parameter can be used to focus on cardiore
110. arameter located on the Cardiovascular view is also available for virtual defibrillation 218 ZW CAE Healthcare Using Lucina Cardiac Pacing A standard transthoracic cardiac pacemaker can be connected to the simulator using the anterior defibrillation connection The software automatically detects and responds to pacing signals from 20 to 200 mA in increments of 10 Three parameters can be used to simulate pacing within the software Pacing Capture Threshold determines the minimum pacing current necessary to pace the heart Pacing Current simulates a specific amount of current discharged by an external cardiac pacemaker Pacing Rate determines the cardiac rate when the Pacing Current is at or above the Pacing Capture Threshold All three parameters are located on the Cardiovascular view Fluids Lucina is capable of vaginal bleeding IV fluid administration and urine output IMPORTANT Use only clear distilled water distilled water tinted with food coloring or distilled water mixed with white vinegar 50 50 inside the mannequin Administration of any other type of fluid is NOT supported and may damage the system Bleeding and blood administration are controlled from the Fluids view in Muse To access the Fluids view from the Run screen click the blood droplet on the human form The Fluids parameters appear Fluid Loss Blood Fluid Loss Plasma Colloid Infusion Crystalloid Infusion PRBC Infusion
111. ardless of arterial oxygen or carbon dioxide levels In such situations the patient can only respond to arterial oxygen or carbon dioxide levels when the Tidal Volume parameter is adjusted Default Modeled Range 4 breaths per minute 40 breaths per minute 278 ZW CAE Healthcare M se Parameter Descriptions Respiratory Rate Factor The Respiratory Rate Factor parameter along with the Tidal Volume Factor parameter is used to change the baseline respiratory rate before the control of breathing and drug influences are taken into account A value of 2 doubles the baseline respiratory rate A value of 0 5 decreases the baseline respiratory rate by 5096 Changing the respiratory rate using this parameter maintains the physiological models Default 1 Range 0 01 6 00 TIP First decrease the respiratory gain factor to reduce the influence of the respiratory control mechanism on the respiratory rate and tidal volume Shunt Fraction The Shunt Fraction parameter is frequently used to assist in desaturating a patient This parameter creates a physiologic bypass of the normal pulmonary circulation resulting in changes in O5 CO and anesthetic gases at the alveolar level Typically values of 0 1 to 0 4 are needed to create large alveolar arterial oxygen gradients sufficient to cause arterial hypoxemia Default 0 02 Range 0 00 0 50 TIP If the parameter is set high 0 5 the patient desaturates rapidly and responds n
112. ario Designer Creating a New Patient When an additional patient with specific physiological characteristics is needed for repeated use a new patient can be created from the Run screen To create a new Patient 1 From the Home page run an SCE that has a Patient with the same gender as the Patient to be created 2 From the Run screen apply the desired conditions and set the necessary parameters 3 Once complete click the Patient button at the bottom of the Run screen The Patient Button The Patient pop up menu appears The Save button Reset The Patient Pop Up Menu 4 Click Save 104 ZW CAE Healthcare Using M se The Save a copy of the Patient dialog box appears Save a copy of the Patient Saves this patient s current physiologic state The Enter the new patient name field Enter the new patient name Enter the duration of CTG B 4 min The Enter the data to save duration of CTG data to save field The Save button The Save a Copy of the Patient Dialog Box 5 Enter a name for the new Patient in the Enter the new patient name field 6 Enter the duration of CTG data to save in the Enter the duration of CTG data to save field The duration entered represents the amount of time from the current time e g entering 30 saves the most recent 30 minutes of CTG data 7 Click Save The new Patient is saved and available for selection from the Base Patien
113. ase narrow the pulse pressure while smaller values increase the pulse pressure Additionally when the pulse pressure increases as a result of a reduced compliance factor both systolic and diastolic pulmonary pressures increase Conversely with a narrower pulse pressure higher compliance factor both the systolic and diastolic pulmonary pressures also drop Default 1 Range 0 20 5 00 Pulmonary Vasculature Resistance Factor The Pulmonary Vasculature Resistance Factor parameter adjusts the baseline pulmonary vascular resistance Raising the value increases the pulmonary vascular resistance while lowering the value decreases the vascular resistance Raising the parameter value is analogous to increasing the resistance to blood flow through the pulmonary vasculature Under such conditions the pulmonary artery pressure PAP and central venous pressure CVP increase due to back pressure through the right side of the heart Default 1 Range 0 10 10 00 301 M se Parameter Descriptions CAE Fidelis ucina Venous Return Resistance Factor The Venous Return Resistance Factor parameter adjusts the resistance between the extrathoracic and intrathoracic venous compartments Raising the value increases the resistance while lowering the value decreases the resistance With less blood returning to the heart there is a reduced volume entering the ventricles prior to ventricular contraction This results in a drop in the cardiac output
114. at supports the management of a non pregnant patient Default Vaginal Delivery Delivery Paused on Run The Delivery Paused on Run parameter is relevant only for the Vaginal Delivery operating mode When set to Yes the delivery mechanism is paused when the SCE starts There is no progress of labor until delivery is requested to resume Default Yes Postpartum Included The Postpartum Included parameter is relevant only for the Vaginal Delivery operating mode When set to Yes the software allows a transition within a delivery SCE to a postpartum configuration Once the baby has been delivered the user has the choice to proceed to postpartum Once proceed to postpartum is requested the user is offered the opportunity to reconfigure the mannequin for postpartum before continuing the SCE Default Yes 321 M se Parameter Descriptions CAE Fidelis ucina Cervix The Cervix parameter is only relevant for the Prepartum amp Latent Phase operating mode This parameter allows the selection of the static cervix to be installed in the mannequin The selected cervix will be mentioned in the configuration screen to let the user know which one to use Possible choices are Closed closed no effacement firm posterior One Finger 096 closed but penetrable by one finger no effacement firm posterior One Finger 5096 closed but penetrable by one finger 5096 effacement medium posterior Two Finger 70 closed bu
115. ata Thresholds Maximum EtCO2 10 mmHg KE Ratio Lv Minimum 1 1 5 5 Maximum 1 2 5 s Minimum Systolic Pressure 60 4 mmHg M ii 1 4 Minimum Diastolic Pressure 20 mmHg cancel ox The CPR Settings Window 2 Adjust the settings as desired 3 Click OK The settings are saved Error Log The Error Log is available for technicians and is used when diagnosing the M se software IMPORTANT Do not clear the Error Log 156 ZW CAE Healthcare Using Mise Account Profile From the Account Profile screen users can view update and reset personal profile information Users can also view and add favorite SCEs from this screen Click the Account Profile button to access the Account Profile features The Account Profile Button The Account Profile screen appears meti admin Email admin meti com Profile Information ID admin FirstName meti Last Name admin Email admin meti com Favorite SCEs 10 admin Medication Preferences Password Reset Profile Preferences New Password Confirm Password The Account Profile Screen 157 UsngM se CAERidels Luna Profile Information From the Account Profile screen the Profile Information panel appears by default If another panel has been selected click Profile Information to return to the Profile Information panel From the Profile Information panel users can change their profile information and
116. aths min Ventilation lE Average Inspiratory Expiratory Ratio Average 331 CAE Fidelis Traction Feedback Display Definition Current Force Neck Traction Force in Newton N Peak Force Maximum Neck Traction Force in Newton N Force Neck Traction Force graph UA Uterine Activity graph TouchPro Patient Monitor and TouchPro CTG The TouchPro Patient Monitor and TouchPro CTG display consists of numeric and volume widgets A 12 lead ECG report can also be generated from the TouchPro Patient Monitor software Waveform Widget Displays Display Physiological Variable ECG ECG Lead ECG II ECG Lead II ECG III ECG Lead III ECG V1 ECG Lead V1 ECG V2 ECG Lead V2 ECG V3 ECG Lead V3 ECG V4 ECG Lead V4 ECG V5 ECG Lead V5 ECG V6 ECG Lead V6 ECG aVL ECG Lead aVL ECG aVR ECG Lead aVR ECG aVF ECG Lead aVF ABP Arterial Blood Pressure PAP Pulmonary Artery Pressure CVP Central Venous Pressure Pleth Optoplethysmograph Capnogram Capnogram 332 CAE Healthcare Numeric Widget Displays Display Physiological Variable ABP Arterial Blood Pressure TAxilla Axillary Temperature TBlood Blood Temperature TBody Body Temperature CVP Central Venous Pressure C O Continuous Cardiac Output EtCO2 End Tidal Carbon Dioxide HR Heart Rate CR Intracranial Pressur
117. avorite SCEs panel To remove a SCE from the Favorite SCEs panel click the Remove button next to the name of the SCE 159 UsngM se CA Fidelis Luna Medication Preferences From the Medication Preferences panel users can import customized medication response files created in the Pharmacology Editor software To access Medication Preferences click Medication Preferences on the Account Profile screen The Medication Preferences panel appears meti admin Email admin meti com Medication Responses ID admin Patient Group Medication Responses Profile Information Th e Favorite SCEs Medication mE Preferences The anel Medication p Profile Preferences Preferences The Set link Remove and Export buttons The Account Profile Screen To import medication response files click the Set button The Select File dialog box appears Select the medication response file to be added and click Open or OK Medication response files can also be removed or exported 160 ZW CAE Healthcare Using Mise Profile Preferences From the Profile Preferences panel users can change the font size used in the software To access Profile Preferences click Profile Preferences on the Account Profile screen The Profile Preferences panel appears meti admin Email admin meti com Profile Preferences ID admin The Font size Profile Information menu Font Size P Normal Favorite SCE
118. be added while creating or editing an SCE Or to apply a condition that is not set up as a Quick Link in the Conditions palette 1 Click the Conditions button The Conditions menu appears Conditions are organized by system or all available conditions are listed under ALL CONDITIONS Q Close JM ALL CONDITIONS Cardiovascular Hemorrhage Neurologic Respiratory The Conditions Menu 2 Navigate the menus to find the desired condition Once the desired condition has been located click the condition s name from the list The condition is applied and affects the patient s physiology Using the Medications Palette There are two ways to administer medications using the Medications palette using a Quick Link or using the Medications menu Quick Links are preconfigured medications that are made accessible in ZW CAE Healthcare Using Muse the Medications palette for quick application Quick Links can also be created for the Conditions and Interventions palettes To set parameters using the Quick Links in the Medications palette click a Quick Link The medication is applied and appears in the patient s physiology NOTE Not all medications affect the patient s physiology but all are logged The F v Medications Medications Acetaminophen button Albuterol Quick Links Amiodarone Atropine Epinephrine 1 10 000 Epinephrine 1 1 000 The Medications Palette NOTE Quick L
119. bleed connection to support vaginal bleeding IMPORTANT Follow these configuration instructions carefully to ensure that no fluid infiltrates the electrical area inside the mannequin and damages the simulator 48 ZW CAE Healthcare Configuring the Mannequin To install the boggy contracted uterus 1 Ensure the rotation ring is removed from the mannequin s torso Ensure the blood tank is installed Ensure the placenta pouch is placed on top of the blood tank KRW N Thread the cable tie completely through the bag opening NOTE The cable tie may also be threaded through the bag after installing the bag on the uterus The cable tie The Boggy Contracted Uterus Bag 5 Insert the boggy contracted uterus fully into the bag up to the tubing to fit snugly Do not cover tubing The Boggy Contracted Uterus Bag Installation 49 Configuring the Mannequin CAE Fidelis Lucina a Ensure cable tie is threaded through the bag opening and tightened snugly to hold bag in place Excess length of cable tie can be cut off The cable tie The Boggy Contracted Uterus Bag Installation 6 Place the boggy contracted uterus with bag in the abdominal cavity over the placenta pouch Ensure the bag is pulled snug with any slack tucked under the uterus The boggy uterus with bag The blood tank The Boggy Contracted Uterus Installed With Bag 50 CAE Healthcare Configuring t
120. buttons The Condition Setup The SCE selections Configuration selections The TouchPro Setup Panel To create a Quick Link drag and drop the desired choice from the Conditions Medications or Interventions palette to the list of Quick Links Click the minus sign to remove a Quick Link from the SCE Modifying the TouchPro Setup Use the TouchPro Setup link to access the TouchPro Setup panel From the TouchPro Setup panel TouchPro layouts can be enabled or disabled for the selected SCE When a layout is enabled it is available to be used in the TouchPro software with the selected SCE When a layout is disabled it is unavailable to be used in the TouchPro software with this SCE 120 CAE Healthcare Using M se Click the On Off switch next to a layout to enable or disable it TouchPro Pre selected Layout EMS ED Telemetry 7 The On Off switch ICU Arterial Line Only ICU OR ICU OR NO CVP Labor and Delivery Saturation Pulse The TouchPro Setup Panel Patient Status Display To configure the Patient Status Display displayed on the Run screen click Patient Status Display under the SCE Configuration heading on the SCE Editor The Patient Status Display screen appears Patient Status Display me mri The Patient Status Display Screen 121 UsngM se CAs Luna To modify the Patient Status Display drag and drop the desired waveform numeric volume CTG
121. c Li The SCE Summary Panel 2 From the SCE summary panel click the View as PDF button A PDF of the selected SCE appears in a new browser window 3 Save the PDF to an external storage device to print from another computer OR To print from the Instructor Workstation consult your network administrator for assistance connecting to a printer 4 When finished saving or printing the PDF close the browser window containing the PDF to return to M se Running an SCE To run an SCE from the Home screen select an SCE and click the Run button The Run screen can also be accessed from the Scenario Designer or SCE Editor by clicking the Run button near the top of the screen NI The Run Button 69 Using M se CAE Fidelis Lucina The Mannequin Setup window appears Mannequin Setup Vaginal Delivery Vertex Make sure the mannequin is setup as follows BIRTHING MECHANISM Ss 1 Install rotation ring 4 Power on delivery fetus and lubricate 2 Use standard birth canal lubricate 5 Attach umbilical cord to delivery fetus 3 Install uterine funnel with delivery cervix 6 Install delivery fetus lubricate Presentation Vertex Loading Position Occiput posterior face up Vaginal Delivery ABDOMEN 7 Connect umbilical cord to placenta 8 Insert intact placenta in placenta pouch Attach pouch to pelvis 9 Install delivery abdomen connect speakers and palpable contraction system
122. causes the uterus to contract Clicking anywhere else on the screen cancels the action Inverted Uterus Can Be Reverted The Inverted Uterus Can Be Reverted parameter is relevant only for the postpartum inverted uterus When set to Yes manual reversion of the inverted uterus is possible Default No Postpartum Additional Parameters Postpartum Parameters Additional Maternal Position The Maternal Position parameters indicates the maternal position By default maternal position is set to Auto In Auto the system is capable of detecting the following maternal positions Supine Left Lateral Tilt Trendelenburg Reverse Trendelenburg Three additional positions that need to be manually set are Hands and Knees Squatting Sitting Default Auto NOTE Ensure the abdomen is installed on the torso whenever the mannequin is positioned upright 326 ZW CAE Healthcare PARAMETER DISPLAY DEFINITIONS The various patient displays and feedback windows in Muse TouchPro Patient Monitor and the TouchPro CTG Monitor use abbreviations to refer to the parameters displayed The following is a list of parameters available for display and their abbreviations Muse Patient Status Display The Mise Patient Status Display consists of waveform numeric and volume widgets along with other special widgets for the maternal fetal simulator Waveform Widget Displays Display Physiological Variable
123. ce Link Instructions Maternal Fetal Simulator Medication Information e Muse Mannequin Setup Screens CAE Healthcare Equipment Overview EQUIPMENT OVERVIEW The CAE Fidelis Lucina Maternal Fetal Simulator is CAE Healthcare s premiere high fidelity birthing simulator Fidelis Lucina comes with standard equipment as well as additional equipment Optional equipment refers to items which are available for purchase to enhance the simulation experience and additional equipment refers to consumable items which are available for purchase as they may need to be replaced Standard Equipment The standard equipment for Fidelis Lucina includes all the necessary equipment for basic use of the simulator The items listed in the table below are shipped with the simulator Standard Equipment Full Body Wireless Mannequin Laptop Instructor Workstation TouchPro Workstation Power Adapters Cords 2 Gown Prepartum Early Labor Kit Vaginal Delivery Kit Postpartum Kit Accessories Full Body Wireless Mannequin All maternal patient assessments and clinical interventions are played out on the maternal mannequin which represents a human patient At 5 feet 9 inches 175 cm in height and weighing 111 pounds 50 39 kg Fidelis Lucina is fully operational in the supine lateral prone and seated positions The simulator offers features such as arm pronation and supination breath and heart sounds palpab
124. centa Disconnection To disconnect the umbilical cord from the fetus push down on the gray disconnection ring and pull the blue tubing out of the connection port The gray disconnection ring The Umbilical Cord Fetus Disconnection 43 POSTPARTUM Filling the Blood Tank The blood tank has a 2 liter fluid capacity There are two ways to fill it 1 Internally e g when the blood tank has been installed in the mannequin 2 Externally using the Blood Tank Adapter accessory e g when the blood tank needs to be prepared prior to starting a simulation to decrease the time spent changing the configuration from delivery to postpartum Internal Filling To fill the blood tank after it is installed in the mannequin 1 Fill the trauma fill tank with a simulated blood preparation holds up to 7 6 liters The overflow bottle The yellow overflow port The blue BLOOD OUT port The Trauma Fill Tank 2 Connect the trauma fill tank to the ports located on the left side of the mannequin ZW CAE Healthcare Configuring the Mannequin The blue tube connects to the BLOOD FILL port and the yellow tube connects to the BLOOD VENT port The BLOOD FILL port The BLOOD VENT port The Battery Compartment and Ports 3 Ensure the yellow pressure relief knob on the trauma fill tank is closed and pressurize the trauma fill tank by pumping no more than 20 times 4 Wait until there is good return of fluid in the r
125. ces NOTE When running an SCE using Norma L Female the Patient Status Display widgets will show the ECG Waveform HR BP MAP RR SpO2 and Lung Volume The Mute All button Patient Status Display A tre Setup button Widgets The Patient Status Display Widgets Use the Mute All button to mute all Patient Status Display alarms To change the information displayed in a Patient Status Display widget click on a desired widget A list appears showing all the parameters available for the selected widget type To adjust the widget layout click the Setup button 73 UsngM se CAERidels luna The Widget Configuration menu opens displaying available widget types Numeric Waveform Volume CTG and Graphic Widget Configuration Numeric Waveform Lung Volume R L 1322 1322 Graphic The Widget Configuration Menu Adjust the Patient Status Display layout by dragging a widget type from the Widget Configuration Menu and dropping it over the Patient Status Display The new widget type replaces the old The Graphic Widget Display cannot be changed This widget displays the fetal position and station and changes during the delivery process Numeric Widget Options Alveolar Enflurane Alveolar Halothane Alveolar Isoflurane Alveolar Nitrous Oxide Alveolar Sevoflurane Cervix Dilatation CTG FHR CVP B EtcO2 FHR IUP Hematocrit HR ICP The Set Color nemi index
126. com Principal hours of operation exclude holidays and non business days Lucina IMPORTANT Effective January 1 2014 technical and clinical phone support are available ONLY for products with active support and maintenance plans 242 CAE Healthcare Care and Maintenance Breakdown After each use the Fidelis should be properly disassembled and stored in a secure place To ensure that the Fidelis remains in good working condition follow the prescribed CAE Healthcare breakdown procedures below Breakdown Steps 1 Clean the Simulator and Fluid Systems Shut Down the Software Power Off the Simulator b amp b uw N Power Off the Fetus Step 1 Clean the Simulator and Fluid Systems Each time the following are used during simulation they must be cleaned of lubricant and fluids with a soft cloth e Maternal airway Birth canals e Cervices Abdomen e Fetus If internal fluid systems were used during simulation e g vaginal bleeding IV fluids epidural genitourinary fluids the fluid must be drained from the simulator and the fluid systems used must be cleaned For more information on cleaning the fluids see Cleaning the Internal Systems on page 250 Step 2 Shut Down the Software Shut down the M se software and any optional TouchPro computers To shut down the M se software on the Instructor Workstation a In the M se software click the Disconnect icon on the Run screen b Stop a
127. cond method increases the number of channels that can be used simultaneously to 20 channels However this method diminishes the channel to channel 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 11 342 ZW CAE Healthcare 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 RF Chan
128. ction is recorded in the Events log and in the Simulation Session In addition the simulator exhibits a right unilateral chest rise and the appropriate physiological changes result NOTE The first breath must be delivered in order for the sensors to detect or record right mainstem intubation 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 cottonseed oil spray provided Use ONLY the provided cottonseed oil to lubricate the adjunct NEVER use a water based lubricant because of resulting residue damage For supported airway adjunct and clinical supply sizes see Recommended Clinical Supply Sizes 207 Using Lucina Cardiovascular Features CAE Fidelis Lucina Lucina produces realistic heart sounds and a wide range of pathophysiologic conditions synchronized to the ORS complex of the ECG and audible with a standard stethoscope Cardiovascular features are controlled from the Cardiovascular view in M se To access the Cardiovascular view from the Run screen click the heart on the human form The basic Cardiovascular parameters appear To view additional parameters click the Basic Additional switch The Basic Additional switch Blood Pressure Heart Rate Heart Rate Factor Cardiac Rhythm Arterial Catheter Central Venous Catheter PA Catheter PA Balloon Defib Pacing Cu
129. ction light flashes once every second If the green connection light fails to blink ensure both units are set to the same RF channel 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 343 Wireless Voice Link CAE Fidelis Lucina microphone jack is enabled for the standalone microphone provided by CAE Healthcare 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 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 Advanced DIP Switch Settings DIP switch settings are only refreshed when the handset is powered on To ensure the DIP switch
130. day 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 2015 CAE Healthcare 905K470052 v2 1
131. de but soon return to pre bolus levels as increased ventilation efforts work to eliminate the added CO Therefore the rise in CO levels is only transitory This parameter can be used to simulate external CO administration such as that used during laparoscopy Default 0 mmHg Range 0 0 mmHg 60 0 mmHg Bronchial Resistance Factor Left and Right The Bronchial Resistance Factor parameter can be used to set the rate of left and right bronchial resistance individually The rate of resistance can also be set to occur over time Default 1 Range 0 00 250 000 00 Alveolar Enflurane The Alveolar Enflurane parameter is used to simulate the presence of enflurane in the alveolar space without using real anesthetic vapors The enflurane percentage is input to the drug models to achieve the expected pharmacodynamic effects e g respiratory depression Using this parameter bypasses pharmacokinetics real and instructor specified inspired fractions venous content lung perfusion and ventilation This parameter can be used to focus on cardiorespiratory effects pharmacodynamics NOTE Muse does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default Modeled Range 0 0096 5 0096 288 ZW CAE Healthcare M se Parameter Descriptions Fraction of Inspired Enflurane The Fraction of Inspired Enflurane parameter is used to simulate the amount of enflurane set in the anesthet
132. decelerations This parameter is defined in beats per minute bpm Default Modeled Range 30 bpm 240 bpm 312 ZW CAE Healthcare Mise Parameter Descriptions FHR Variability Coefficient The FHR Variability Coefficient parameter determines the variability present in the fetal heart rate signal When set to modeled the variability will be dependent on the fetus oxygen levels and the fetal state This parameter is not defined in bpm it is a unitless factor Default Modeled Range 0 5 Umbilical Cord Compressibility Factor The Umbilical Cord Compressibility Factor determines how susceptible the umbilical cord is to compression through uterine contractions The primary use of this parameter is to introduce variable decelerations to the fetal heart rate signal due to uterine contractions The parameter also allows for the scaling of these decelerations Default 0 Range 0 2 0 FHR Acceleration Amplitude The FHR Acceleration Amplitude parameter determines the amplitude of the accelerations in the fetal heart rate signal When set to modeled it is dependent on the fetus oxygen levels and the fetal state The acceleration amplitude has some variability associated with it This parameter is defined in bpm Default Modeled Range 0 bpm 20 bpm FHR Acceleration Interval The FHR Acceleration Interval parameter determines the interval between the accelerations in the fetal heart rate signal When set to modeled it is depende
133. dial 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 To use the ECG lead ports locate the posts provided in the accessory kit and screw each post onto a lead port NOTE The inferior locations have an extender permanently in place Manual Blood Pressure Blood pressure can be taken manually on either arm Non invasive blood pressure monitoring techniques can be used by attaching the standard cuff modified with a T fitting and adapters 214 ZW CAE Healthcare Using Lucina To modify a standard cuff for use with the maternal mannequin 1 Using a standard blood pressure cuff cut the hose that connects to the pressure gauge 2 Insert one of the supplied adapter fittings into each of the open ends of the cut hose Use a female fitting on one end and a male fitting on the remaining end 3 Insert the T fitting into the hose adapters The pressure gauge The T fitting end connection to NIBP port The T fitting m The Blood Pressure Cuff with T Fitting 215 Using Lucina CAE Fidelis Lucina 4 Locate and connect the other end of the T fitting to the
134. displayed on the CTG Unused reserved space is reallocated to the available widgets to minimize visual impact Connected The emulated CTG does have the capability to display the maternal temperature and a probe is connected The temp widget is displayed and provides live measurement of the maternal temperature Disconnected The emulated CTG does have the capability to display the maternal temperature but no probe is connected The Temp widget is displayed but displays to indicate no data is being received Default Connected 318 ZW CAE Healthcare Muse Parameter Descriptions FHR Signal Loss The FHR Signal Loss parameter controls the overall quality of the fetal heart rate signal to emulate quality of the probe installation This parameter indicates the relative amount of signal loss as a percentage 096 is a clean signal with no loss 10096 results in no signal Intermediary values create progressively larger gaps of data on the graph The FHR widget displays when there is no valid data This parameter is applied regardless of the probe type Instructors can create various FHR signal quality scenarios by using this control and the probe type selection Default 0 Range 0 100 UA Signal Loss The UA Signal Loss parameter controls the overall quality of the uterine activity signal When set to yes the uterine activity signal is set to 0 regardless of the probe type Default No TOCO Offset The TOCO Of
135. ditional parameters transitions and notes can be added Each state can contain multiple parameters and transitions Double click the state name to rename it Click the Collapse State button to minimize the state Double click the collapsed state to expand it Adding Conditions Interventions and Parameters Conditions can be added to states by dragging and dropping them from the Conditions menu to the desired state To add parameters to a state click the Parameters button within the state 128 ZW CAE Healthcare Using Muse The State Parameters screen appears Basic Initial Assessment edit Rate of Descent 0 0 A Normal Delivery Fetal State P Calm Slee E Contraction Frequency Searle DM ae Contracti 5 3 ead ab x Contraction Amplitude Ete her 290 i Th e State Contraction Amplitude 80 Temperature Blood ssec Parameters Contraction Duration 0 usce boas ase pa n el Patient Pusing ne Heart Rate Factor 115 Early Deceleration Magnitude P None Systemic Vascular 135 Resistance Factor Late Deceleration Amplification Factor 10 Venous Capacity Factor 0 9 Disabled Systemic Arteries Shoulder Dystocia isal Compliance Factor d Shoulder Dystocia Resolution P None Pulmonary Arteries 09 Compliance Factor Extraction of Posterior Arm A Respiratory Rate Factor 125 Th Arrested Labor Disable Shunt Fraction 0 08 z EENE m Complete Arrested Labor Trigger Station rs me compres Dutton Arrested Labor Resolved by
136. e 196 ZW CAE Healthcare Using the TouchPro CTG Monitor Exiting the CTG Monitor To exit the CTG monitor 1 Click the Settings button from the bottom right corner of the CTG Monitor fF Settings The Settings Button The CTG Monitor Settings menu appears fg CTG Qu Alarm Suspension Time Qu Audio Setup MNIBP Cycling d Language Selection Q Shutdown The Shutdown button The CTG Monitor Settings Menu 2 From the Settings menu click Shutdown A warning box appears asking if you want to exit 3 Click Shutdown The CTG Monitor shuts down and the M se Start Screen appears 197 Using the TouchPro CTG Monitor CAE Fidelis Lucina This page intentionally blank 198 ZW CAE Healthcare Using Lucina UsiNG LUCINA Once Lucina has been set up the software has been loaded and an SCE started the simulator is ready for learner interventions From the Run screen the features of Lucina can be accessed They are broken down into the following categories Fetal and Labor Neurological Respiratory Cardiovascular Fluids and Sounds Speech balloon Brain Heart Lung Uterus Fluids Control icon Sound Control icon The Physiological Views To access each view click the appropriate organ icon or button For Fetal and Labor click the uterus e For Neurological click the brain For Respiratory click the lung For Cardiovasc
137. e MAP Mean Arterial Pressure NIBP Non Invasive Blood Pressure PACO2 Alveolar Partial Pressure Carbon Dioxide PaCO2 Arterial Partial Pressure Carbon Dioxide PAO2 Alveolar Partial Pressure Oxygen PaO2 Arterial Partial Pressure Oxygen PCWP Pulmonary Capillary Wedge Pressure PAP Pulmonary Artery Pressure Pulse Pulse PvCO2 Venous Partial Pressure Carbon Dioxide PvO2 Venous Partial Pressure Oxygen TRectal Rectal Temperature RR Respiratory Rate SpO2 Oxygen Saturation Therm C O Thermodilution Cardiac Output 333 Parameter Display Definitions CAE Fidelis Lucina 12 Lead ECG Report Parameters Parameter Physiological Variable ECG Lead Hl ECG Lead III aVL ECG Lead aVL V1 ECG Lead V1 V3 ECG Lead V3 V5 ECG Lead V5 334 ZW CAE Healthcare Recommended Clinical Supply Sizes RECOMMENDED CLINICAL SUPPLY SIZES The following clinical supply sizes are recommended for use with maternal fetal simulator Other sizes may cause damage to simulator and should not be used Recommended Clinical Supply Sizes Combitube 41 Fr Endotracheal ETT 6 5 7 5 mm i gel Supraglottic Airway 4 Intrauterine Balloon 24 Fr IV Cannula 14 20g King Airway 4 Laryngeal Mask Airway LMA 4 5 Nasal pharyngeal Airway 28 Fr Oropharyngeal Airway 90 mm Urinary Catheter 14 Fr THE ISCHEMIC INDEX DEATH SPIRAL The Ischemic Index is a measure of the myocardial ischemia model
138. e mannequin must be wrapped in a sheet Failure to wrap the mannequin in a sheet may result in permanent damage to the mannequin skin CAE is not responsible for damage to the mannequin skin if the mannequin is not wrapped in a sheet while using the stretcher xii ZW CAE Healthcare Table Of Contents TABLE OF CONTENTS CAE Healthcare End User License Agreement scsscsscsscssssssssssssssssecsscssssscsssessesserseres i System Requirements ETT vii Specifications ee Nr ix SIZE M T ix Weight eco m mc I PH aeaaeai ix Environmental Requirements sssscssssssssssssssssssssssssssssssssssssssessessssssssssessessssessesssseesers ix Ambient Temperature Daniel vasa CIS ER b EREpa Erb RR rtr f bu i po Sdn ix Maximum Altitude NET TETTE OLET ENT DIE RSS ix Lil ge H n X oun en Peut X Electrothera py MR X iR m X Cautions and TID me xi Electrical Safeby aso nnd dai npa do cp a o HDD ORE DORADO AER PL ARA xi latex VATER ech tita tan st Dope sent ned p a a sudeste c iue Xi General Use Warnings ausus duod RAE encanta bapa ERROR OBDATEQUREME SON VUA DNA NNR po ala TR MUN Xii IL fi Jl m xiii Introduction ss escais casos Toss v noson 1 Contained in this User Guide
139. e Instructor Workstation MUST be connected to the simulator network prior to performing the steps below See the previous setup step for more information To connect the TouchPro software to a different computer than the workstation provided by CAE Healthcare a Power on the computer to be used for the TouchPro software b On the Instructor Workstation Maclntosh laptop from the Apple menu click System Preferences The System Preferences screen appears c From the System Preferences screen click Network The Network screen appears d From the Network screen click Advanced The Advanced screen appears e From the Advanced screen click TCP IP Note the IP Address listed next to the IPv4 Address header ch Write down the IP Address and click Cancel to close the Advanced screen g Close the Network screen h On the computer to be used for the TouchPro software open a web browser window Inthe address field enter the noted IP address The M se Start screen appears EN TouchPro Patient Monitor TouchPro m e The M se Start Screen j Choose the TouchPro CTG or the TouchPro Patient Monitor to launch the software NOTE If you experience poor waveform quality or connection dropouts consider relocating the simulator to a position with less interference in the 2 4Ghz wireless frequency 18 ZW CAE Healthcare CONFIGURING THE MANNEQUIN The maternal mannequin must be configured properly in
140. e Mannequin To attach the umbilical cord to the fetus push one of the blue ends of the cord into the umbilical opening on the fetus The blue tubing The Umbilical Cord Attached to the Fetus 5 Lubricate the fetus head neck and upper torso using cottonseed oil DO NOT lubricate under the fetus arms 6 Insert the fetus by placing the head against the delivery cervix and facing upright Ensure that the fetus arms are firmly adducted against its torso The Fetus in the Rotation Ring Vertex Presentation 33 Configuring the Mannequin CAE Fidelis Lucina 7 Insert the buttocks of the fetus into the rotation ring up to the two dimples near the umbilical cord area The two dimples The Fetus in the Rotation Ring Vertex Presentation 8 Bend the legs at the knees and tuck the feet into the rotation ring up to the ankles The Fetus in the Rotation Ring Bent Legs 34 CAE Healthcare Configuring the Mannequin 9 Inflate the rotation ring by pressing either grip button inside the mannequin torso indicated by the lock icon The Lock icon The Gripper Lock Icon The fetus is now installed for a vertex vaginal delivery Installing the Placenta NOTE For active and vaginal delivery configurations prior to installing the placenta the fetus and placenta should be connected to the umbilical cord The Fetus Umbilical Cord and Placenta Connected For more information on attaching the umb
141. e and the state is highlighted on the Scenario screen NOTE Double click on the states to expand to the full view 5 Click the Close Window button to return to the Run screen Pausing Labor When a vaginal delivery SCE begins running labor may start automatically or may be paused initially depending on the selection made in the Patient Baseline when the SCE was created NOTE The default setting is that labor will be paused when SCE begins running If labor is paused when the SCE begins labor can be started at any time by clicking the Resume Delivery button in the upper right corner of the M se screen Pe S the Resume Delivery button 00 20 08 Delivery The Delivery Controls The Delivery Clock When a vaginal delivery labor is in progress the delivery clock counts down to delivery NOTE The delivery time is an estimate based on the current position on the descent mechanism and the constant selected rate of descent the delivery time does not take into account the contractions Therefore the clock will always reach 0 before the fetus is delivered The higher the descent rate the more difference there will be between the clock reaching 0 and the actual delivery The time left on the delivery clock is driven by the patient s physiology and may change if certain parameters such as Contraction Frequency and Rate of Descent are modified Once the fetus is in position for delivery and can be retrieved from the mate
142. e 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 292 ZW CAE Healthcare M se Parameter Descriptions Heart Rate Factor The Heart Rate Factor parameter is used to change the baseline heart rate before physiological controls are taken into account A value of 2 doubles the baseline heart rate while a value of 0 5 decreases the heart rate by 5096 Use this parameter to raise or lower the heart rate Default 1 Range 0 10 4 00 Cardiac Rhythm The Cardiac Rhythm parameter is used to change the patient s underlying cardiac rhythm displayed on the Patient Status Display or TouchPro patient monitor To change the cardiac rhythm click the Cardiac Rhythm parameter and select the desired rhythm from the available list If a number appears following the cardiac rhythm on the list this overrides the heart rate to the rate indicated For cardiac rhythms without a number the Heart Rate Factor parameter can be used to independently control the heart rate Default Modeled Options Modeled Asystole Atrial Enlargement Left Atrial Enlargement Right Atrial Fibrillation Atrial Fibrillation HR 120 Atrial Fibrillation HR 80 Atrial Flutter Atrial Flutter HR 150 Atrial Tachycardia AV Block First Degree AV Block Second Degree
143. e eene eee eene rone n etta stone etas teas staat aaeo 351 Mannequin Setup Screen for a Prepartum SCE 4 e eeeee eene eere entente enero enatne 352 Mannequin Setup Screen for an Active Phase Breech SCE eere eere 353 Mannequin Setup Screen for an Active Phase Vertex SCE eere eere 354 Mannequin Setup Screen for a Vaginal Delivery Breech Left Sacrum SCE 355 Mannequin Setup Screen for a Vaginal Delivery Breech Right Sacrum SCE 356 Mannequin Setup Screen for a Vaginal Delivery Vertex SCE eere 357 Mannequin Setup Screen for a Cesarean Breech SCE cernere eee eere 358 Mannequin Setup Screen for a Cesarean Vertex SCE 4 eere eene eere ener 359 Mannequin Setup Screen for a Non Gravid SCE eeeeeeee eerte e eene entren enne 360 XXV Table Of Contents CAE Fidelis Lucina This page intentionally blank xxvi ZW CAE Healthcare Introduction INTRODUCTION Welcome to the CAE Fidelis Lucina Maternal Fetal Simulator user guide This guide provides complete instructions on how to use and maintain your simulator The Fidelis Lucina simulator has been designed to provide instructors and learners with advanced tools for obstetrical training The CAE Fidelis Lucina Maternal Fetal Simulator Mate
144. e events as states save the Patient and associate records with the Patient 71 Using M se CAF Fidelis Luna SCE Information The SCE Information is a drop down menu which is accessed by clicking the SCE title in the upper left corner of the screen The SCE Information drop down menu The SCE Title and Patient Name Mannequin Setup SCE Details a Pera Contraction Frequency Contraction Amplitude Late Deceteration Amglifi Shoulder Oystocia Shoulder Oystocia Resolution Arrested Lobor Arrested Labor Trigger Station Arrested Labor Resolved by Traction Traction Force Required to Resolve Arrested Labor Po Traction Feedback 49 CPR Monitor QO Event Recorder The Run Screen Select Mannequin Setup to view the Mannequin Setup screen as a popup screen Click Close to exit the Mannequin Setup Window and return to the Run screen Select SCE Details to access the SCE Editor screen where the baseline setup SCE Content and Configuration Setup information can be viewed To return to the Run Screen click the Continue button in the upper right corner of the screen 72 ZW CAE Healthcare Using Mise 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 eight available display spaces for the widgets Waveform and CTG widgets utilize two display spa
145. e pe rei a drole rn nuari rer rn red ein abo 326 Parameter Display Definitions i a ons erre rh YE Een EFIE EY WEE SEERS YER FEE RER EE EH REEESE RS ERR EUIS 327 Muse Patient Status Display 327 Waveform Widget Displays orci Qu ORA MP UR READ GRO UMEN HUE RR RUE 327 Numeric Widget Displays usce eoi s age CORTE LUN HR CURE QUA UU RUA QUERER RERBA RUE 328 Volume Widget Displays ucoouceric tori perspi etup Pani pU EO bep t Eten p ied 330 Other Widget DIS DIOS sco scenes GaU Gentoo Co noa ton onn a bend REND RO HER OM 330 did pi e essaia 330 rjj M A 332 TouchPro Patient Monitor and TouchPro CTG eere eres ee reete enata enano 332 Waveform Widget Displays usucacsiosirirmisan rog cR pannos pA ERR GEL BOR RUD Rd 332 Numeric Widget Displays sc cogi p AIRES EORR E CONO DUO RA VUA ose SR NU pre NR 333 12 Lead ECG Report Pafaitielbls sooo oen EE ERUDR HR Odit cO Frida tun ha nod 334 Recommended Clinical Supply Sizes 4 e eeeee eene enero nena nna anoe 335 The Ischemic Index Death Spiral eene ener ener entere enero enaenanue 335 Llc al E em 337 Cautions and Warnings sock dee rir oU RAF UO ear DDR Y AR HR RO RO A 337 What s Induded e 338 How ij T
146. ecifying an ELSE transition from a state the state must first contain at least one other transition To add an ELSE transition click ELSE in the original state The ELSE menu appears listing all the available states The ELSE button j Rapid Trauma Assessment Pulseless Electrical Activity Casualty Evacuation The ELSE menu Unresponsive The Scenario Designer Select the desired state A black connector line appears indicating that the states are now linked by an ELSE transition Black connector line The Scenario Designer 132 ZW CAE Healthcare Using Muse Deleting Scenario States To delete a state drag and drop the state into the Trash States can be dragged and dropped to the Trash from the Graphical view or the Line Item view Deleted states remain in the Trash until you log out of the software or the Trash is cleared Deleting Parameters and Transitions To delete a parameter or transition from an active state drag and drop the desired parameter or transition into the Trash To drag a parameter click anywhere within the parameter To drag a transition click the yellow selection bar to the left of the transition The yellow selection bar A dragged transition The Trash The Scenario Designer Parameters and transitions can be dragged and dropped to the Trash from the Graphical view or the Line Item view Deleted parameters and transitions remain in the Trash until you log out
147. eclaim bottle will start dripping slowly first then accelerate to an almost constant flow this may take a few minutes A constant flow into the reclaim bottle indicates the blood tank is full 5 Disconnect the trauma fill tank from the mannequin and depressurize The blood tank is ready for use External Filling To fill the blood tank before it is installed in the mannequin 1 Locate the Blood Tank Adapter accessory The red connector The beige connector The white connector The Blood Tank Adapter Accessory 45 2 Connect the red connector to the blood tank outlet clear tubing located at the top of the blood tank 3 Locate the trauma fill tank The overflow bottle The yellow overflow port The blue BLOOD OUT port The Trauma Fill Tank 4 Connect the beige connector to the trauma fill tank BLOOD OUT port blue tube 5 Connect the white connector to the trauma fill tank overflow port yellow tube 6 Fill tank as per above instruction for internal filling steps 3 and 4 When the tank is full disconnect all ports The filled blood tank is now filled and ready to be installed in the mannequin Installing the Blood Tank To install the blood tank 46 ZW CAE Healthcare Configuring the Mannequin 1 Ensure the rotation ring from inside the mannequin s torso is removed CAUTION Do not place pressure or any object on the rotation ring support arms while the rotation ri
148. ed from the birthing mechanism and is ready to be manually delivered Default No Traction Force Required to Resolve Arrested Labor The Traction Force Required to Resolve Arrested Labor parameter sets the traction force required to resolve the arrested labor Traction force is measured in Newtons Default 30 N Range 10 N 100 N Manual Release of the Baby The Manual Release of the Baby parameter is used to manually release the fetus from the birthing mechanism at any time and make the fetus ready for delivery Upon activation a Release now confirmation button appears Clicking the button immediately releases the fetus Clicking anywhere else on the screen cancels the action 310 CAE Healthcare M se Parameter Descriptions Fetal and Labor Additional Parameters Fetal and Labor Parameters Additional Maternal Position The Maternal Position parameters indicates the maternal position By default maternal position is set to Auto In Auto the system is capable of detecting the following maternal positions Supine Left Lateral Tilt Trendelenburg Reverse Trendelenburg Three additional positions that need to be manually set are Hands and Knees Squatting e Sitting Default Auto NOTE Ensure the abdomen is installed on the torso whenever the mannequin is positioned upright 311 M se Parameter Descriptions CAE Fidelis ucina Contraction Resting Tone The Contraction Resting Tone parameter deter
149. ed 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 plan does not cover normal wear or 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 Assurance plans do 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 The Assurance plan 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 the customer will be given an RMA number and instructions for returning the product An unauthorized return e 9 one for which an RMA number has not been issued will be returned at the customer s expense Authorized shipments are to be shipped prepaid to the address on the RMA The original box and packaging mater
150. ed using classical determinants When an unfavorable oxygen supply demand ratio occurs myocardial ischemia follows The lower the Ischemic Index the greater the myocardial ischemia The Ischemic Index is derived through the underlying physiological models and cannot be measured clinically Favorable supply demand ratios slower heart rates higher blood oxygenation levels generally result in a higher Ischemic Index value whereas unfavorable supply demand ratios faster heart rates lower blood oxygenation levels generally result in a lower Ischemic Index value The patient s Ischemic Index value can be viewed by selecting the Ischemic Index widget from the Patient Status Display 335 The Ischemic Index CAE Fidelis Lucina The table below lists Ischemic Index values and their corresponding patient conditions Model Driven ECG Rhythm Ischemic Index I I I I gt 0 90 0 90 gt l l 0 70 gt l l 0 60 gt l l 0 40 gt l l 1 minute after VTach 1 minute after VFib The patient s response to myocardial ischemia may be altered using the Ischemic Index Sensitivity parameter found in the Cardiovascular view Additional Parameters To make the patient less sensitive to ischemia lower the value below the default setting To make the patient more sensitive increase the value above the default setting 336 ZW CAE Healthcare Wireless Voice Link WIRELESS VOICE LINK This
151. editing a previously created SCE The processes of creating and editing SCEs each begin with a unique button on the Home screen Use the New SCE button to create a new SCE The New SCE Button The minimal requirements for creating a new SCE include selecting a Patient naming the SCE and saving the SCE Once the new SCE is created you can continue with the SCE development or edit it later Use the Review button to edit an existing SCE The Review Button Creating a New SCE Creating an SCE requires naming the SCE and selecting a Base Patient To create a new SCE 1 From the Home screen click New SCE fe New SCE The New SCE Button 111 UsngM se CA Fidelis Luna The Patients Palette appears The selected base patient Name Stannette Momtobe Shantal Lewis Age 29 years old 35 years old The Create Weight 74 0 kg Weight 85 0 ko button Ld The Patients Palette 2 Click on a patient to select that patient from the palette and click Create The SCE Editor appears showing the Enter a name for the SCE dialog box The SCE Name field The Save button The SCE Editor 3 Enter the name for the SCE NOTE The name of the SCE may NOT exceed 80 characters Additionally SCE file names CANNOT contain any special characters such as lt gt 06 4 Click Save Once the SCE is saved it is stored and can be edited and reviewed at any time including creating a
152. egatively to the administration of supplemental O gt SpO The SpO gt parameter is used to override the normal pulmonary circulation and set the SpO at a fixed numeric value regardless of the oxygen applied Resetting to Modeled returns control of the underlying SpO to the physiological models If SpO is set to less than 7596 the eyes will automatically close when in the Auto mode Default Modeled Range 096 10096 279 M se Parameter Descriptions CAE Fidelis ucina 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 setting instructs the pharmacologic models to determine the degree of neuromuscular blockade based upon the drugs injected and their pharmacologic properties When a numeric value is assigned to this parameter the degree of NMB is set to that level For example 8096 NMB causes the simulator to set the degree of NMB to 8096 regardless of the presence or absence of neuromuscular blocking drugs Clinically the spontaneous tidal volume is markedly reduced If NMB is set to greater than 3096 the eyes will automatically c
153. en Roll of hook and loop fastener for forceps Uterine funnel with delivery cervix Umbilical cord e Vein tubing replacement kit This page intentionally blank 8 CAE Healthcare Setup SETUP This section provides instructions and guidelines for assembling the simulator and configuring the Instructor Workstation Follow these steps to prepare for your simulation experience Setting Up the Maternal Fetal Simulator 1 Place Mannequin in the Work Area Power on the Mannequin Power on the Instructor Workstation Connect to the Wireless Network Connect the TouchPro CTG Monitor to the Wireless Network Start Muse Configure the Mannequin 2 3 4 5 6 Connect the TouchPro Patient Monitor to the Wireless Network optional 7 8 9 Fill the Bleeding Fill Tank optional NOTE Replacement procedures are located in the Care and Maintenance section of this user guide Before Beginning Setup Proper operation of the simulator requires correct configuration Before setting up the system keep in mind these basic guidelines Read and understand the Cautions and Warnings located in the beginning of this User Guide Follow the sequence of the 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 returned and shipped in their original p
154. en click the name of the SCE category The SCEs in the chosen category are displayed and available for selection The SCE Operating Mode Icon The icon next to each SCE name in the SCE Selection Panel indicates the operating mode of the SCE The operating mode determines the state of the maternal simulator and whether and how delivery occurs during the simulation The operating mode also determines several simulator setup factors such as which cervix should be used and whether the fetus should be inserted Recent Vaginal Delivery Without Complications The Vaginal Delivery 9 Stannette Momtobe icon The Prepartum and Flre Labor Contractions Latent Phase icon 9 Stannette Momtobe Postpartum The Postpartum icon Norma L Female C Section The Cesarean Stannette Momtobe Section icon The SCE Selection Panel 67 Using M se CAE Fidelis Lucina The SCE Summary Panel The SCE Summary Panel provides information about the selected SCE The Review button The View as PDF A Normal Delivery Paula Jimenez fere button Age 27 years old s Add To Favorites eie The Add to Paula Jimenez pMode Vaginal Delivery Favorites Guinan button The patient is a 27 year old primigravida who was admitted in labor four hours ago at 40 weeks gestation Mother s blood group is O positive Group B streptococcus at 36 weeks was negative This SCE consists of three states that are transitioned
155. escriptions CAE Fidelis ucina Positive End Expiratory Pressure PEEP The PEEP parameter specifies the amount of positive end expiratory pressure applied during mechanical ventilation Setting this parameter results in clinically appropriate intrathoracic pressures and hemodynamic responses Default 0 0 cmH O Range 0 0 cmH5O 25 0 cmH O O Consumption The O5 Consumption parameter is used to change the rate of consumption of oxygen and production of carbon dioxide When O Consumption is increased and used with increased Shunt Fraction profound levels of hypoxia can be achieved rapidly Default 250 mL per minute Range 0 mL per minute 2000 mL per minute CO Production Factor The CO Production Factor parameter allows for the manipulation of metabolic CO production to simulate a variety of pathophysiological conditions CO production is determined by the O Consumption and Respiratory Quotient settings A CO Production Factor value of 2 doubles the CO production while a value of 0 5 decreases the CO production by 5096 Default 1 Range 0 50 4 00 PaCO Set point The PaCO Set point parameter is a set point for PaCO The control of breathing model adjusts tidal volume and respiratory rate in order to bring the PaCO toward this set point Factors that influence the success of this control effort include baseline tidal volume baseline respiratory rate respiratory gain O consumption respiratory quotient lung
156. etwork printer must be configured in order to appear as an option 4 From the Print window click the Print button The report prints to the designated network printer 176 ZW CAE Healthcare Using the TouchPro Patient Monitor 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 NIBP Cycling can be used to set the patient s NIBP to be updated at regular intervals To set NIBP cycling 1 Click the Settings button in the bottom right corner of the TouchPro display The Settings Button The TouchPro Settings menu appears 2 From the Settings menu click NIBP Cycling The NIBP Cycling window appears NIBP Cycling SSS 2 0 mins 3 0 mins 5 0 mins 10 0 mins 15 0 mins 30 0 mins 60 0 mins Custom Cycling The NIBP Cycling Window 3 From the NIBP Cycling window select the desired interval for the cycling 4 Click Start Custom cycling is also available 177 Using the TouchPro Patient Monitor CAE Fidelis Lucina To display the patient s current NIBP click the Manual NIBP button The Manual NIBP button br min The TouchPro Display The current NIBP is displayed NOTE Manual NIBP can be used at any time during cycling However this turns off auto cycling 178 ZW CAE Healthcare Usin
157. f the balloon with cottonseed oil and insert into the uterus 3 Fill intrauterine balloon with 500 mL distilled water per manufacturer s recommendations To remove the intrauterine balloon remove the 500 mL water from the balloon and remove the catheter from the uterus 226 CAE Healthcare Using Lucina Administering an Epidural Fluid can be administered to the mannequin through a permanent epidural port located at the back of the mannequin The luer fitting The Epidural Port An epidural cannula can be inserted through the luer access split septum attached to the epidural port located on the back of the maternal mannequin Prior to administering an epidural the epidural system must be empty To empty the epidural system remove the split septum fitting from the epidural port located on the back of the maternal mannequin The split septum The luer fitting The Epidural Port Connect a syringe to the luer fitting Withdraw the syringe until no air or water is present IMPORTANT Use only clear distilled water distilled water tinted with food coloring or distilled water mixed with white vinegar 50 50 inside the mannequin Administration of any other type of fluid is NOT supported and may damage the system The epidural system must be primed prior to use if cerebrospinal fluid aspiration is desired The epidural reservoir holds a maximum of 60 mL of fluid This reservoir is not pressurized and if it is not f
158. fic Electrotherapy Defibrillation 20 to 360 joules Monophasic Biphasic Pacing 20ma to 180ma Air Supply To properly regulate psi the optional wall air kit must be used in conjunction with the facility supply source and facility wall adapter CAE Healthcare Cautions and Warnings CAUTIONS AND WARNINGS Please read and understand these cautions and warnings before you begin using the CAE Fidelis Maternal Fetal Simulator 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 Fidelis 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 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
159. fset parameter is applicable only if the UA probe selected is TOCO This parameter is used to shift the uterine activity signal by adding removing a fixed pressure offset to the uterine pressure It is useful to emulate conditions such as a tight UA probe belt The effect is only from the change previous historical data is not changed Default 0 Range 100 100 MHR Graph The MHR Graph parameter activates the display of the maternal heart rate over the FHR display when set to on The maternal heart rate graph appears as a blue line Default Off MHR Overrides FHR The MHR Overrides FHR parameter activates the condition whereby the FHR probe picks up the maternal heart beat rate when set to on Default Off MSPO Printing Frequency The MSPO Printing Frequency parameter activates printing of the maternal SpO value on the strip at the specified frequency selected Printing occurs only if there is a connected SpO probe Frequency selections include in minutes 1 2 3 5 10 15 30 60 90 Default 10 minutes 319 M se Parameter Descriptions CAE Fidelis ucina MNIBP Printing Frequency The MNIBP Printing Frequency parameter activates printing of the maternal MNIBP value on the strip atthe specified frequency selected Printing occurs only if there is a connected MNIBP probe Frequency selection includes in minutes 1 2 3 5 10 15 30 60 90 Default 30 minutes Patient Baseline Parameters Patie
160. g Sounds UA Synchronized Vocal Clip Neonate Cry Selection slider Fetal Heart Sound Location The Audible Breathing Sounds Menu Click the Audible Breath Sounds drop down menu to change the type of sound Click and drag the slider to adjust the volume By default no breathing sound is selected The Default volume level is 30 NOTE The Audible Breath Sounds volume control applies as well to the speech sounds and UA synchronized vocal clip 233 Using Lucina CAE Fidelis Lucina UA Synchronized Vocal Clip The UA Synchronized Vocal Clip menu can be used to select a sound to be played in synchrony with uterine activity UA The sound is repeated each time a uterine contraction occurs The UA Synchronized Vocal Clip can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select UA Synchronized Vocal Clip The UA Synchronized Vocal Clip menu appears Breath Sounds Heart Sounds Audible Breathing Sounds UA Synchronized Vocal Clip gt Aaah when pushing None Short push Long push Aaah when pushing Neonate Cry Selection AAAH when pushing Fetal Heart Sound Location The UA Synchronized Vocal Clip Menu Click the UA Synchronized Vocal Clip drop down menu to change the type of sound To adjust the volume of the UA Synchronized Clip click on Audible Breathing Sounds and drag the slider 234 ZW CAE Healthcare Usi
161. g module 1 Click Install Learning Module The Select file to upload dialog box appears 2 Locate the correct learning module file on the external storage device or the hard drive location where the SCE file is saved The file extension is mim 3 Select the file and click Select or Open 140 ZW CAE Healthcare Using Muse 4 Refresh the screen by clicking the Home button in the Muse software and then return to the Learning Modules panel The learning module appears on the Learning Modules panel and is available for use To delete a learning module from Muse 1 Select a learning module from the Learning Modules panel 2 Click the Remove button The Remove Learning Module warning appears Remove the Learning Module The associated SCEs and scenarios will be removed The Remove Learning Module Warning 3 Click Delete The learning module and all its SCEs are deleted NOTE Preconfigured learning modules cannot be deleted If a user attempts to delete them a failure message appears SCEs From the Content Management options click SCEs to access the SCEs panel The SCEs panel appears The SCEs Panel All user created SCEs are listed in the SCEs panel On the SCEs panel users can review copy delete import and export the SCEs they have created NOTE SCEs purchased from CAE Healthcare CANNOT be exported Click Import SCE to import an SCE from an external device or the hard drive location where
162. g the TouchPro Patient Monitor Patients To view the available Patients 1 Click the Settings button in the bottom right corner of the TouchPro display The Settings Button The TouchPro Settings menu appears 2 From the Settings menu click the Patients button The current Patients window appears A Patients x Stannette Momtobe The Patients Window NOTE When connected to the simulator the TouchPro only displays the active Patient 179 Using the TouchPro Patient Monitor CAE Fidelis Lucina Configuring the TouchPro Software The background color and alarm suspension time can be set from the TouchPro Configure panel To access the Configure panel 1 Click the Settings button in the bottom right corner of the TouchPro screen The Settings Button The Settings menu appears 2 From the Settings menu click the Configure button The Configure window appears 3 From the Configure window set the background color and alarm suspension time Background Color x The Exit button m mH Alarm Suspension Time 20 secs 1 min 5 mins Indefinite The Configure Window 4 Click the Exit button to exit the Configure window when finished 180 ZW CAE Healthcare Using the TouchPro Patient Monitor Changing the TouchPro Language To change the language of the TouchPro software 1 Click the Settings button in the bottom right corner of the TouchPro screen The Settings Button The
163. ge 149 UsngM se CA Fidelis Luna From the Groups panel users can create new groups delete groups and assign privileges to groups In the Groups panel three groups appear by default e Administrators e Educators Deactivated Users Each default group has privileges assigned Maintenance The Maintenance panel is used to flush fluids from the simulator To access the Maintenance panel from the System Administration screen click Maintenance The Maintenance panel appears The Maintenance button Bleeding System Hush The Flush The Maintenance System button panel The Maintenance Panel For more information on flushing the system see the Care and Maintenance section of this user guide 150 ZW CAE Healthcare Using Mise Privilege System The Mise 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 M se 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 backup and restore data and apply software updates User Management Users with the User Management privilege can manage all users
164. he Mannequin NOTE If the boggy contracted uterus is already installed in the mannequin be sure to install the bag per instructions above The Boggy Contracted Uterus NOTE The bag style and color may vary 7 Connect the uterus inflation port clear blue tubing labeled BOGGY to the mannequin UTERUS pneumatic port clear blue tubing The UTERUS The uterus pneumatic port inflation port The Uterus Inflation Port and UTERUS Pneumatic Port 51 Configuring the Mannequin CAE Fidelis Lucina 8 Connect the uterus bleed port clear tubing to the mannequin BLOOD UTERUS port clear tube The uterus bleed port The BLOOD UTERUS port Y re MM The Uterus Bleed Port and BLOOD UTERUS Port 9 Lightly lubricate the birth canal and the mannequin s external genitalia using the cottonseed oil provided 10 Lubricate the boggy contracted uterus external genitalia 52 CAE Healthcare Configuring the Mannequin 11 Gather the boggy contracted uterus external genitalia fully inside the 12 13 14 15 mannequin s torso and push the skin through the birth canal The external genitalia The Boggy Contracted Uterus with External Genitalia Tuck in the labia and position the uterus genitalia smoothly over the standard birth canal Tuck the edge skin of the uterus under the torso skin around the genitalia opening Push the external genitalia flap under the buttocks and att
165. he System Administration button to manage stored content user accounts groups and system settings Click the Account Profile button to manage and determine preferences for the active account History From the History screen users can view and export simulation session logs Each simulation session is listed with the Start Time the title of the SCE and the Patient s name In addition the SCE Events Physiological Data CTG data Traction data and CPR data are available for review and export secre cs patient Sci weite o 2014 05 21 11 23 25 Michelle Cook rz 4 ra F beg beg x 2014 05 21 11 22 47 Ei bi Her Fc Fd x 2014 05 21 10 37 44 Paula Jimenez Fc ka x 2014 05 21 10 28 27 Paula Jimenez Fd Fd x The History Screen By clicking the SCE 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 Clicking the CTG Data link of a Simulation Session displays the CTG data associated with the SCE The Traction Data and CPR Data links display the traction and CPR data associated with the SCE if applicable 138 ZW CAE Healthcare Using Mise On the SCE Events Physiological Data and CPR Data screens there is an Export button that
166. he baby has been removed from the maternal mannequin 2 Click Yes The Neonate Status window appears displaying the baby s APGAR at one minute and five minutes and the umbilical cord blood sample for pH PO and PCO gt The APGAR scores and blood sampling are generated automatically based on maternal physiology and events leading up to delivery Neonate Status The APGAR scores The Umbilical Cord Umbilical Cord Blood Sample Blood Sample pH PO2 ams Arterial 7 34 18 1 Venous 7 42 26 4 The baby was delivered The Neonate Crying switch The Crying Type menu Neonate Gry Selection Neonate Cry Volume The volume slider The Proceed to The Close button postpartum button The Neonate Status Window From this window users can also toggle Neonate Crying on or off The Neonate Cry Selection drop down menu can be used to select the type of crying and the volume slider can be used to increase or decrease the volume 3 Select the desired crying settings 94 ZW CAE Healthcare Using Muse The default crying type is Modeled with crying sounds based on APGAR scores 4 Click Close to close the window without transitioning the mother to postpartum or to close the window and transition the mother to postpartum click Proceed to postpartum This event will be logged NOTE The Proceed to postpartum option will only appear in the Neonate Status Window if Including Postpartum was selected on the Patient Baseline
167. he base station DIP switch positions 6 and 7 to OFF and 8 to ON 2 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 3 Leave the power switch on the outside of the base station in the on position 678 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 341 Wireless Voice Link CAE Fidelis Lucina 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 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 se
168. he mitral valve Default 1 Range 1 1000 Pulmonic Valve Resistance Factor The Pulmonic Valve Resistance Factor parameter is used to adjust the resistance to blood flow across the pulmonic valve Increasing the value to greater than 1 corresponds to increased resistance to blood flow through the pulmonic valve Default 1 Range 1 1000 305 CAE Fidelis Fetal and Labor Basic Parameters Fetal and Labor Parameters Basic Rate of Descent Fetal State Contraction Frequency Contraction Amplitude Contraction Duration Patient Pushing Early Deceleration Magnitude Late Deceleration Amplification Factor Shoulder Dystocia Shoulder Dystocia Resolution Extraction of Posterior Arm Arrested Labor Arrested Labor Trigger Station Arrested Labor Resolved by Traction Traction Force Required to Resolve Arrested Labor Manual Release of the Baby Rate of Descent The Rate of Descent parameter controls the rate of fetal descent during labor cm minute The fetus descends only during contractions Therefore if there are no contractions even if the rate of descent is set to maximum the fetus will remain at the same position Default 1 0 cm minute Range 0 cm minute 15 cm minute Fetal State The Fetal State parameter determines the state of the fetus during labor and can be set to Calm Sleep Active Sleep or Active Vigilance Default Active S
169. he simulator s arms If additional fluid administration is desired an empty IV bag and tubing can be connected to the IV Drain port located on the simulator s left side 220 ZW CAE Healthcare Using Lucina Anatomy Physiology dm Description Software Control Manual Control and Clinical Signs IV Fluid Administration IV fluids can be adminis tered in the IV hands and arms bilaterally at the dorsal metacarpal basilic median ante brachial ante cubital fossa and median cubital locations Up to 300 mL of adminis tered IV fluid are col lected in reclaim bags located in the simulator s arms If additional fluid administration is desired an empty IV bag and tub ing can be connected to the IV Drain port located on the simulator s left side Vaginal Bleeding NOTE Vaginal bleeding can only be performed when the mannequin is laying down flat in a supine position Blood loss is continuously reported to the physiological models The models respond to the reported blood loss with the appropriate cardiovascular and respiratory system changes to heart rate blood pressure and respiratory parameters The vaginal bleeding reservoir holds up to 2 liters of fluid allowing for simulation of the Class III postpartum hemorrhage The amount of vaginal bleeding can be set from the Vaginal Bleeding Severity menu none mild moderate severe and profuse NOTE When the blood pressure diminis
170. hes the effective blood flow diminishes as well If the patient s physiological condition cannot support the desired blood flow a lower blood flow than requested will occur IMPORTANT If any fluid gets under the skin during a vaginal bleed follow these cleaning instructions immediately to prevent damage to the simulator 1 Ensure the abdomen is installed on the torso whenever the mannequin is positioned upright 2 Elevate the torso 221 Using Lucina o N OA Uu BR W Lean the mannequin forward Unzip the torso skin zipper Open the skin on the back to expose the area under the buttock Clean the area where fluid is located Reattach the skin and return the mannequin to supine position Clean any remaining liquid in the front of the vaginal opening CAE Fidelis Lucina For instructions on filling the blood tank connecting the blood tank to the simulator and installing the postpartum uterus please see the Configuring the Mannequin section of this user guide 222 ZW CAE Healthcare Using Lucina Hematology Model The physiological model calculates hematocrit values i e percentage of total blood hemoglobin dynamically and continuously taking into account blood and fluid losses as well as the intravenous infusion of fluids such as whole blood packed red blood cells colloids and crystalloids Instructors can create patients with both normal and pathophysiological hematocrit levels In addition
171. hould be configured for a postpartum SCE prior to cleaning the bleeding system with the blood tank and postpartum uterus installed 1 Make sure the tank has been drained of any simulated blood 250 ZW CAE Healthcare Care and Maintenance 2 Rinse thoroughly the trauma fill tank of any simulated blood 3 Fill with distilled water or the 50 50 mixture of distilled water and white vinegar 4 Connect the trauma fill tank to the mannequin The blue tube connects to the BLOOD FILL port and yellow tube connects to the BLOOD VENT port 5 Pressurize the trauma fill tank using the hand pump Wait until there is reflow in the reclaim bottle 6 Place absorbent pads under the buttocks and the vaginal opening 7 From the Instructor Workstation click on the System Administration icon in the upper right corner of the Miise home screen The System Administration Button The System Administration screen appears 8 Click on the Maintenance tab The Maintenance tab The Flush The Maintenance System button panel The Maintenance Panel The Maintenance panel appears 9 Click the Flush System button The Flush in progress window appears 10 Run until the fluids run clear from the simulator and click the Finished button 11 Disconnect the trauma fill tank from the mannequin and depressurize 251 Care and Maintenance CAE Fidelis ucina 12 Disconnect the UTERUS pneumatic port from the uterus inflation
172. ials should be kept for storing or shipping your product To request an RMA please contact Customer Service Training for Life With CAE Healthcare s new Training for Life you now have access to free and unlimited beginner to advanced simulator training courses for everyone on your staff with the purchase of a CAE Assurance plan This benefit extends to everyone in your institution for the life of your simulator Training for Life offers you the opportunity to refresh your skills learn current best practices and ensure you are getting maximum training value from your simulator Training for Life includes access to all courses taught by our clinical experts and certified technicians in our Sarasota Florida and Mainz Germany offices 240 ZW CAE Healthcare Care and Maintenance System Software Upgrade Support Customers with current support and maintenance plans are entitled to receive updates and upgrades to applications software previously purchased Installation of the system software is the user s responsibility The System Software Upgrade Support includes software upgrades for base software and purchased optional learning modules NOTE This does not apply for major upgrades or technological enhancements Time and Materials For those systems not under a support and maintenance plan service will be provided as required on a Time and Materials basis The principal period of on site support customer s local time is
173. ic effect and simply maps to the user instructions in the configuration screen Default No 323 M se Parameter Descriptions CAE Fidelis Lucina Placenta Condition The Placenta Condition parameter is only relevant for the Vaginal Delivery Cesarean Section and Postpartum operating modes This parameter indicates what is the desired placenta condition This has no automatic effect and simply maps to the user instructions in the configuration screen indicating which part to use The options are Intact or Fragmented Default Intact Postpartum Initial Uterine State The Postpartum Initial Uterine State parameter is only relevant for the Postpartum operating mode This parameter indicates which type of uterus to use for postpartum There are two different types of uterus the revertible uterus used for inverted uterus condition and the boggy contracted uterus used to manage a boggy uterus condition Possible choices are Contracted Requests use of the Boggy Contracted uterus Uterus will be in the contracted state Boggy Requests use of the Boggy Contracted uterus Uterus will be in the boggy state Fully Inverted Requests use of the Revertible uterus Configuration instructions will request that the uterus be fully inverted Partially Inverted Requests use of the Revertible uterus Configuration instructions will request that the uterus be partially inverted Default Contracted 324 ZW CAE Healthcare M se
174. ic vaporizer and is used to calculate alveolar enflurane This parameter has a faster effect on physiology than anesthesia machine settings because mixing in the breathing circuit is not simulated NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default 096 Range 0 0096 5 0096 Alveolar Halothane The Alveolar Halothane parameter is used to simulate the presence of halothane in the alveolar space without using real anesthetic vapors The halothane percentage is input to the drug models to achieve the expected pharmacodynamic effects e g respiratory depression Using this parameter bypasses pharmacokinetics real and instructor specified inspired fractions venous content lung perfusion and ventilation This parameter can be used to focus on cardiorespiratory effects pharmacodynamics NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default Modeled Range 0 0096 5 0096 Fraction of Inspired Halothane The Fraction of Inspired Halothane parameter is used to simulate the amount of halothane set in the anesthetic vaporizer and is used to calculate alveolar halothane This parameter has a faster effect on physiology than anesthesia machine settings because mixing in the breathing circuit is not simulated NOTE M se does not verify a 10096 sum of all fractions because this would require all fract
175. ick Link NOTE Not all interventions affect the patient s physiology but all are logged Th i Interventions Interventions button Bag Valve Mask Crystalloids Intubated Quick Links Nasal Cannula Non Rebreather Mask The Interventions Palette Once an Intervention is selected a menu appears with available options for the selected Intervention Click the desired option to select it The intervention is applied and appears in the patient s physiology Rodm ae a Interventions The g 1 LPM Bag Valve Mask Interventions 2 LPM Crystalloids options st Intubated 4 LPM A selected 5 LPM Non Rebreather Mask intervention 6 LPM The Selected Intervention Options NOTE Quick Links can only be added while creating or editing the SCE Or to apply an intervention that is not set up as a Quick Link in the Interventions palette 1 Click the Interventions button 88 ZW CAE Healthcare The Interventions menu appears Close ALL INTERVENTIONS Electrical Therapy Fluids Invasive Procedures Oxygen The Interventions Menu Close ALL INTERVENTIONS Childbirth Electrical Therapy Fluids Oxygen The Interventions Menu Interventions are organized by type or all available interventions are listed under ALL INTERVENTIONS 2 Navigate through the menus to find the desired intervention 3 Once the desired intervention has been located clic
176. ilar age The woman has a cocaine habit which has led to an abruptio placentae at 34 weeks gestation The learners will participate in three states diagnosis stabilization and treatment of the patient The learners will admit the patient perform a physical assessment communicate findings to the healthcare provider carry out the orders to stabilize the patient and her fetus reassure the patient and her significant other and prepare the patient for emergency cesarean section The preoperative form will be completed and a surgical consent form explained This Simulated Clinical Experience SCE consists of three states that are transitioned manually at the discretion of the facilitator With manual transitions the facilitator should advance to the applicable state when appropriate interventions are performed In State 1 Initial Assessment the patient s HR is in the 100s BP is in the 100s 60s RR is in the mid 20s SpO2 is in the low 90s on room air and temperature is 37C Her cardiac rhythm is sinus with an audible S3 Breath sounds are clear and bowel sounds are normal Her skin is pale moist and cool She is alert and oriented to person place and time but is anxious with pressured speech She is crying Her pupils are equal and reactive to light and accommodation Her reflexes are normal There is a bluish circle around her umbilicus and her abdomen measures 32 cm She complains of sharp continuous pain in her abdomen and abdominal guarding is
177. ilical card to the fetus see Loading the Fetus 35 Configuring the Mannequin CAE Fidelis Lucina To install the placenta 1 Connect one end of the umbilical cord to the placenta by pushing the extended blue tubing into the opening on the placenta The blue tubing The Umbilical Cord Connected to the Placenta 2 Lubricate the placenta and umbilical cord with cottonseed oil spray If the placenta and umbilical cord connection or the umbilical cord and fetus connection detaches too easily use rubbing alcohol to clean the blue tube of the cord and remove the cottonseed oil 3 Place placenta in the placenta pouch with umbilical cord connection facing up and oriented towards the opening of the pouch NOTE The connection must be positioned on the left or right side not in the center of the pouch to ensure a snag free delivery 36 ZW CAE Healthcare Configuring the Mannequin 4 Coil the remaining umbilical cord inside the placental pouch ensuring that the cord exits the placenta pouch on the same side that the fetus is facing The umbilical cord connection on the left side of the pouch The umbilical cord The Placenta Inside the Placenta Pouch Vaginal Delivery Placenta Pouch Placement For a vaginal delivery configuration 1 Cover the fetus with the placenta pouch 2 Ensure that the front of placenta pouch closest to the uterine funnel is tucked under the top part of the uterine fun
178. illed completely air may be aspirated back with fluid Once the epidural port is primed fluid can be aspirated from the epidural port IMPORTANT Clean the epidural system before storing the mannequin For detailed instructions on cleaning the epidural system please see Cleaning the Epidural System in the Care and Maintenance section 227 Using Lucina CAE Fidelis Lucina Priming the Epidural Site If cerebrospinal fluid aspiration is desired the epidural site must be primed before use To prime the epidural system 1 Ensure the epidural system is empty prior to priming as described in Administering an Epidural 2 Fill a 50 mL syringe with distilled water 3 Connect the filled syringe to the epidural port and slowly depress the syringe until no water remains in the syringe 4 Reconnect the luer access split septum to the epidural port Administering Suppositories Up to five small aspirin sized suppositories can be administered via the simulator s rectum The suppositories must be removed and the rectum cleaned after administration For information on how to clean the rectum see the Care and Maintenance section of this user guide 228 ZW CAE Healthcare Using Lucina Sounds A variety of simulated sounds are available to enhance realism A patient must be running in Muse for any sounds to be available Patient Speech Patient speech can be achieved using the Speech Sounds feature in M se or by
179. ime one presses on the uterus whether or not the message Uterine compression was applied is logged in the event log and is independent of the uterus mode Effective or Recurring atony Recurring atony With Recurring atony the function is similar to Effective i e the boggy uterus contracts after five successful logged massages However 90 seconds after contraction the uterus returns to the boggy state and the message Boggy uterus was declared resolved does not appear in the event log In this mode if massage is interrupted for 90 seconds or longer before it fully contracts the massage count is reset even when the uterine compressions are marked as effective i e logged as Uterine compression was applied For example if the learner applies three logged massages then waits 90 seconds or longer to apply the next massage the massage count resets From this point five effective consecutive massages i e without interruption are required before the uterus contracts 325 M se Parameter Descriptions CAE Fidelis ucina Resolve Boggy Uterus The Resolve Boggy Uterus parameter is relevant only for the postpartum boggy contracted uterus Activation of this parameter causes the boggy uterus to contract regardless of uterine massage When contraction of the uterus is desired the Resolve Boggy Uterus parameter should be manually activated This brings up the Contract now confirmation button Clicking the button
180. inks can only be added while creating or editing an SCE Or to apply a medication that is not set up as a Quick Link in the Medications palette 1 Click the Medications button Medications are organized by type and all available medications are listed under ALL MEDICATIONS 2 Navigate through the menus to locate the desired medication 3 Once the medication has been located click the medication s name from the list Q ALL MEDICATIONS E The All Medications Menu 85 Using M se CAE Fidelis Lucina The Medication Dose menu appears displaying the pre defined dose and custom dose routes for the chosen medication Morphine d Intraosseous 10 The custom 4 dose options Intramu 1 mg IV 2 5 mg IV 5 mg IV 10 mg IV 15 mg IV 20 mg IV 1 mg 10 The 2 5 mg 1o 5 mg 10 predefined 10 mg 10 15 mg 10 dose options 20 mg IO 5 mg IM tos ont 10 mg IM toy orm 1l The Medication Dose Menu 4 Select a dose option This can be done one of two ways a Choose a pre defined dose Q Morphine Intraosseous IO Intravenous IV Intramuscular IM log only 1mg Iv 2 5 mg IV 5 mg IV 10 mg IV 15 mg IV The GE uw x1 predefined 1 mg IO 2 5 mg 10 dose options 5 mg IO 10 mg IO 15 mg IO 20 mg IO 5 mg IM log only 10 mg IM beads d The Medication Dose Menu The dose is applied and appears in the patient s physiology
181. ion Feedback window displays current force peak force and force over time To activate a two level warning tone when traction force nears or exceeds the acceptable range specified in the M se System Settings turn the Warning Tone toggle switch On When the Warning Tone is On an intermittent beep sounds when traction reaches or exceeds 90 percent of the maximum acceptable force When traction reaches or exceeds the maximum acceptable force the warning tone changes to a continuous beep To close the Traction Feedback window click the Close button 100 ZW CAE Healthcare The CPR Monitor The CPR monitor available from the Run screen is used to monitor the efficacy of CPR interventions To use the CPR monitor click the CPR Monitor button at the bottom of the Run screen Q9 CPR Monitor The CPR Monitor Button The CPR Monitor appears displaying the live data view Using M se Vevitilation Veliume mL Hand Position Chest Compression Compression Depth Compression Rate Chest Recoil O Compression Fraction Depth Vartabaity CPR Monitor Ventilation in 9 Ventilation Volume 0 Imin 9 Ventilation Rate O wx I Rave Minute Ventianon Alveciar Vencilation 408 we Patient Vitals m Blood Pressure cope breaths min CoPP Sp02 ErCo2 Umia U min mag mmHg mmHg The Close button esee The CPR os 10 seconcs per section Summary button The C
182. ion near mannequin in a convenient location b Connect the AC adapter to the Instructor Workstation and a surge protected power outlet optional NOTE If the Instructor Workstation is running on battery power ensure the battery is fully charged c Press the power button on the Instructor Workstation 14 ZW CAE Healthcare Setup Step 5a Connect to the Wireless Network Laptop Instructor Workstation Macintosh Option Once the mannequin and the Instructor Workstation are both powered on they automatically establish a wireless connection and when the default web browser is opened the M se software launches If the auto connect does not occur perform the following steps a Click once on the AirPort icon located at the top right hand corner of the screen MFS 009 RR M M M MM9 The Airport Icon b Select the simulator wireless network mfsxxx c Enter the password caeadmin case sensitive ana AirPort The selected AirPort network requires a password to join Wireless Security WPA Personal e Password eveeseee Show password Remember password in my keychain Cancel OK k Airport Login Window d Click OK The M se software can now be launched For more information on starting the application see the Using M se section of this user guide Step 5b Connect to the Wireless Network Laptop or Tablet Instructor Workstation Windows Option
183. ions to be set Default 096 Range 0 0096 5 0096 289 M se Parameter Descriptions CAE Fidelis ucina Alveolar Isoflurane The Alveolar Isoflurane parameter is used to simulate the presence of isoflurane in the alveolar space without using real anesthetic vapors The isoflurane percentage is input to the drug models to achieve the expected pharmacodynamic effects e g respiratory depression Using this parameter bypasses pharmacokinetics real and instructor specified inspired fractions venous content lung perfusion and ventilation This parameter can be used to focus on cardiorespiratory effects pharmacodynamics NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default Modeled Range 0 0096 5 0096 Fraction of Inspired Isoflurane The Fraction of Inspired Isoflurane parameter is used to simulate the amount of isoflurane set in the anesthetic vaporizer and is used to calculate alveolar isoflurane This parameter has a faster effect on physiology than anesthesia machine settings because mixing in the breathing circuit is not simulated NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default 096 Range 0 0096 5 0096 Alveolar Nitrous Oxide The Alveolar Nitrous Oxide parameter is used to simulate the amount of nitrous oxide set in the anesthetic vaporizer and is used to calculate alveol
184. ipen the cervix prior to Ripeningf stimulation of uterine contractions Ergonovine L Uterine Used in management of postpartum Stimulants hemorrhage PPH due to uterine atony Not available in U S Hydralazine LL Cardiovascular Used to control severe hypertension in preeclampsia or eclampsia Magnesium Sulfate L Tocolutics Used to supress preterm labor Used in preeclampsia and eclampsia to treat hyperreflexia twitching and prevent convulsions seizures Methyldopa L Cardiovascular Used to lower blood pressure in PIH or preeclampsia Methylergonovine IL Uterine Used in management of postpartum Stimulants hemorrhage PPH due to uterine atony 349 Medication Mode Category Fidelis Lucina Simulator M Modeled Application L Log only Misoprostol L Uterine Used for labor induction to ripen Stimulants the cervix and promote uterine contractions Use in management of postpartum hemorrhage PPH due to uterine atony Not approved for labor induction in U S Ritodrine L Tocolytics Used to suppress preterm labor Not available in the U S Sulprostone Uterine Used in management of postpartum Stimulants hemorrhage PPH due to uterine atony Not available in the U S Uterine atony loss of contractions Cervical ripening effacement or thinning make the cervix softer and more distensible 350 ZW CAE Healthcare Muse Mannequin Setup Screens MUSE MANNEQUIN SETUP SCREENS
185. ired CTG data to create a new SCE OR a b C e Select SCE with desired CTG data Run the SCE for two minutes From the Patient menu click Save The Save a copy of the Patient window appears Enter a new patient name and select the duration of CTG data to be included NOTE The maximum duration is dependent on the length of the CTG data from the original SCE Click Save f Stop the SCE The Home screen appears From the SCE Selection panel select New SCE Locate the recently created new patient and click Create The SCE Overview screen appears with the desired CTG data 2 By creating CTG data and applying it to a new SCE To use this method 117 Using M se CAF Fidelis Luna a Create a new SCE This SCE will be used only to generate CTG data b Apply the desired settings e g physiology to the SCE c Run the SCE for as long as CTG data is desired The fast forward buttons can be used to accelerate the SCE and the CTG data capture NOTE Up to 12 hours of patient data can be stored on the CTG data per SCE d From the Patient menu click Save The Save Patient window appears e Click Overwrite f Enter the duration of CTG data to be included g Click Save h Stop the SCE The SCE now includes the CTG data collected while running the SCE and this CTG data will be present when running the SCE Content Management SCE Content is entered from the SCE Editor using the Over
186. isplay to a desired location A dragged waveform The TouchPro Display 171 Using the TouchPro Patient Monitor CAE Fidelis Lucina Saving a Layout Once a layout has been configured it can be saved and reused To save a layout 1 Ensure the desired waveforms and numerics are in place 2 Click Settings The Settings menu appears 3 Click Save As The Save Layout window appears 4 Inthe Save Layout window in the Layout Name field enter a name for the layout Layout Name New Layout The Layout Name field The Save Layout Window 5 Click Save 6 Click the Close button to exit the Settings menu Saved layouts can be deleted from the Settings menu by dragging and dropping them in the Trash NOTE When a layout is saved it is available for use only with the current SCE To enable the layout for use with any other SCE enable the layout from the TouchPro Setup panel for the desired SCE 172 ZW CAE Healthcare Using the TouchPro Patient Monitor Sounds All sounds can be silenced by clicking the Mute button in the bottom left corner of the TouchPro display The Mute Button To set up the audio for the TouchPro 1 Click the Settings button in the bottom right corner of the TouchPro display The Settings Button The TouchPro Settings menu appears 2 From the Settings menu click Audio Setup The Audio Setup window appears Audio Setup Pleth SpO2 ECG Art
187. ita S LINE bo Ev Xi AIR ELLO IE eMule el tsssiiecasiansssntvsaieays 204 R alistic Upper APA S RO RARE ECHO RARE LORD DR EDDA 207 Cardiovascular Features ios pa Y iDEIS ERR RUUARNVIA 2x YR ESAE PN V YER UNIES UGG ERU ARRA EA dSRNKS 208 Pulses e T 212 E xs o M CMM ER T 214 Manual Blood BR SECTIO 214 Korotkotf SUNOS TT 216 Defibrillation and CARIIQVeISIUEl icoscoscco savent HEN PRONUS NERN UP EOM POE YER EO 217 xvii Table Of Contents CAE Fidelis Lucina Cardiac Paetos EO UNDO DA RU R DE aHa EOM DR Opp ORE DEOR DD ERO RA DLOR RHONE 219 LI D fe 219 Vaginal sor RR innoaseecisasidnpadeansdw tuanbeadtoeunmainer ec elomnebe 221 Hematology Model M 223 The Genitourinary System Lsca coena ERR KO Ern O RR Fon boot pan Garena AURA DNA trina c 224 Medication and Fluid Administration snssscssssessonssscsssssssonssscrsnesesonsseeraneessnsssceranersssstecerseersenst 225 Priming th Epidural SER rci PR RADEON TRE DR LORS 228 Administering Suppositories acccareicc dir ax p ED RR rr nord abl n un 228 Dp Wem 229 Patient 5 d MN EN m PR 229 Speedi MONS osos reme pP ERO IRI ORO ian dd rarae MIRI E 229 TS SILTRS PTT TITo RR P 231 Heart gl T 232 Audible Breathing SOUS ass oca dai pr E ERR RREPDR ba ra CRUDO QU MR URH
188. k the intervention s name from the list The Intervention Options menu appears showing the available options for the selected intervention Face Mask Room Air 40 FiO2 50 FiO2 60 FiO2 The Intervention Options Menu 4 Click the desired option The intervention is applied and appears in the patient s physiology Using M se 89 Using M se CAE Fidelis Lucina Transitioning Scenario States from the Run Screen To move between scenario states from the Run screen 1 Click the desired scenario Anaphylaxis Beginning Anaphylaxis 00 00 11 A Scenario The Scenario Management pop up menu appears and all available states are listed Show Scenario Anaphylaxis H Beginning Anaphylaxis 00 01 05 4 Beginning Anaphylaxis Mild Anaphylaxis JM Conditions Moderate Anaphylaxis Apnea Severe Anaphylaxis BP Hypertension Condition Improves BP Hypotension Desaturation Play Heart Rate Bradycardia Pause Heart Rate Tachycardia s Medications Close Acetaminophen e Albuterol Amiodarone The Scenario Management Pop Up Menu 2 Select the desired state The scenario proceeds to the selected state The scenario can also be paused or continued by selecting the Pause and Play options from the Scenario Management Pop Up menu 90 ZW CAE Healthcare Using Mise Transitioning Scenario States from the Scenario Screen To move between scenario
189. layed the Patient Records button remains red until the list is re opened and Stop Displaying is chosen NOTE Only one patient record can be displayed at a time For more information about uploading patient records for selection from the Run screen see the Patient Records section of Using Muse 77 UsngM se CA Fidelis luna Adding a Scenario to a Running SCE SCEs incorporate scenarios that contain pre programmed physiology and events Scenarios can be added to SCEs to enhance patient physiology To add a scenario to an SCE that is running 1 Click the Add Scenario button on the Run screen P Add Scenaric The Add Scenario Button The Choose Scenario dialog box appears Scenarios leas Name Last Modified Anaphylactoid Syndrome of Pregnancy 2013 09 04 09 30 12 Hyperemesis Gravidarum 2013 09 04 09 30 12 Postpartum Hemorrhage Two Hours After Delivery 2013 09 04 09 30 12 Preeclampsia 2013 09 04 09 30 12 The Add The Search button Add Q x field The Choose Scenario Dialog Box 2 Select a scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 3 Click Add The scenario is added to the SCE and appears under the Scenarios heading on the Run screen Scenarios a Add Scenario Anaphylaxis Beginning Anaphylaxis 00 00 12 An Added Scenario 78 ZW CAE Healthcare Using Muse Changing Physiology and Controlling De
190. le pulses patient voice labor and delivery features and genitourinary features The mannequin comes with two batteries in place on the left side Laptop Instructor Workstation The Laptop Instructor Workstation is a computer that utilizes M se 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 IMPORTANT All CAE Healthcare computer components are preconfigured for use with the Fidelis Lucina system There are no software installation or configuration steps required Only approved CAE Healthcare applications should be installed or run on the Fidelis Lucina system TouchPro Workstation The TouchPro workstation is a touchscreen display monitor that utilizes the TouchPro Patient Monitor or the TouchPro CTG software The TouchPro CTG software represents the cardiotocography monitor for reading the fetal heart rate FHR and the uterine contractions as well as displays the maternal heart rate NIBP SpO and body temperature Power Adapters and Cords 2 The Fidelis Lucina comes with two sets of power adapters and cords one for the maternal simulator and one for the fetal simulator Gown A gown is provided for the maternal mannequin to enhance the reality of the simulation Prepartum Early Labor Kit The Prepartum Early Labor Kit contains the following items Prepartum birth canal e Static Cervix backpla
191. learners discover how administering various fluids affects hematocrit the oxygen carrying capacity of blood and the resulting patient response The following important assumptions have been made in the design of the Hematology Model Blood is comprised of two components red blood cells and plasma Plasma is comprised of two components colloid and crystalloid The term colloid is used to describe substances that generate a clinically significant colloid osmotic pressure for example fresh frozen plasma albumin and hetastarch The term crystalloid is used to describe salt solutions for infusion for example normal saline dextrose in water and Ringer s Lactate The mixing of blood and its various constituents is instantaneous and homogeneous In other words one liter of crystalloid administered intravenously equilibrates immediately and homogeneously throughout the entire circulation This Hematology Model does not distinguish between the differing clinical effects of colloids and crystalloids For example osmotic pressures and capillary leakage rates are not taken into account Likewise fluid kinetics and fluid distribution within the circulation and interstitial and intracellular spaces are also not modeled In the Hematology Model the following model variables definitions and relationships have been established e Red Blood Cell Volume The volume of red blood cells within the circulation Plasma Volume The volume of
192. leep 306 ZW CAE Healthcare M se Parameter Descriptions Contraction Frequency The Contraction Frequency parameter determines how often uterine contractions occur This parameter is defined as the number of contractions per ten minutes The contraction frequency parameter has some variability The magnitude of the variability is determined by the Contraction Frequency Variability parameter found in the Fetal amp Labor Additional Parameters Default 3 ctx 10 min Range 1 ctx 10 min 7 ctx 10 min Contraction Amplitude The Contraction Amplitude parameter determines the amplitude of the uterine contractions This parameter is defined in units of mmHg The contraction amplitude has some variability The magnitude of the variability is determined by the Contraction Amplitude Variability parameter found in the Fetal amp Labor Additional Parameters Default 50 mmHg Range 0 mmHg 120 mmHg Contraction Duration The Contraction Duration parameter determines the length of the uterine contractions and is defined in units of seconds Default 80 sec Range 0 sec 120 sec Patient Pushing The Patient Pushing parameter determines whether the patient will be pushing during contractions When this parameter is activated On there will be increased variability and increased peak height of both the intrauterine pressure and transabdominal uterine activity signals during a large contraction Default Off Early Deceleration Magnitude
193. lity to display the maternal oxygen saturation but no probe is connected The SpO widget is displayed but displays to indicate no data is being received Default Connected 317 M se Parameter Descriptions CAE Fidelis ucina MNIBP Probe The MNIBP Probe parameter indicates if the emulated CTG has the capability to monitor the maternal blood pressure non invasive measurement and if the relevant probe is connected Possible selection includes Not Available The emulated CTG does not have the capability to display the maternal blood pressure No MNIBP widget is displayed on the CTG Unused reserved space is reallocated to the available widgets to minimize visual impact Connected The emulated CTG does have the capability to display the maternal blood pressure and a probe is connected The MNIBP widget is displayed and provides live measurement of the maternal non invasive blood pressure Disconnected The emulated CTG does have the capability to display the maternal blood pressure but no probe is connected The MNIBP widget is displayed but displays to indicate no data is being received Default Connected Temp Probe The Temp Probe parameter indicates if the emulated CTG has the capability to monitor the maternal temperature and if the relevant probe is connected Possible selection includes Not Available The emulated CTG does not have the capability to display the maternal temperature No Temp widget is
194. livery The patient physiology can be adjusted while an SCE is running in two ways by using one of the physiological views on the Run screen to modify parameters or by using the Conditions Interventions and Medications palettes Delivery can also be controlled from the Run screen using the Fetal and Labor physiological view parameters and labor can be paused using the Pause Labor button Using the Physiological Views From the Run screen users can select from six different views representative of various body systems and features Neurological Respiratory Cardiovascular Fetal and Labor Fluids and Bleeding Sounds To access each view click the appropriate organ icon or button For Neurological click the brain For Respiratory click the lung For Cardiovascular click the heart For Fetal and Labor click the uterus For Fluids and Bleeding click the Fluids Control icon e For Sounds click the Sound Control icon 79 80 Using M se CAE Fidelis Lucina From each view various parameters can be viewed and adjusted Brain Heart Lung Uterus Fluids Control icon Sound Control icon The Physiological Views To change a patient s physiology using the physiological views ZW CAE Healthcare Using Muse 1 Click the appropriate organ icon or button from the homunculus to select the desired physiological view The associated paramete
195. ll display gt When Shoulder Dystocia is Enabled a specific maneuver can be selected that will resolve the shoulder dystocia Default Disabled Shoulder Dystocia Resolution The Shoulder Dystocia Resolution parameter determines what maneuver if any will resolve shoulder dystocia Six options are available None McRoberts Suprapubic Pressure Rotation of Posterior Shoulder Rotation of Anterior Shoulder and Zavanelli By default shoulder dystocia resolution is set to None The McRoberts option activates the automatic resolution of shoulder dystocia upon the detection of the McRoberts maneuver performed correctly Upon detection McRoberts maneuver was performed and Shoulder dystocia condition resolved will be logged in the event log Once shoulder dystocia is resolved the fetus continues to be pushed during the contractions through the birth canal until reaching the final position At the final position the fetus is released from the birthing mechanism and is ready to be manually delivered The Suprapubic Pressure option activates the automatic resolution of shoulder dystocia when suprapubic pressure applied The right force needs to be applied for at least 5 seconds to resolve the condition Upon detection Suprapubic pressure was applied and Shoulder dystocia condition resolved will be logged in the even log Once shoulder dystocia is resolved the fetus continues to be pushed during the contractions through the birth can
196. lose when in the Auto mode Default Modeled Range 096 10096 Tidal Volume The Tidal Volume parameter is used to set the tidal volume to a given volume per breath Once Tidal Volume is set to a numeric value arterial oxygen and carbon dioxide values have no effect on the tidal volume but continue to influence other components of the physiological models For example with the tidal volume set to 600 mL in the adult simulator the tidal volume remains a constant set 600 mL even in the event of falling arterial oxygen levels In such situations the patient can only respond to arterial oxygen or carbon dioxide levels when the respiratory rate is adjusted Default Modeled Range 0 mL 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 Breath sounds and chest rise are automatically diminished on the appropriate side due to decreased ventilation of the affected lung Default 0 Range 0 mL 2500 mL 280 CAE Healthcare M se Parameter Descriptions Fraction of Inspired O5 FiO This parameter is used to simulate changes in the FiO such as would occur with the administration of supplemental oxygen Default
197. lumes to result in elevated inspiratory pressures with positive pressure ventilation Also see Intrapleural Volume Vol Left and Right Default 1 Range 0 10 10 00 Functional Residual Capacity The Functional Residual Capacity parameter sets the combined left and right lung volume remaining atthe end of a normal spontaneous exhalation This parameter influences the speed of desaturation during apnea Default 2300 mL Range 500 mL 4000 mL Lung Compliance Factor Left and Right These two parameters independently set the left and right lung compliance Lung Compliance Factor determines how easily the lungs inflate Low compliance factors less than 1 create stiff lungs such as in acute respiratory distress syndrome or pulmonary edema requiring more pressure for expansion High compliance factors greater than 1 create loose lungs that easily inflate with less pressure Default 1 Range 0 15 10 00 287 M se Parameter Descriptions CAE Fidelis ucina Venous CO Shift The Venous CO Shift parameter affects the partial pressure of CO in the venous blood Changing this parameter allows large and rapid shifts in total body CO concentration Increases in alveolar and arterial CO follow rapidly in a physiologically correct magnitude and time course This parameter is useful for giving a bolus of CO to the venous system The alveolar and arterial CO levels rise rapidly in response to the added carbon dioxi
198. manually at the facilitator s discretion In State 1 Initial Assessment the patient demonstrates a HR in the 80s BP in the 110s 70s RR in the mid 20s and SpO2 in the upper 90s on room air and a temperature of 37 0C Vaginal examination on admission revealed that the cervix is 10096 effaced and 5 cm dilated The fetus is in cephalic presentation vertex at 2 and the membranes were ruptured upon vaginal examination The fundal height is 35 cm and fetal heart rate FHR is 130s beats per minute bpm The patient is presenting regular contractions at four minute intervals No Th e SC E Conte nt analgesia has been requested The learner is expected to provide support and information to patient and family recognize cervical dilatation evaluate FHR and contractions and recognize regular contraction frequency Su mma ry In State 2 Four Hours Later the patient demonstrates a HR in the 80s BP in the 120s 80s RR in the upper 20s SpO2 in the upper 90s on room air and the FHR is in the 140s The patient states that she feels the urge to push The learner is expected to complete a vaginal examination and find the cervix 10 cm dilated and fetus at 4 station recognize the start of second stage labor ensure the presence of appropriate personnel in the room position and prepare the patient for delivery and complete the delivery of the fetus In State 3 Delivery of Placenta the patient demonstrates a HR in the 70s BP in the 110s 70s RR in the teens and
199. me Controls The SCE time controls are located at the top of the Run screen The Fast Forward The Timeline bar button The Pause Play button The Bookmark button 00 10 28 ub y Bookmark Simulation The SCE Time Controls The Timeline bar shows the amount of time that has elapsed and bookmarks that have been created The Bookmark button creates a bookmark at the current point in the SCE The bookmark can be used later to reset the patient s physiology to what it was when the bookmark was created Clicking the Fast Forward button once accelerates the SCE time at a 4 1 ratio Clicking the Fast Forward button a second time accelerates the SCE time at an 8 1 ratio The Pause Play button pauses the SCE time or starts the SCE if it has been paused The Pause Play button also returns the SCE time to normal speed after Fast Forward has been selected 98 ZW CAE Healthcare Using M se Using Bookmarks To create a bookmark click the Bookmark button A bookmark appears on the Timeline bar A bookmark The Timeline bar The Bookmark button 00 02 12 a Ee J Poua Simulation The SCE Time Controls To return to a bookmarked time in the SCE 1 Click the bookmark on the timeline The Return to Bookmark message appears Return to Bookmark Return the patient to Bookmark 3 at time 00 01 27 The Return button The Return to Bookmark Message 2 Click Return The patient s physiology returns to the selec
200. meter should be manually activated This brings up an Extract now confirmation button Clicking the button resolves shoulder dystocia and immediately releases the fetus that can now be manually extracted Clicking anywhere else on the screen cancels the action Arrested Labor The Arrested Labor parameter should be set to Enable to activate the condition of arrested labor Enabling Arrested Labor leads to the interruption of fetal descent once the fetus has reached the trigger station The message Now in arrested labor condition will be logged in the event log Default Disabled 309 M se Parameter Descriptions CAE Fidelis Lucina Arrested Labor Trigger Station The Arrested Labor Trigger Station parameter sets the fetal position at which the arrested labor condition will be applied Arrested labor can be performed between station 3 and 3 Default 0 Range 3 3 Arrested Labor Resolved by Traction The Arrested Labor Resolved by Traction parameter activates deactivates yes no the automatic resolution of arrested labor upon detection of the required traction force Upon detection of an adequate force applied during uterine contractions Traction was applied to the fetus and Arrested labor condition resolved will be logged in the event log Once the arrested labor condition resolved the fetus can be pulled during contractions through the birth canal until reaching the final position At the final position the fetus is releas
201. mines the uterine pressure level when there are no active contractions This parameter is defined in units of mmHg The contraction resting tone has some variability The magnitude of this variability is determined by the UA Noise parameter Default 10 mmHg Range 0 mmHg 100 mmHg Contraction Frequency Variability The Contraction Frequency Variability parameter determines the variability present in the frequency of uterine contractions This parameter is defined as a percentage Default 10096 Range 096 10096 Contraction Amplitude Variability The Contraction Amplitude Variability parameter determines the variability present in the amplitude of uterine contractions This parameter is defined as a percentage Default 10096 Range 096 10096 UA Noise The UA Noise parameter determines the noise present in the uterine pressure signal This parameter is defined as a percentage Default 10096 Range 096 10096 TOCO Amplitude Gain The TOCO Amplitude Gain parameter modifies the amplitude of the uterine contractions in the transabdominal uterine activity signal only This parameter is defined as a percentage Default 10096 Range 096 20096 FHR Baseline The FHR Baseline parameter determines the baseline of the fetal heart rate signal When set to modeled the baseline will be dependent on the fetus oxygen levels and arterial blood pressure When overridden the fetal heart rate will still be susceptible to accelerations and early
202. mperature Blood 3750 2 The Neurological View Both eyes can be controlled together by setting the Apply To Both Eyes option to On When this option is selected any changes made to one eye are also automatically applied to the other eye Currently there are three pupil options that are used to control the baseline diameter of the pupils in both eyes Pinpoint Blown or a Fixed Pupil Size from 3 mm to 8 mm 202 ZW CAE Healthcare Using Lucina The simulator s eyes can be set to Blinking or Closed The default setting is Auto With this setting the eyes are either blinking or closed based on the patient s physiology When the simulator s eyelids are closed the eyes can still be manually opened for clinical inspection Additionally eyelids can be programmed in scenarios to open and close spontaneously or can be fixed in the closed position Blinking frequency is controlled by the Eyes Blink Speed menu and can be set to one of four speeds Normal the default Slow Fast and Rapid Setting the Reactive pupils option to Yes causes the pupils to re size from the baseline in response to changes in light Light Reactivity Speed can be set to Sluggish or Brisk Seizures Lucina simulates seizure activity when the feature is activated in M se To activate seizures from the Neurological view set the Seizures option to On To deactivate seizures set the Seizures option to Off NOTE If eyes have been set to Closed or if neurom
203. mulator is still in use ensure that the AC adapter is plugged into the simulator and a working power source prior to removing both batteries To charge the simulator batteries using the external battery charger 1 Locate the battery compartment cover on the left side of the maternal mannequin s torso 2 Pull down on the silver security pin and pull the cover away from the torso The security pin The Battery Compartment and Ports with Cover The cover is removed and the batteries are visible in the mannequin 3 Remove the batteries from the simulator by pulling on the tabs and lifting the batteries out of the battery compartment NOTE Ensure that the battery tab is accessible and not tucked into the battery compartment 4 Plug the external charger into a power source 5 Insert the batteries into the external charger charging station Batteries require approximately four hours to fully charge NOTE Batteries will lose charge over time when left in a stored unused simulator When storing the simulator for an extended amount of time remove the batteries from the simulator 248 CAE Healthcare Care and Maintenance Charging the Fetus Battery To charge the fetus battery using the USB charger 1 Connect the USB charger cord provided by CAE Healthcare to the back of the fetus The USB charger connection The USB charger cord The Back of the Fetus 2 Connect the other end of the USB charger cord to a USB p
204. mum Adobe Flash Player 16 x x x minimum Adobe Reader 11 x or higher Windows Operating System Windows 7 or Windows 8 Firefox 24 ESR Internet Explorer 9 minimum Adobe Flash Player 16 x x x minimum Adobe Reader 11 x or higher Windows Hardware Intel Core 2 Duo 2 0 GHz minimum 4 GB DDR3 RAM minimum 32 GB Hard Drive space available 1366x768 screen resolution minimum USB 2 0 Wireless 802 1 1b g n Ethernet card 100BASE T Ethernet Adapter Standard DVD R Drive vii System Requirements CAE Fidelis Lucina Macintosh Hardware Intel Core 2 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 1 1b g n Ethernet card 100BASE T Ethernet Adapter Standard DVD R Drive NOTE Macintosh Quicktime 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 viii ZW CAE Healthcare Specifications SPECIFICATIONS All hardware and software needed for the operation of the simulator are supplied If you wish to extend the Instructor Workstation to other computers contact CAE Healthcare Size Mannequin Simulator 69 H x 22 W x 15 D 175cm x 56cm x 38cm Fetus Simulator 19 H x 6
205. n 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 simulator automatically records the amount of energy discharged and the time defibrillation was performed The 217 Using Lucina CAE Fidelis Lucina 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 Monophasic and Biphasic defibrillators can be used with either paddles or hands free connectors For paddle placement on the chest the simulator comes with two anterior defibrillation disks provided in the accessory kit Screw the disks onto the threaded connections or leave the threaded connections as required The right defibrillation connection The left defibrillation connection The Defibrillation Ports NOTE The Defib p
206. nance section Priming the IV System To prime the IV system 1 Ensure the IV system is empty prior to filling connect the 140 mL syringe to the IV drain port and withdraw fluid and or air until a vacuum is formed 2 Filla 50 mL syringe with distilled water and clinically appropriate food coloring if desired for added realism 225 Using Lucina CAE Fidelis Lucina 3 Connect the filled syringe to the IV FILL port on the left side of the simulator s torso The IV FILL port The Battery Compartment and Ports 4 Depress the syringe until no water remains in the syringe and disconnect from the IV FILL port WARNING If a flashback 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 NOTE Fluids and medications can be administered intravenously by attaching the tubing from a standard IV solution set to the desire IV access site If administering more than 300 mL connect an external empty IV bag and tubing to the IV DRAIN port located on the left side of the mannequin s torso to prevent overfilling the simulator Administering Intrauterine Balloon The simulator allows for the insertion of an intrauterine balloon used to manage postpartum hemorrhage To insert and fill the intrauterine balloon 1 Configure mannequin with the postpartum boggy contracted uterus 2 Lubricate the end o
207. ndard syringes and infusion devices can be utilized to administer medications and fluids through bilateral IV access sites at the dorsal metacarpal cephalic basilic median antebrachial and median cubital locations IMPORTANT Use only clear distilled water distilled water tinted with food coloring or distilled water mixed with white vinegar 50 50 inside the mannequin Administration of any other type of fluid is NOT supported and may damage the system Vein Punctures When the veins are punctured clinically appropriate flashback occurs To enable flashback the IV system must be primed prior to use Ensure the cap is on the IV Drain port prior to priming or using the IV system to avoid any fluid overflow The vein tubing must be replaced after a certain number of punctures to avoid any fluid leakage within the simulator arms Leakage will occur when the IV system is primed Replace vein tubing after Asingle puncture from a 14 gauge cannula or needle Three punctures with a 16 gauge cannula or needle 10 punctures from a 18 gauge or 20 gauge cannula or needle NOTE A 14 gauge needle can be used in the forearm veins only Do not use a 14 gauge cannula or needle on the antecubital or dorsal veins IMPORTANT After each use of the IV system the system must be cleaned The IV system must be empty prior to priming or using the IV system For more information on cleaning the IV system see Cleaning the IV System in the Care and Mainte
208. ndicated in the MEPGTC 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 PROPRIETARY NOTICE This document including the information contained herein is confidential and or proprietary to CAE Healthcare Inc and shall not be reproduced or disclosed in whole or in part or used for any purpose whatsoever unless authorized in writing by CAE Healthcare Inc Information on copyright and trademarks vi ZW CAE Healthcare System Requirements SYSTEM REQUIREMENTS If you are not using a TouchPro computer or Wireless Remote provided by CAE Healthcare please be sure to utilize a computer with wireless capability When operating the TouchPro or Mise software a computer with a Macintosh or Microsoft Windows operating system may be used To run the TouchPro or Muse software the computer used must meet the following minimum requirements Macintosh Operating System Mac OS X10 6x minimum Firefox 24 ESR mini
209. ned and manufactured in Canada the substantive laws of the Province of Ontario excluding its conflict of law rules and the laws of Canada applicable therein shall apply 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 Save and except for Products designed and manufactured in Canada all disputes arising from or related to this Agreement shall be litigated in Santa Clara County in the State of California For those Products designed and manufactured in Canada the venue shall be Toronto Canada 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
210. nel The uterine funnel The Placenta Pouch Covering the Torso 37 Configuring the Mannequin CAE Fidelis Lucina 3 Attach the placenta pouch to mannequin s pelvis by connecting the pouch straps to each side of the pelvis The Placenta Pouch Strap Connection The placenta pouch is installed IMPORTANT If the placenta and umbilical cord are not properly positioned the simulator motor may become obstructed and begin to make a clicking or knocking sound If the noise does not stop right away on its own open the abdomen and ensure the placenta and umbilical cord are not jammed Once the placenta and umbilical are in the proper position close the abdomen and delivery will automatically resume Installing the Abdomen NOTE Ensure the abdomen is installed on the torso whenever the mannequin is in an upright position Delivery Abdomen Installation To install the delivery abdomen 38 ZW CAE Healthcare Configuring the Mannequin 1 Locate the speaker system cable and the palpable contraction system cord inside the abdomen shell The Speaker cable The Contraction cord The Abdomen Contraction and Speaker Cables 2 Plug the cables into the corresponding connections inside the mannequin s torso The Contraction cord The Abdomen Contraction and Speaker Connection 39 3 Latch the abdomen shell into the mannequin s torso and ensure the speaker cable is not pinched or constricted
211. nel Group 1 RF Channel Group 2 ON ON co MBA cus Bi AA 12345 12 ON CH 18 QR CH 24 45 123 345 CH 30 EST L CE o m CH7 o ir o cz o amoj em EE 7 rema 2 m2 cmm wie pecs ocmm ocumm o E E E m Ea m b v n eem omma moj 2mo nn 2 oem vio omma E m PEST v n vem E o EN Z Cum LES O JE ES EH TEE vm o x N jas male NN um bl CEN o T d o o I Un i E of HC of B CESo B CESo ncm 2 com 2 eee ema cmm p wo ce fee ff eee ff ee omm Pom LT pa mj E mj pi mj pi m vD pecs feces l vocem E of O oj ni 2 oem 2 i we n Eom PLE vm om jn i 12345 12345 Hn 12345 12345 ON ON oc WM oo aM 12345 12345 ON ON 12345 12345 ON ON 12345 12345 RF Channel Selection Methods For a complete list of the initial frequencies associated with the RF Channels see RF Channel Initial Operating Frequencies 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 conne
212. nen rnt ornata enean uto 181 Exiting the TouchPro Software iussi i i XU VE QC YYEIR DH CUQVRRUEHKR RVR KOHLE XD REL MEXUDU M 182 Using the TouchPro CTG Monitor Software eene eene eren reete enne nnne 183 Accessing the TouchPro CTG Software ee eeeee ener eene eene ene tn etn etna tatnen tno 183 Configuring CT GALAN soceri nr een RO toan dun adunco 185 Setting CTG Alarm Threshold aisassassviessxerarsas couse dito rper Eve etuer On abd p PAR Pu 185 Setting CTG Alarm Suspension TATE sasssczossneecasvacasnstounsavivesvmncoenssedenwcrewaynsavesinesaehsavanseceesseasceavasbecsint 186 Adj sting Audio SEMIS den E BIA RPM DER RERUR RR VERE RUNS AERA ORO Or EHE 188 M ting CTG irnn m 190 MNIBP Cycling and Manual MNIBP cernere eene eene roe inen an eno ena en ena sna en 190 Resetting Tocography NOISE adver ed vitx dd a itia eoi ad n Coa ego 192 Viewing the CT SHI MT 193 Changing the CTG Monitor Language cscsscsscsssscsssssssssssssesssssssessessessssssssssessassaseees 195 Exiting tie CTG MOHITOE ilo hoivEon aL RUD CUEVA CUARTA VRAC 197 Lg e 199 Netirological m 200 jl Me 202 xul T 203 Respiratory Features disuiis i odi
213. ng Lucina Neonate Cry Selection The Neonate Cry Selection menu can be used to control neonate crying Changing this selection prior to delivery causes the selected crying sound to be the default when the baby is marked as delivered The Neonate Cry Selection menu can also be used after delivery to change or stop crying sounds If Modeled is selected the neonate cry is directly related to the fetal physiology at the time of birth The Neonate Cry Selection can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select Neonate Cry Selection The Neonate Cry Selection menu appears Breath Sounds Heart Sounds Neonate Cry Selection Audible Breathing Sounds P Modeled Modeled UA Synchronized Vocal Clip nee NM None Lor Weak Strong Fetal Heart Sound Location The Neonate Cry Selection Menu Click the Neonate Cry Selection switch to toggle crying On or Off Click the Neonate Cry Selection drop down menu to change the type of sound Click and drag the slider to adjust the volume 235 Using Lucina Fetal Heart Sound Location CAE Fidelis Lucina The Fetal Heart Sound Location menu can be used to control the location of where the fetal heart sounds can be heard in the maternal abdomen This feature allows instructors to select the appropriate location based on the current fetal position The Fetal Heart Sound Location is adjusted by clicking the Sound Control icon
214. ng is removed The Mannequin s Torso Rotation Ring Removed 2 Ensure no other birth canal is installed within the standard delivery birth canal NOTE The standard birth canal is installed by default 3 Connect the clear blue tube located at the bottom of the blood tank to the BLEEDING tube inside the mannequin The clear The BLEEDING blue tube tube The BLEEDING Tube Connection NOTE The BLEEDING tube is a clear blue tube located on the left side of the mannequin s torso 47 Configuring the Mannequin CAE Fidelis Lucina 4 Connect the blood tank outlet clear tube located at the top of the blood tank to the mannequin BLOOD port on the baffle The blood tank outlet The BLOOD port The Blood Tank Outlet and Blood Port 5 Place the blood tank inside the mannequin s torso 6 Place the placenta pouch on top of the bleeding tank with no placenta or umbilical cord inside Installing the Boggy Contracted Uterus With Bag IMPORTANT Ensure the blood tank is installed with the use of the postpartum boggy contracted uterus whether or not the bleeding function is used The postpartum boggy contracted uterus with bag is placed inside the abdominal cavity over the blood tank NOTE The uterus bag should be installed and used with the boggy postpartum uterus at all times The uterus has two connections A pneumatic connection to inflate the uterus and create the perception of a boggy uterus A
215. nstriction and increased vascular tone The volume of blood in the venous system has an inverse relationship to the blood pressure Lowering the value is analogous to a shift in blood from the venous system to the arterial system and this shift when coordinated with increased systemic vascular resistance results in an increase in blood pressure arterial blood pressure ABP pulmonary artery pressure PAP and central venous pressure CVP Default 1 Range 0 10 100 00 300 ZW CAE Healthcare M se Parameter Descriptions Systemic Arteries Compliance Factor The Systemic Arteries Compliance Factor parameter adjusts the pulse pressure difference between systolic and diastolic pressures of the simulated patient s systemic blood pressure Increases in the compliance factor result in a decreased narrower pulse pressure while smaller values increase the pulse pressure Additionally when the pulse pressure increases as a result of a reduced compliance factor both systolic and diastolic pressures increase Conversely with a narrower pulse pressure higher compliance factor both the systolic and diastolic blood pressures also drop Default 1 Range 0 50 5 00 Pulmonary Arteries Compliance Factor The Pulmonary Arteries Compliance Factor parameter adjusts the pulse pressure difference between systolic and diastolic pressures of the simulated patient s pulmonary blood pressure Increases in the compliance factor decre
216. nsure a urinary catheter is inserted and place the exposed end of the catheter in a basin to catch the fluid 2 If distilled water tinted with food coloring was used fill the syringe with 50 mL clear distilled water and flush the water through the GU filling tool connected to the Urinary port located on the torso baffle inside the mannequin Continue to flush clear water through until the waste water is completely clear 3 Fill the syringe with air and slowly push air through the GU filling tool connected to the Urinary port until no more water drains into the basin 4 Disconnect the GU filling tool from the Urinary port and remove the urinary catheter Cleaning the Rectum To clean the rectum 1 Remove the rectal plug from back of lower torso 2 Fill a syringe with distilled water and push water through the anus 3 Repeat as necessary until suppositories are extracted if applicable 4 Insert the rectal plug back in place 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 256 CAE Healthcare Care and Maintenance To drain condensation 1 Locate
217. nt Baseline Parameters Operating Mode The Operating Mode parameter determines the overall hardware configuration and mode of operation for the mannequin Operating modes are mutually exclusive and govern the mannequin hardware configuration and operation for the complete execution of a given SCE Migration from one operating mode to another always entails a physical reconfiguration of the simulator Reconfiguration occurs only at the start of the SCE except for Postpartum operating mode that can be combined with a vaginal delivery 320 ZW CAE Healthcare M se Parameter Descriptions Possible modes include Prepartum amp Latent Phase Non delivery operating mode that calls for a hardware configuration that allows performance of Leopold maneuver and assessment of static cervices Active Phase Non delivery operating mode that calls for a hardware configuration that uses the dynamic cervix to allow access and or visibility to the fetus Intended to emulate such conditions as cord prolapse or placenta abruption Vaginal Delivery Delivery operating mode that supports spontaneous realistic delivery of the fetus Cesarean Section Non delivery operating mode that allows the trainee to go through the motions of a cesarean section in order to support cesarean teamwork training Postpartum Non delivery operating mode that supports the management of the postpartum uterus Non Gravid Non delivery operating mode th
218. nt of fluid or blood that is building up in the space between the myocardium and the pericardium causing a cardiac tamponade Default 0 mL Range 0 mL 500 mL 303 M se Parameter Descriptions CAE Fidelis Lucina Ischemic Index Sensitivity The Ischemic Index Sensitivity parameter determines the relative sensitivity of the simulated patient to myocardial ischemia A lower ischemic index sensitivity value corresponds to less sensitivity to an unfavorable oxygen supply demand ratio i e poor oxygenation with high heart rate A patient with a low value is less sensitive to poor oxygenation takes longer to go into the death spiral and therefore survives longer Default 0 45 Range 0 10 5 00 Model Driven ECG Rhythm Ischemic Index I I I I 0 90 0 90 gt I I 0 70 0 70 gt I I 0 60 0 60 gt I I 0 40 0 40 gt l l 1 minute after VTach 1 minute after VFib The patient s response to myocardial ischemia may be altered using the Ischemic Index Sensitivity parameter found on the Cardiovascular view To make the patient less sensitive to ischemia lower the value below the default setting To make the patient more sensitive increase the value above the default setting These changes are then reflected in the patient s Ischemic Index as shown in the table above Ischemic Index Averaging Ischemic index averaging determines how quickly myocardial ischemia develops
219. nt on the fetal state The acceleration interval has some variability associated with it This parameter is defined in minutes Default Modeled Range 1 min 40 min FHR Acceleration Duration The FHR Acceleration Duration parameter determines the duration of the accelerations in the fetal heart rate signal When set to modeled it is dependent on the fetal state The acceleration duration has some variability associated with it This parameter is defined in seconds Default Modeled Range 20 sec 60 sec 313 M se Parameter Descriptions CAE Fidelis ucina Placental Perfusion Factor The Placental Perfusion Factor parameter determines how easily blood flows into the placenta from the maternal circulation Lowering this factor results in a decreased blood flow and oxygen supply to the fetus leading to a gradual decrease in fetal heart rate and a general deterioration of the fetus condition The effect of this parameter is independent of uterine contractions Default 1 0 Range 0 10 Umbilical Flow Factor The Umbilical Flow Factor parameter determines how easily blood flows into and out of the fetal side of the placenta Lowering this factor results in a decrease in blood flow and oxygen supply to the fetus heart as well as an increase in the fetus blood pressure leading to a decrease in fetal heart rate anda general deterioration of the fetus condition This effect occurs much quicker with this parameter compared to
220. ntact CAE Healthcare Customer Service Charging the Batteries To charge the simulator batteries using the AC adapter 246 CAE Healthcare Care and Maintenance 1 Connect the AC adapter into the port located on the right side of the maternal mannequin s torso located next to the power button The AC adapter connection The AC Adapter Connection 2 Connect the electrical plug on the other end of the AC adapter to a power source Three maternal mannequin battery indicator lights are located on the left side of the mannequin When all three indicator lights are illuminated and not blinking the maternal mannequin s batteries are fully charged When two indicator lights are illuminated and not blinking the maternal mannequin s batteries have less than 5096 power remaining When one indicator light is illuminated and not blinking the maternal mannequin s batteries have less than 2096 power remaining When one indicator light is illuminated and blinking the maternal mannequin batteries have less than 1596 power remaining When one light is illuminating at one time in sequence from left to right the maternal mannequin s batteries are charging NOTE The batteries charge at a slower rate if the simulator is powered on while the AC adapter is plugged in An external battery charger can be purchased to charge the batteries outside of the simulator 247 Care and Maintenance CAE Fidelis ucina WARNING If the si
221. ntilation Increasing the respiratory rate with minimal increase in tidal volume produces this Default 1 Range 0 1 10 0 Chest Wall Capacity The Chest Wall Capacity parameter sets the total combined intrapleural and lung volumes at which the chest wall is considered distended Also see Chest Wall Compliance Factor and Distended Chest Wall Compliance Factor Default 3900 Range 1500 3900 286 ZW CAE Healthcare M se Parameter Descriptions Chest Wall Compliance Factor This Chest Wall Compliance Factor parameter describes the interaction of the chest wall with the lungs The Chest Wall Compliance Factor parameter defines the volume pressure relationship in the normal operating lung volumes Once distended however the chest wall rapidly becomes much less compliant i e much stiffer and resistant to further inflation Default 1 Range 0 15 10 00 Distended Chest Wall Compliance Factor The Distended Chest Wall Compliance Factor parameter along with the Chest Wall Compliance Factor parameter describes the interaction of the chest wall with the lungs The Chest Wall Compliance Factor parameter defines the volume pressure relationship in normal lung volumes Once distended however the chest wall rapidly becomes much stiffer and resistant to further inflation Also see Chest Wall Compliance Factor The Distended Chest Wall Compliance Factor parameter must be set to a low value for increased intrapleural vo
222. ny running SCEs The Stop Simulation dialog box appears c Click the Stop Simulation button The Simulation stops and returns to the Home page d Click the Account Name in the lower right hand corner of the screen 243 Care and Maintenance CAE Fidelis ucina The Logout dialog box appears e Click Logout to exit the software To shut down the TouchPro Patient Monitor software a Clickthe Settings button in the bottom right hand corner of the TouchPro Patient Monitor screen b From the Settings menu click Shutdown A warning box appears asking if you want to exit c Click Shutdown To shut down the TouchPro CTG software a Clickthe Settings button in the bottom right hand corner of the TouchPro CTG screen b From the Settings menu click Shutdown A warning box appears asking if you want to exit c Click Shutdown Step 3 Power Off the Simulator Press the power button on the right side of the simulator s torso The simulator powers off Step 4 Power Off the Fetus Press the power button on the back side of the fetus The fetus powers off 244 CAE Healthcare Care and Maintenance Maintenance Advice Simple care and maintenance helps to ensure that the maternal fetal simulator stays in good working condition Many problems are caused by inadequate or improper maintenance Perform a thorough check of the various components each time the simulator is used General Simulator Care Follow
223. o 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 ZW CAE Healthcare End User License Agreement 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
224. o files A single patient record file cannot exceed 20MB To upload a patient record 1 From Patient Records panel click Upload Patient Records A file selection window appears 2 Select the desired file and click Open or OK The file is uploaded and is available to display in the TouchPro software M se can store at least 2GB of patient record files depending on the disk space available To ensure adequate space please delete patient records when they are no longer needed 145 UsngM se CAs Luna To delete a patient record 1 From the Patient Records panel select the patient record to delete 2 Click Delete The patient record is deleted and is no longer available to display in the TouchPro software Individual patient records can also be previewed renamed or exported by selecting the record and clicking Rename Export or Preview Vocalization List The MFS maternal mannequin has the ability to voice custom sounds Custom sounds are managed from the Vocalization List panel on the Content Management tab of the System Administration screen Vocalization files Preview Upload Vocalization File Rename Delete The Vocalization List Panel The following vocalization file types can be uploaded to M se Wav A single vocalization file cannot exceed 1MB To upload a vocalization file 1 From Vocalization List panel click Upload Vocalization File A file selection window appears 2 Selec
225. o monitor the maternal heart rate and if the relevant probe is connected Possible selection includes Not Available The emulated CTG does not have the capability to display the maternal heart rate No MHR widget is displayed on the CTG Unused reserved space is reallocated to the available widgets to minimize visual impact Connected The emulated CTG does have the capability to display the maternal heart rate and a probe is connected The MHR widget is displayed and provides live measurement of the maternal heart rate Disconnected The emulated CTG does have the capability to display the maternal heart rate but no probe is connected The MHR widget is displayed but displays to indicate no data is being received Default Connected MSPO Probe The MSPO Probe parameter indicates if the emulated CTG has the capability to monitor the maternal oxygen saturation and if the relevant probe is connected Possible selection includes Not Available The emulated CTG does not have the capability to display the maternal oxygen saturation No SpO widget is displayed on the CTG Unused reserved space is reallocated to the available widgets to minimize visual impact Connected The emulated CTG does have the capability to display the maternal oxygen saturation and a probe is connected The SpO widget is displayed and provides live measurement of the maternal oxygen saturation Disconnected The emulated CTG does have the capabi
226. od pressure changes A baroreceptor gain cardiac factor of less than 1 corresponds to baroreflex depression e g less heart rate response to MAP changes A value greater than 1 leads to a stronger response to MAP changes Default 1 Range 0 00 10 00 302 ZW CAE Healthcare Mise Parameter Descriptions Baroreceptor Gain Peripheral Factor The Baroreceptor Gain Peripheral Factor parameter adjusts the influence of mean arterial pressure MAP on systemic vascular resistance and venous capacity influencing how much the vasculature responds to changes in blood pressure For example when blood pressure falls the arteries increase their vascular tone resistance and there is less pooling of the blood in the venous system in an attempt to maintain adequate blood pressure A factor of less than 1 corresponds to baroreflex depression e g less systemic vascular resistance response to MAP changes A value greater than 1 leads to a stronger response to MAP changes Default 1 Range 1 00 10 00 Chest Compression Efficacy The Chest Compression Efficacy parameter is used to determine the effectiveness of chest compressions administered by the caregiver The 100 setting indicates that chest compressions are completely effective while the 0 setting prevents them from having any effect on intrathoracic pressure Default 100 Options 100 0 Tamponade Volume The Tamponade Volume parameter is used to set the amou
227. on The History ded The Home button The SCE m Summary panel The SCE Selection panel The Logout button The Home Page 63 Using M se The SCE Selection Panel SCEs are process tools that enable the facilitator to execute a learning strategy using simulation Preconfigured CAE Healthcare SCEs provide an extensive overview and outline of the learning exercise and require minimal additional faculty development time for use Each SCE is comprised of a patient and up to four scenarios Available SCEs appear in the SCE Selection panel on the Home page The Search button The Search field Base SCEs The Open Library button ls Open Library Running Now Recent CAE Fidelis Lucina The Clear button Tabs a ri Abruptio Placentae Secondary to Cocain a Anaphylactoid Syndrome of Pregnancy Jovita Williams a Healthy Adult Female Norma L Female a Hyperemesis Gravidarum Divya Shetty a _ Postpartum Hemorrhage Two Hours Afte 2 Lyslie Allison a Preeclampsia Johna Mccoskey Pregnancy With Drug Abuse o Stannette Momtobe Page 1 2 gt ie New SCE EH The selected SCE MT Page arrows The New SCE button The SCE Selection Panel The SCE Selection panel has four tabs that access SCEs Running Now Recent Favorites and All Running Now tab Lists the
228. on ring For Right Sacrum breech presentation the fetal head should be facing the mother s left side when placed into the rotation ring NOTE Ensure fetal head skin is over on top of the neck skin and the neck skin is over on top of the fetal torso skin as shown in picture above 8 Inflate the rotation ring by pressing the Lock icon on the gripper button pad located on either side of the mannequin s torso The Gripper Button Pad 31 Configuring the Mannequin CAE Fidelis Lucina 9 Position the arms firmly adducted against the torso of the fetus with the hands of the fetus towards the back of the fetus not the front The Breech Fetus in the Rotation Ring Arms Adducted IMPORTANT Ensure the umbilical cord exits the placenta pouch on the same side that the fetus is facing to prevent snag during delivery The umbilical cordon same side fetus is facing The Breech Fetus in the Rotation Ring Vaginal Delivery Vertex To load the delivery fetus for a vaginal delivery in a vertex presentation 1 Ensure the rotation ring from inside the mannequin s torso is installed and returned to the Home position 2 Ensure the delivery uterine funnel with dynamic cervix is installed 3 Ensure the fetus is powered on indicated by the illuminated power light in the umbilical opening on the front of the fetus 4 Ensure the umbilical cord is connected to the fetus 32 CAE Healthcare Configuring th
229. on the Run screen When the Sounds panel appears select Fetal Heart Sound Location The Fetal Heart Sound Location menu appears Breath Sounds Heart Sounds Audible Breathing Sounds UA Synchronized Vocal Clip Neonate Cry Selection Fetal Heart Sound Locatioi None M Breech Left Side Breech Right Side Cephalic Left Side Cephalic Mid Cephalic Right Side The Fetal Heart Sound Location Menu Click the Fetal Heart Sound Location drop down menu to change the location of fetal heart sounds Click and drag the slider to adjust the volume 236 ZW CAE Healthcare Using Lucina Bowel Sounds Non Gravid Only The Bowel Sounds menu can be used to control bowel sounds The bowel sounds can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select Bowel Sounds The Bowel Sounds menu appears All Bowel Sounds x i LUQ Bowel Sounds RUQ Bowel Sounds Breath Sounds The dropdown pec Ap Ww menu LLQ Bowel Sounds RLQ Bowel Sounds Heart Sounds Audible Breathing Sounds The Bowel Sounds Menu Independent control of the type and volume of bowel sounds may be selected in each anatomical region To affect the bowel sounds simultaneously in all anatomical regions select All Bowel Sounds and the desired sound and volume Click any of the drop down menus to change the type of sound Click and drag the slider beneath the drop down men
230. or graphic widgets from the Available Widgets panel to an available Patient Status Display space NOTE Waveform and CTG widgets occupy two spaces Once the desired widget is placed click the widget to change the physiologic parameter displayed NOTE The parameter displayed on the CTG and Graphic widgets cannot be changed Adding a Scenario from the SCE Editor SCEs incorporate scenarios that contain preprogrammed physiology Scenarios can be added to SCEs to enhance patient physiology When a scenario is added to an SCE from the SCE Editor the scenario becomes associated with the SCE and begins automatically when the SCE is run To add a scenario to an SCE from the SCE Editor 1 From the Review screen click the Add Scenario button under the Preloaded Scenarios heading Pre Loaded Scenarios The Add Scenario Button The Choose Scenario dialog box appears Scenarios Name Last Modified Anaphylactoid Syndrome of Pregnancy 2013 09 04 09 30 12 Anaphylaxis 2013 09 10 11 16 35 Hyperemesis Gravidarum 2013 09 04 09 30 12 Scenarios Postpartum Hemorrhage Two Hours After Delivery 2013 09 04 09 30 12 Preeclampsia 2013 09 04 09 30 12 The Add The Search button field The Choose Scenario Dialog Box 2 Select a saved scenario from the Choose Scenario Dialog Box The Search field can be used to search for a scenario to select 122 ZW CAE Healthcare Using Mise 3 Click Add The scenario is added to the
231. orm and numeric readouts for ECG Lead Il 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 SpO and pulse To select a preconfigured layout 1 Click the Settings button in the bottom right corner of the display mmc The Settings Button 165 Using the TouchPro Patient Monitor CAE Fidelis Lucina The TouchPro Settings menu appears JE rouchPro The Close Settings button Layouts The Layouts panel i EMS ED Telemetry i ICU Arterial Line Only i ICU OR NO CVP i ICU OR A Gaturation Pulse o Save As Qu Audio Setup NIBP Cycling A Patients fm About 1o Tee pl The TouchPro Settings Menu 2 Select a layout from the Layouts panel 3 Click the Close Settings button The Settings menu closes and the selected layout appears NOTE Preconfigured layouts must be enabled in the M se TouchPro Setup for the currently running SCE to be accessible in the Layouts panel 166 ZW CAE Healthcare Using the TouchPro Patient Monitor Changing a Waveform or Numeric Display Waveforms and numeric displays can be changed to suit the user s needs To
232. os are listed in the Scenarios panel From the Scenarios panel users can rename review delete import and export scenarios they have created by clicking the respective buttons within each scenario Locked scenarios can only be reviewed Users can also create new scenarios from the Scenarios screen by clicking the Create New Scenario button Click Import to import a scenario file from an external device or the hard drive location where the SCE file is saved Click Export to export a scenario file to an external device The scenario file extension is mss NOTE Locked CAE Healthcare scenarios CANNOT be exported 143 UsngM se CA Fidelis Luna Conditions From the Content Management options click Conditions to access the Conditions Editor The Conditions Editor appears The Conditions link Patient Records 2 The Rename Vocaiizetion List ZL II amp w O amp 0 8 cem button The Edit The Delete button Parameters The Add button D Pues The Conditions Editor All conditions can be viewed in the Conditions panel by selecting their associated categories and groups from the Condition Categories and Condition groups panels From the Conditions Editor users can create new Conditions to be used in SCEs To create a new condition 1 From the Condition Categories panel select a category NOTE Conditions CANNOT be added to the Interventions category 2 From the Condition Group panel selec
233. ottom center of the birth canal from the rectal groove The rectal extension The Mannequin Torso 9 Lift and remove the birth canal NOTE Ensure rectal extension is completely removed from the rectal groove before removing the birth canal The rectal extension De R Sa The Birth Canal Removed 262 CAE Healthcare Care and Maintenance The mannequin with birth canal removed The Mannequin Torso To install the birth canal 1 Position the birth canal inside the mannequin torso ensure exterior of birth canal is facing towards feet and rectal extension is at bottom The Mannequin Torso Birth Canal Placement 263 Care and Maintenance CAE Fidelis Lucina 2 Locate the ischial spine post on the bottom left or right side of mannequin torso squeeze and slide one side only of the birth canal completely onto post The ischial spine post The Mannequin Torso 3 Insert squeeze and push the rectal extension located on the bottom center of the birth canal completely into the rectal groove The rectal extension The Mannequin Torso 264 1 CAE Healthcare Care and Maintenance NOTE The rectal extension must fit completely into the rectal groove The rectal extension groove The Mannequin Torso 4 Squeeze and slide the remaining side of the birth canal completely onto ischial spine post The ischial spine post The Mannequin Torso 265 Care and Mainten
234. ou do not wish to delete the items listed they can be dragged back into the scenario at which time they are removed from the Trash Logging out of the software automatically empties the Trash IMPORTANT Items emptied from the Trash cannot be retrieved Saving States to the State Library Users can save states to the State Library for later use To access the State Library click the States button in the bottom right corner of the Scenario Designer ao The States button The States Button To save a state drag and drop the state into the State Library button A Normal Delivery k The State Library A dragged State The Scenario Designer The state is stored in the library 136 ZW CAE Healthcare The State Library appears listing all saved states Delivery of Placenta The State Library To exit the State Library click Conditions The Conditions button L j ao The Conditions Button Using M se 137 Using M se CAF Fidelis Ludna Administrative Tools The M se 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 page The History button The System Administration button The Account Profile button The Administrative Tools Buttons Click the History button to view and manage simulation session logs Click t
235. ouchPro Patient Monitor 3 Click the empty waveform field The Wave Vital Selection menu appears Wave Vital Selection ECG I ECG II ECG III ECG V1 ECG V2 ECG V3 ECG V4 ECG V5 ECG V6 ECG aVL ECG aVR ECG aVF Pleth Capnogram Blank Set Alarm J Set Color Jl Set Scale J The Wave Vital Selection Menu 4 Select the desired waveform from the Wave Vital Selection menu The new waveform is displayed 169 Using the TouchPro Patient Monitor CAE Fidelis Lucina 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 A blank numeric field The TouchPro Display The Numeric Vital Selection menu appears Numeric Vital Selection ABP TAxilla TBlood TBody CVP CO EtCO2 HR ICP MAP NIBP PaCO2 PACO2 PaO2 PAO2 PCWP PAP Pulse The Numeric Vital Selection Menu 2 Select the desired numeric The new numeric vital is displayed 170 JW CAE Healthcare Using the TouchPro Patient Monitor 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 d
236. ower source The USB Charger Cord NOTE A USB AC power adapter may be used to plug the USB cord into a power outlet Batteries require approximately 4 to 6 hours to fully charge The batteries charge at a slower rate when the fetus is powered on during charging 249 Care and Maintenance CAE Fidelis Lucina Cleaning the Internal Systems The internal systems of the maternal mannequin must be cleaned after each simulation session Only the systems that were used need to be cleaned Cleaning the IV System To clean the IV system 1 Connect an empty 140 mL syringe to the IV DRAIN port located on the left side of the simulator s torso The Battery Compartment and Ports 2 Slowly withdraw air from the port until a vacuum is formed If only clear fluid was injected into the IV system during use the cleaning procedure is complete IMPORTANT If colored fluid was injected in the IV system complete the Priming the IV System instructions in the Using Lucina section with clear fluids and complete the Cleaning the IV system instructions for a second time Cleaning the Bleeding System The bleeding system needs to be cleaned with distilled water after simulated blood has been used Once a month flush the system with a 50 50 mix of distilled water and white vinegar to keep mineral and algae build up to a minimum Always flush with distilled water to remove any trace amounts of vinegar NOTE The mannequin s
237. present on palpation She rates her pain as a 5 out of 10 There are irregular short uterine contractions with uterine irritability throughout and The Continue continuous vaainal bleedina She is unclean and disheveled wearina bloodstained pants and socks There is a mmm ppm button The SCE Summary Panel Stopping the SCE Running SCEs can be stopped from the Run screen or the Home page To stop an SCE from the Run screen 1 Click Stop in the upper right corner of the screen The Stop Button 109 Using M se The Stop the Simulation dialog box appears Stop the Simulation Do you want to stop the simulation The Stop The Simulation Dialog Box 2 Click Stop Simulation The SCE stops running and the Miise Home page is shown To stop an SCE from the Home page CAE Fidelis Lucina The Stop Simulation button 1 Click the Stop button in the bottom left corner of the SCE Summary Panel The Stop Button The Stop the Simulation dialog box appears Stop the Simulation Do you want to stop the simulation The Stop The Simulation Dialog Box 2 Click Stop Simulation The SCE stops running IMPORTANT Always stop all running SCEs before logging out of Muse 110 The Stop Simulation button ZW CAE Healthcare Using M se Developing SCEs Creating and editing SCEs are similar processes Once an SCE is created the steps for modifying the SCE are the same as those for
238. proximately 10 times 3 Lubricate the inside of the vaginal canal with cottonseed oil 4 Use one hand to gently squeeze the uterus Use the other hand to reach in the vaginal canal and grab the internal liner squeezing the uterus creates air pressure to help pull out the liner TIP A second person holding the uterus may be helpful The Invertible Uterus 55 Configuring the Mannequin CAE Fidelis Lucina 5 Pull out the liner to invert the uterus do not extend more than two inches outside the labia The Invertible Uterus 6 Ensure the birthing mechanism on the mannequin is at the highest position and the rotation ring is removed from the mannequin s torso 7 Ensure the blood tank is installed with the placenta pouch placed on top of the blood tank 8 Place the invertible uterus in the abdominal cavity over the placenta pouch on the blood tank and into the vaginal opening 9 Lockthe uterus in place with the static cervix backplate The Invertible Uterus installed in Mannequin 56 CAE Healthcare Configuring the Mannequin 10 11 12 13 14 Lightly lubricate the birth canal and labia using the cottonseed oil provided Lubricate the uterus external genitalia Gather the invertible uterus external genitalia fully inside the mannequin s torso and push the skin through the birth canal until the genitalia is completely on the outside Tuck in the labia and position the uteru
239. ptor Maximum Pressure Baroreceptor maximum pressure defines the mean arterial pressure MAP at which the baroreceptor inhibitory activity on the heart and systemic vasculature is maximal When a simulated patient s MAP increases above baseline pressure the baroreceptor response exerts greater inhibitory controls on the MAP e g reduction in heart rate in an attempt to return the MAP to the patient s baseline pressure However these controls have an upper limit and this maximum pressure is defined as the baroreceptor maximum pressure 298 ZW CAE Healthcare M se Parameter Descriptions In other words as the MAP increases the physiological controls i e baroreceptor response work to bring the pressure back toward baseline primarily by reducing the heart rate For every 5 mmHg increase in MAP the heart rate may decrease by 2 beats per minute in an attempt to keep the MAP in check However there is an upper limit maximum pressure after which these controls are no longer effective Once the MAP reaches the baroreceptor maximum pressure there is no additional reduction in heart rate if the pressure continues to rise For example should the pressure continue to rise the heart rate would not show a corresponding slowing The MAP set point is exactly between baroreceptor maximum pressure and baroreceptor minimum pressure Default 112 mmHg Range 40 mmHg 220 mmHg Baroreceptor Minimum Pressure Baroreceptor minimum pre
240. puts 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 Usechannels 0 through 11 for the best sound
241. quality Usechannels 12 through 31 if more than 12 simulators are present in one area 338 ZW CAE Healthcare 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 WVL Handset The base station device antenna is almost fully exposed WVL Base Station 339 Wireless Voice Link CAE Fidelis Lucina 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 EN Red power light Green connection light WVL Front View The following features are located on
242. quin Setup Screen Cesarean Vertex Presentation 359 M se Mannequin Setup Screens CAE Fidelis Lucina Mannequin Setup Screen for a Non Gravid SCE Once a Non Gravid SCE is selected the mannequin must be manually configured prior to beginning the simulation The configuration will correspond with the diagrams presented on the Mannequin Setup screen in the M se software Mannequin Setup Non gravid Female Non gravid Female Make sure the mannequin is setup as follows BIRTHING MECHANISM ABDOMEN 1 Remove rotation ring 4 Install Leopold tub 6 Install non gravid abdomen connect 2 Remove uterine funnel with delivery cervix if 5 Ensure no fetus is installed speakers in place 3 Install prepartum birth canal with closed cervix Cancel Continue The Mannequin Setup Screen Non Gravid 360 B i ET 4 EI z NUS BA useoamom CAE Healthcare T 02 2911 5233 F 02 2911 6855 E info kyst com tw www kyst com tw n fa 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 Fri
243. r a prepartum and latent SCE configuration 1 Ensure the cervix retention plate is placed into the grooves located in the center of the backplate The cervix retention plate The Backplate 2 Install the backplate with the cervix retention plate The retention plate should be flush against the static cervix NOTE Ensure the arrows on the top of the plate point towards the mannequin s feet The arrows The cervix retention plate The Backplate Installed The backplate is now installed for a prepartum and latent SCE 24 ZW CAE Healthcare Configuring the Mannequin Installing the Support Tub The support tub is used to hold the fetus during prepartum latent phase 1 Install the Leopold support tub in the mannequin s torso The rotation ring removed The Mannequin s Torso The Support Tub The mannequin is ready for installing the Leopold fetus CAUTION Do not place pressure or any object on the rotation ring support arms while the rotation ring is removed Loading the Fetus Prepartum Prepartum and Latent To load the Leopold fetus 2 Ensure the Leopold support tub is installed in the mannequin s torso 3 Place empty placenta pouch on top of the support tub 4 Place the Leopold fetus on top of the placenta pouch and tub in the desired position 5 Cover with the prepartum abdomen Active Phase To load the delivery fetus 1 Install the placenta pouch 2 Attach umbilic
244. rameter NOTE Not all changes to parameters affect the patient s physiology but all are logged Using the Conditions Medications and Interventions Palettes The Conditions Medications and Interventions palettes on the Run screen enable the application of conditions medications and interventions during simulation Once applied conditions are reflected in the patient s physiology and logged All medications and interventions are also logged and most affect the patient s physiology Using the Conditions Palette Conditions are preprogrammed pathophysiological states that use one or more physiological parameters and are designed to enable you to create physiological changes on the fly 83 Using M se CAERielis Ludna There are two ways to apply conditions using the Conditions palette using a Quick Link or using the complete Conditions menu Quick Links are preconfigured conditions that are made accessible in the Conditions palette for quick application Quick Links can also be created for the Medications and Interventions palettes To set parameters using the Quick Links in the Conditions palette click one of the Quick Links The condition is applied and affects the patient s physiology The Conditions button Conditions pnea BP Hypertension Quick Links 8 Hypotension Desaturation Heart Rate Bradycardia eart Rate Tachycardia The Conditions Palette NOTE Quick Links can only
245. rameter falls outside the acceptable range the CTG alarm sounds NOTE The fetal heart rate FHR alarm only sounds when FHR has been below the acceptable range for at least 30 of the last 60 seconds or above the acceptable range for at least 150 of the last 300 seconds The alarm also sounds when a FHR probe is connected but no FHR data has been received for 90 of the last 180 seconds To set CTG alarm thresholds 1 From the CTG Monitor click the Alarm button in the lower left corner of the CTG display The Alarm Button 185 Using the TouchPro CTG Monitor CAE Fidelis Lucina The Alarm Thresholds window appears The Low value The High value column mn column 160 IL Ji 25 d td e de Dae al n qid yo a High 120 T a Rb Dy Wee P 0b d 4 iT High 100 i si 1 EU An Increase Higl button Systolic 90 LJ 160 LJ Ej ue ae Ae het Pago th dd Gee fed Ae E De ea A slider Diastolic The Alarm Thresholds Window 2 From the Alarm Thresholds window adjust the desired parameters using the Increase and Decrease buttons or the sliders next to parameters Any parameter value that falls below the Low value or above the High value causes the CTG alarm to sound 3 Click anywhere outside the Alarm Thresholds window to close the window and return to viewing the CTG Monitor Setting CTG Alarm Suspension Time The alarm suspension time determines how long an ala
246. rd button skips forward one screen The Skip to End button skips to the end of the strip When the CTG strip data displayed on the screen is not current e g the Rewind button has been used the time bar turns blue FAR TUA r 97 36 5 bpm US mmHg TOCO bar TE me Cen pan m 3000 Zere m pee The CTG Monitor Display When the strip returns to showing current data the time bar turns white again 194 ZW CAE Healthcare Using the TouchPro CTG Monitor Changing the CTG Monitor Language To change the language of the CTG Monitor 1 Click the Settings button from the bottom right corner of the CTG Monitor fF Settings The Settings Button The CTG Monitor Settings menu appears fg CTG Qu Alarm Suspension Time Qu Audio Setup MNIBP Cycling My Language Selection The Language Selection button Q Shutdown The CTG Monitor Settings Menu 2 From the Settings menu click the Language Selection button 195 Using the TouchPro CTG Monitor CAE Fidelis Lucina The Language Selection window appears Languages English US German French France Spanish Spain Chinese Traditional Chinese Simplified Polish Russian Korean Japanese rm rere The Accept button The Language Selection Window 3 From the Language Selection window select a language 4 Click Accept The TouchPro CTG Monitor software changes to the selected languag
247. retcher 10 CAE Healthcare Setup Step 2 Power on the Maternal Mannequin To power on the maternal mannequin a Priorto powering on the simulator ensure the Fidelis Lucina mannequin has fully charged batteries inserted into the left side of the torso or the power cord is attached on the right side of the torso b Locate the power button on the right side of the Fidelis Lucina mannequin s torso c Press and release the power button The button illuminates when the mannequin is powered on The Power The Power cord button The Mannequin Power Button and Power Cord IMPORTANT Wait three 3 minutes while the simulator establishes a wireless network before attempting to connect to the instructor workstation Failure to wait will prevent proper connection if the user attempts to make a direct Ethernet connection to the simulator network The mannequin should say Hello when it is ready to be used with the M se software 12 Each time the maternal mannequin is powered on the rotation ring must be returned to the Home position To return the rotation ring to the Home position press and hold the upward arrow button until the rotation ring returns to the Home position e g the highest position of the Birthing Mechanism rotates and locks in place The upward arrow icon The Gripper Button Pad For information on recharging batteries see the Care and Maintenance section of this user guide
248. rint button located in the bottom right corner of the 12 lead ECG report The Report Title window appears Report Title The Print button The 12 Lead Report Title Window 2 Enter a title for the 12 lead report 3 Click Print The Page Setup window appears 4 On Page Setup Window click OK The Print window appears 5 From the Print window click the PDF drop down menu in the lower left corner 6 From the drop down menu select the Save as PDF option The Save window appears N In the Title field enter the 12 lead report title 8 Click Save 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 The Print dialog box appears 2 From the drop down menu select Microsoft XPS Document Writer The report saves on the Windows Instructor Workstation 175 Using the TouchPro Patient Monitor CAE Fidelis Lucina 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 Report Title Hamm Cancel Print The Print button The 12 Lead Report Title Window 2 Enter a title for the 12 lead report The Print window appears 3 From the Printer drop down menu select the appropriate network printer NOTE A n
249. rm stays silent after it is manually muted using the Mute button in the lower left corner of the CTG display To adjust the alarm suspension time 1 Click the Settings button in the bottom right corner of the screen f settings The Settings Button 186 ZW CAE Healthcare Using the TouchPro CTG Monitor The CTG Monitor Settings menu appears fr CTG QDA suspansion tma The Alarm Suspension Qu Audio Setup Time button MNIBP Cycling fg About a Language Selection Q Shutdown The CTG Monitor Settings Menu 2 Click the Alarm Suspension Time button 187 Using the TouchPro CTG Monitor CAE Fidelis Lucina The Alarm Suspension Time window appears Alarm Suspension Time imin 2 mins 5 mins Indefinite The Alarm Suspension Time Window 3 Select the desired suspension time 4 Click the Close button The window closes and the selected alarm suspension time is applied NOTE The alarm suspension time does NOT apply when all alarms are muted using the Audio Setup window or the Mute button in the bottom left corner of the CTG monitor When all alarms are muted using these methods they remain muted until the user manually un mutes them using the Audio Setup window or by pressing the Mute button in the bottom left corner of the CTG monitor a second time Adjusting Audio Settings The CTG alarm sound can be changed or all alarms can be muted from the Audio Setup menu To change CTG
250. rnal Mannequin The autonomous simulator reacts to medical interventions with appropriate physiological responses and wirelessly communicates with the Instructor Workstation creating an authentic experience for the learner and keeping the instructor informed as the scenario progresses The Instructor Workstation provides the instructor with scenario development tools and programmable patient physiology to create an immersive realistic training environment The Fidelis Lucina simulator provides all the components necessary for prepartum care normal and complicated vaginal deliveries and postpartum care The simulator supports cephalic and breech delivery placenta delivery shoulder dystocia nuchal cord neonate crying postpartum vaginal bleeding and boggy and inverted uterus In addition the following medical interventions can be performed ECG and electrical therapy Epidural administration Forceps delivery Intubation Leopold s maneuvers McRoberts maneuver Medication and fluid administration Mechanical ventilation support Neonate suctioning Rotational maneuvers Suppository administration Uterine massage and bimanual compression Vacuum delivery e Zavanelli maneuver Introduction CAE Fidelis Lucina Contained in this User Guide This User Guide has been designed for quick access to information on how to use and maintain the CAE Fidelis Maternal Fetal Simulator Please be sure to read and follow the Caution
251. rnal mannequin the event is logged as fetus released from the birthing mechanism 92 ZW CAE Healthcare Using M se When labor is in progress the Resume Delivery button becomes a Pause Delivery button To pause labor click the Pause Delivery button The Delivery TM Dicen co AN eq Ihe Pause Delivery button Delivery The Delivery Controls The delivery clock stops and the fetal mannequin stops descending inside the mother However SCE time and physiology DO NOT stop When labor is paused labor can be resumed by clicking the Resume Delivery button Marking the Baby Delivered When the baby is delivered vaginally during simulation the instructor or facilitator must log this event in M se To mark the baby delivered 1 From the Run screen click the Show Neonate Status icon NOTE The Show Neonate Status icon is only available after the labor clock has counted down to zero and the fetus has reached the end of its descent inside the maternal mannequin The icon changes from gray to yellow at this time 00 03 31 gt gt s TS i 002032 The Show Neonate Status icon The Run Screen 93 UsngM se CA Fidelis Luna The Show Neonate Status window appears asking if you want to mark the baby as delivered Show Neonate Status Mark the baby as delivered The Show Neonate Status Window IMPORTANT Marking the baby delivered is irreversible DO NOT mark the baby as delivered until t
252. roper rotation of the anterior shoulder requires that the anterior shoulder is rotated at least 35 Improper rotation of the anterior shoulder is prevented For example if after restitution the fetus is in LOT position automatic resolution of shoulder dystocia requires that the anterior shoulder is rotated counter clockwise at least 35 In LOT position rotating the anterior shoulder clockwise is prevented The Zavanelli option activates the automatic resolution of shoulder dystocia upon detection of proper Zavanelli performed When in shoulder dystocia the simulator allows the learner to manually push the fetus backwards through the birth canal in between contractions A successful Zavanelli maneuver is detected when the fetus is pushed up the descent mechanism a distance of approximately 6cm Upon detection Zavanelli maneuver was performed and Shoulder dystocia condition resolved will be logged in the event log The fetus must be powered on and connected to the simulator s wireless network and confirmed by the presence of a fetal battery charge status in the fetal battery status icon The connection is required in order for the system to recognize the applied force to the head of the fetus as the learner attempts Zavanelli Extraction of Posterior Arm The Extraction of Posterior Arm maneuver to resolve shoulder dystocia is not detected automatically When a proper extraction has been performed the Extraction of Posterior Arm para
253. rrent Pacing Rate Pacing Capture Threshold Cold Fluid Inject Modeled Modeled 1 70 3 amp Modeled P Peripheral Artery P Right Atrium P Pulmonary Art Deflated The Cardiovascular View 208 ZW CAE Healthcare Cardiovascular Features Anatomy Physiology and Clinical Signs Description ECG waveforms can be viewed on a standard monitor and or on the Patient Status Display Normal and abnormal cardiac rhythms are linked to patient physi ology e g blood pres sure cardiac output Software Control None required specific rhythms can be selected VIEW Cardiovascular PARAMETER S Car diac Rhythm Manual Control ECG monitor may be used Cardiovascular system automatically com pensates for changing hemodynamic condi tions None required but adjustable VIEW Cardiovascular PARAMETER S Baro receptor Maximum Pressure Barorecep tor Minimum Pres sure None required A transthoracic car diac pacemaker can be used with Lucina Pac ing results in appropri ate physiological changes in blood pres sure and cardiac out put The instructor can set the level at which elec trical capture and mechanical capture occur VIEW Cardiovascular PARAMETER S Pac ing Current Pacing Rate Pacing Capture Threshold See Pacing on the fol lowing pages for car diac pacing disk locations and instruc tions The variou
254. rs The homunculus ee D mou simte The Run Screen The associated parameters appear to the left of the homunculus 2 Locate the desired parameter NOTE Some views include a Basic Additional switch that can be used to toggle between basic and advanced parameters Basic parameters are always shown by default 3 Select the parameter and set the new value 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 81 Using M se CAF Fidelis Ludna and Seconds and Minutes a slider that sets the beats per minute and an available field where the beats per minute value can be keyed in Heart Rate The Override Modeled switch The value setting slider The Heart Rate Parameter Once the parameter has been set itis reflected in the patient s physiology Types of Parameters There are two types of parameters numeric and discrete Once a parameter is selected and set the patient s physiology changes according to the model for that parameter Numeric Parameters Numeric parameters set either a measured value e g 20 mL a multiplied value called a factor e g Heart Rate Factor 2 0 is two times the baseline Heart Rate or a coefficient that affects a physiological value in a non linear way e 9 FHR Variability Coefficient Numeric parameters
255. rvix is 10096 effaced and 5 cm dilated The fetus is in cephalic presentation vertex at 2 and the membranes were ruptured upon vaginal examination The fundal height is 35 cm and fetal heart rate FHR is 130s beats per minute bpm The patient is presenting regular contractions at four minute intervals No analgesia has been requested The learner is expected to provide support and information to patient and family recognize cervical dilatation evaluate FHR and contractions and recognize regular contraction frequency In State 2 Four Hours Later the patient demonstrates a HR in the 80s BP in the 120s 80s RR in the upper 20s SpO2 in the upper 90s on room air and the FHR is in the 140s The patient states that she feels the urge to push The learner is expected to complete a vaginal examination and find the cervix 10 cm dilated and fetus at 4 station recognize the start of second stage labor ensure the presence of appropriate personnel in the room position and prepare the patient for delivery and complete the delivery of the fetus In State 3 Delivery of Placenta the patient demonstrates a HR in the 70s BP in the 110s 70s RR in the teens and SpO2 in the upper 90s on room air The learner is expected to deliver and examine the placenta Learning Objectives Recognizes the normal progression of the active phase of labor and the second stage of labor Rerognizes normal fetal heart rate FHR patterns and normal uterine contraction frequen
256. ry Additional Parameters 4 e eeeee eene eere rente rn traen en enata sensns sna tn 281 Respiratory alfo aces adatti ttdmistceeu ud dnd tds rA cma Morandi dare i ite 282 Tidal VOUM RR T M EEr aie 283 Tidal PITT ea o tme PE T 283 PH SRi cscs 283 Positive End Expltatory Pressure PEEP i a ases tritico epatis ebit ert i ortis 284 07 CONSUM ti inniinn ar te RR CHEER esl ROB CORE RE abo cin 284 CO2 PROOHCHORIU ACUI secet toE S HEREG ARE PRO RRERBUUEDDRRRR UBND ROS DENBU DU OM BOTE 284 Pa CO2 SU OUI NI RR RR ER 284 Pe Setpoint RR REI ERE RR ERR RIED ERR alveolar 285 Ito E Ratio TX RERO 285 PettO2 PaC02 Fat RT 285 Respiratory Gain Fatto t soo aciei adi eei E EUR FED aaia 286 Respiratory Quotient uso obese aded van abo canina ciis didt e ima ca dA ete 286 Volume Rate Control Factor ooo RUF ERRORI RARRU RO IERN ERU eR Rp R S BIe raSR DU 286 Chest Wall Capacity coss da eer nU ER CUN Hp DUE EUR EPOR DD FH DOR OLG M Pr Dr RE 286 Chest Wall Compliance Factor Jacagese edd viae la ERR PPORY FE Eve tx ORA SUO ERAT IRR 287 Distended Chest Wall Compliance Factor ssscssssssssscsssssssscssessssscsssnssssssessnscssssessnsccssscesnscesssecsness 287 Functional Residual Cap BUG caida PERRA RUN QE ER ARR EROR PR AR 287 Lung Compliance Factor Left and Right seen enn tennttnnnttnnnntnnnon 287 Venous COD SIN RTT
257. s Medication Preferences The Profile Preferences panel The Profile Preferences link The Account Profile Screen To change the font size click on the Font size selection The Font size drop down menu appears From the Font size drop down menu select Normal Small or Large 161 UsngM se CA Fidelis luna This page intentionally blank 162 ZW CAE Healthcare Using the TouchPro Patient Monitor USING THE TOUCHPRO PATIENT MONITOR The TouchPro Patient Monitor software enables users to view patient physiology The software can be used from the Instructor Workstation or on another computer provided the computer has joined the simulator s wireless network IMPORTANT Only two TouchPro software screens can be open at a time Accessing the TouchPro Patient Monitor Software Like the Muse software the TouchPro Patient Monitor software is compatible with computers that have touch screen capabilities To run the TouchPro Patient Monitor software the Instructor Workstation must be connected to the simulator s network IMPORTANT An SCE must be running on the Mise software for any physiological data to be displayed on the TouchPro Patient Monitor software The TouchPro Patient Monitor software can only show one Patient at a time To launch TouchPro Patient Monitor from the Instructor Workstation 1 With the Mise software running open a new tab in the web browser and go to the Home page of the web browser
258. s parameter specifies the desired sequence of cardinal movements as a sequence of target position for vertex presentation initial position internal rotation target restitution target The eleven possible choices include LOA OA LOT ROA OA ROT LOT OA LOT ROT OA ROT LOP OA LOT LOP OP LOT ROP OA ROT ROP OP ROT OP OA OA no rotation and OP no rotation Exceptions OP OA has only an internal rotation to OA and no restitution OA no rotation and OP no rotation have no spontaneous rotation Default LOA OA LOT Breech Initial Position The Breech Initial Position parameter is relevant only for the Vaginal Delivery operating mode This parameter specifies the initial fetal position for breech presentation There is no spontaneous rotation with breech presentations The eight possible choices are LSA LSP LST RSA RSP RST SA SP Default LSA Cord Prolapse The Cord Prolapse parameter is only relevant for Vaginal Delivery Active Phase and Cesarean Section operating modes When activated Yes the umbilical cord should be configured in a prolapse condition This has no automatic effect and simply maps to the user instructions in the configuration screen Default No Nuchal Cord The Nuchal Cord parameter is only relevant for the Vaginal Delivery and Cesarean Section operating modes When activated Yes the umbilical cord should be set in a nuchal cord condition This has no automat
259. s and Warnings on the pages preceding the Table of Contents This is for the safety of users as well as for the protection of the simulator The Equipment Overview outlines the items that come standard with the purchase of a Fidelis Before using the system follow the step by step instructions included in the Setup section The Configuring the Mannequin section shows users how to configure the internal components i e cervix uterus fetus of the Fidelis for the different birthing options The Using M se section describes the different features and functions in the M se software The Using TouchPro Patient Monitor and Using the TouchPro CTG sections describe how to setup and utilize the TouchPro Patient Monitor and TouchPro CTG software The Using the Maternal Fetal Simulator section provides instructions on the use of the various parameters and hardware features integrated into the simulated experiences This section also includes information on how the simulator and software components work and the functionality that each supports The Care and Maintenance section contains warranty details and cleanup and care instructions that must be followed to ensure optimal functioning of the Fidelis The user guide also includes information on e Condition Guidelines for Programming Patients in Muse e Muse Parameter Descriptions e Parameter Display Definitions Recommended Clinical Supply Sizes Ischemic Index Conditions Wireless Voi
260. s can select which probes are connected to the patient modify the signal status for fetal heart rate and uterine activity and make changes to the TouchPro CTG Monitor display Accessing the TouchPro CTG Software Like the M se software the TouchPro CTG Monitor software is compatible with computers that have touch screen capabilities To launch the TouchPro CTG Monitor software from the Instructor Workstation 1 With the M se software running open a new tab in the web browser and go to the Home page of the web browser The M se Start Screen appears m se EN TouctiPro PudHPro The TouchPro CTG icon The M se Start Screen 2 Select the TouchPro CTG icon 183 Using the TouchPro CTG Monitor CAE Fidelis Lucina The TouchPro CTG Monitor software opens displaying simulated TouchPro CTG monitor readings and a simulated CTG paper strip CTG monitor readings FHR UA TS 125 79 100 148 7 B 98 36 5 bpm US mmHg TOCO Th e C EELS oS Peer peed epee ga FEE RITE PALA T ase simulated paper strip The CTG Monitor 184 ZW CAE Healthcare Using the TouchPro CTG Monitor Configuring CTG Alarms There are three factors that determine CTG alarm behavior alarm thresholds alarm suspension time and audio settings Setting CTG Alarm Thresholds The CTG alarm thresholds define the acceptable ranges for the various parameters shown on the CTG monitor When a pa
261. s cardiac rhythms can be selected The response to clini cal intervention must be controlled by the instructor VIEW Cardiovascular PARAMETER S Car diac Rhythm None required 209 Anatomy Physiology Cardiovascular Features Description Software Control CAE Fidelis Manual Control and Clinical Signs Effective chest com pression results in arti ficial circulation cardiac output central and peripheral blood pressures palpable pulses and CO return The Mise CPR Moni tor displays key com pression parameters in real time None required but adjustable VIEW Cardiovascular PARAMETER S Chest Compression Effi cacy CPR Monitor Apply chest compres sions Normal and abnormal circulation e g hypo volemia hypervol emia and right left heart failure can be adjusted None required but adjustable VIEW Cardiovascular PARAMETER S Sys temic Vascular Resis tance Factor None required Lucina supports opera tion with a variety of manual and automatic external defibrillators Defibrillation can be simulated by the instructor VIEW Cardiovascular PARAMETER S Defib See Defibrillation on the following pages for defibrillation disk loca tions and instructions Various hemodynamic physiological indica tors are registered and can be monitored None required but adjustable VIEW Cardiovascular PARAMETER S Arte ri
262. s external genitalia smoothly over the standard birth canal Tuck the edge skin of the uterus external genitalia under the torso skin around the genitalia opening The Invertible Uterus with External Genitalia 57 15 Connect the reversion lock collar pneumatic line yellow Gripper line to the mannequin Fetus Gripper port The Fetus Gripper port The Invertible Uterus Installed In Mannequin 16 Remove the syringe allowing uterus to slowly deflate Empty any air from the inverted portion and ensure correct positioning IMPORTANT The clear end fittings must remain attached to the syringe tubing The clear end fittings The Syringe 17 Install the prepartum abdomen 58 ZW CAE Healthcare Configuring the Mannequin Postpartum Backplate Installation To install the backplate for a postpartum SCE configuration NOTE Ensure the blood tank and either the boggy contracted uterus with bag or the invertible uterus are installed prior to performing the backplate installation 1 Remove the cervix retention plate located in the center of the backplate by lifting and sliding the retention plate out of the backplate The cervix retention plate The Backplate 2 Install the backplate without the cervix retention plate over the uterus to hold it in place NOTE Ensure the arrows on the top of the plate point towards the mannequin s feet The backplate installed The boggy u
263. s 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 e g 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 Pulmonary Artery 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 296
264. scenarios will be paused Reset the Patient This will reset the patient to the physiology at load time and pause all currently running scenarios The Reset button The Reset the Patient Dialog Box 3 Click Reset The patient returns to its original physiological state as at the start of the SCE The patient reset is indicated with a red marker on the SCE timeline bar 4 To resume any paused scenarios click the loaded scenario on the left side of the screen The Scenario Management pop up menu appears 5 From the Scenario Management pop up menu select Play The scenario is resumed 107 Using M se CAF Fidelis Luna The Medication Monitor The Medication Monitor tracks the infusion of medication administered for medications that affect patient physiology To activate the Medication Monitor from the Run screen click the Medication Monitor button in the bottom right portion of the screen s Medication Monitor The Medication Monitor Button The Medication Monitor appears as a movable box on the Run screen s Medication Monitor The Close button Medication name rocuronium 0 0002 mg kg e The Reset button Normalized effector site concentration The Medication Monitor The normalized effector site concentration is Shown next to each medication listing The Reset button is used to clear a medication from the physiological model and the Medication Monitor To close the Medication
265. screen The window closes and the delivery is logged in Muse Neonate crying settings can be modified at any time after delivery by clicking the Show Neonate Status icon again or clicking the Sounds Controls In SCEs where the baby is delivered by C section Muse automatically detects delivery However the Show Neonate Status icon is enabled throughout the simulation and can be used to display APGAR score and control neonatal crying IMPORTANT The placenta should only be delivered AFTER the baby is marked as delivered Transitioning the Mother to Postpartum NOTE The Proceed to postpartum option will only appear in the Neonate Status Window if Including Postpartum option was selected on the Patient Baseline screen If additional assessments and interventions are to be performed after the baby has been delivered and the delivery has been logged in Muse the patient and mannequin must be transitioned to the postpartum phase 1 From the Neonate Status Window click Proceed to postpartum 2 Once the baby has been marked as delivered the Delivery icon is replaced by the Postpartum indicator The Postpartum indicator The Run Screen 95 Using M se CAE Fidelis Luna 3 Click Postpartum for instructions on how to configure the mannequin for the postpartum phase The Mannequin Setup window appears Mannequin Setup Postpartum Boggy Contracted uterus The Mannequin Setup Window 4 Perform the mannequin config
266. screw The GU Tank Ensure the birth canal is completely and securely attached to all fittings 269 Care and Maintenance CAE Fidelis Lucina This page intentionally blank 270 ZW CAE Healthcare Condition Guidelines for Programming CONDITION GUIDELINES FOR PROGRAMMING MES WITH MUSE This section is intended to help you select Muse 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 Mise 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 SpO Value 98 96 97 94 96 91 93 87 90 84 86 80 83 77 80 74 77 69 71 lt 69 271 Condition Guidelines for Programming CAE Fidelis j Lucina Cardiovascular Blood Pressure Hypertension Hypotension 110s 70s 110s 70s 120s 80s 100s 70s 130s 80s 100s 60s 140s 90s 90s 50s 150s
267. se CAF Fidelis Luna The Patient Records list appears displaying all available patient records Patient Records Normal Abdominal Ultrasound Patient records The Start Displaying button Start Displaying The Patient Records List 2 Select a patient record from the list 3 Click Start Displaying The patient record is shown in a new TouchPro web browser window IMPORTANT Ensure pop up blocking is turned OFF in the web browser of the Instructor Workstation and any TouchPro workstations Consult the web browser s help menu for assistance NOTE The web browser window containing the patient record may be minimized initially If the window is not readily visible click the web browser icon on the Dock Macintosh Instructor Workstation or Taskbar Windows Instructor Workstation to locate the new window The Patient Records button turns red indicating that a patient record is being displayed The Patient Records Button 76 ZW CAE Healthcare Using M se The Start Displaying button at the bottom of the Patient Records list changes to a red Stop Displaying button Patient Records Patient record Normal Abdominal Ultrasound The Stop Displaying button The Patient Records List To stop displaying a patient record click Stop Displaying at the bottom of the Patient Records list To close the Patient Records list click the Patient Records button The list closes If a patient record is being disp
268. se under any of the following conditions SpO2 7596 Spontaneous minute ventilation 1500 mL Neuromuscular blockade NMB gt 30 e Non pulsatile cardiac rhythm 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 Eyes Blink Speed The Blink Speed parameter controls the eyelid blinking frequency and can be set to Slow Normal Fast or Rapid 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 Reactive Pupils The Reactive pupils parameter determines whether pupils re size in response to changes in light When Yes is selected pupils re size in response to changes in light and when No is selected they do not Default Yes Light Reactivity Speed The Light Reactivity Speed parameter determines the speed at which the eyes reactto light when the Reactive pupils parameter is set to Yes Light Reactivity Speed can be set to Sluggish or Brisk Default Brisk Seizures The Seizures parameter is used to simulate the presence of seizures They are either On or Off Default Off 276 ZW CAE Healthcare M se Parameter Descriptions Intracranial Pressure ICP The ICP parameter is used to set the ICP displayed as a numeric value on Patient Status Display and on the TouchPro Patient monitor The
269. selected The Medication Transition menu appears asking for the comparison type and transition value Dopamine A Greater than or Eqenl Comparison type Transition value G c 7 8 9 4 5 6 1 2 3 0 _meg kg cm The Accept button The Medication Transition Menu Follow the same steps to make selections from similar menus for the Assessment Intervention Physiology Scenario Vitals and Fetal and Childbirth variable types 3 Once the variable values e g comparison type and transition value have been selected click Accept 130 1 CAE Healthcare Using M se The selected transition variable is listed beneath the original state on the Scenario Designer 4 From the Scenario Designer click the GOTO arrow beneath the new transition variable The Defib GOTO Initial Assessment arrow Four Hours Later Deli f Pl t 1 Sey eee The Available None States menu The Scenario Designer The Available States menu appears listing all the available states 5 Select a state from the menu An orange connector line appears indicating that the states are now linked by a transition IF Station Equal To 1 GOTO Four Hours Later The orange connector line The Scenario Designer 131 ELSE Transitions An ELSE transition is used to transition to a state automatically when none of the other programmed transitions occur Before sp
270. sion Cardiac Rhythm Set Cardiac Tamponade Heart Rate Bradycardia Heart Rate Tachycardia Patient Stability Pulses Ventricular Failure Both Ventricular Failure Left Ventricular Failure Right The Scenario Designer Canvas Or a new empty state can be added using the New State button To add a new state using the New State button 1 Click the New State button on the upper left side of the Scenario Designer afe New State The New State Button A new state appears A New State 2 From the Graphical View double click the new state or from the Line Item View click the Expand Collapse arrow to the left of the state to expand it 127 Using M se CAF Fidelis Luna The state expands and additional options appear The state stat name parameters C notes 4h Custom Variable i T a The Expanded State 3 Double click the state name By default new states are named State The Rename state window appears and contains a field for entering a new state name Ns en a The Save Amen button The Rename State Window 4 Enter a new state name 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 V lt gt 5 Click Save The state is renamed Modifying Scenario States Once a scenario state has been placed on the canvas it can be modified Ad
271. speakers using the Wireless Voice Link For detailed instructions on using the wireless voice link see the Wireless Voice Link section of this user guide 230 ZW CAE Healthcare Using Lucina 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 Anterior and posterior sounds and each of the four quadrants of the torso can be set independently to produce a particular breath sound Breath sounds can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select Breath Sounds The Breath Sounds menu appears All Breath Sounds Heart Sounds The Anterior Posterior switch Right Upper Lobe Ant Left Upper Lobe Ant Audible Breathing Sounds UA Synchronized Vocal Clip A LY Right Lower Lobe Ant Left Lower Lobe Ant Neonate Cry Selection Fetal Heart Sound Location The Breath Sounds Menu Use the Anterior Posterior switch to toggle between anterior and posterior breath sounds Click any one of the drop down menus that control one of the four quadrants to change the type of sound Click and drag the slider for each location to adjust the volume Selecting a sound from the All Breath Sounds menu changes all posterior or anterior sounds Click and drag the slider to adjust the volume of all anterior or po
272. spiratory effects pharmacodynamics NOTE M se does not verify a 10096 sum of all fractions because this would require all fractions to be set Default Modeled Range 0 0096 8 0096 Fraction of Inspired Sevoflurane The Fraction of Inspired Sevoflurane parameter is used to simulate the amount of sevoflurane set in the anesthetic vaporizer and is used to calculate alveolar sevoflurane This parameter has a faster effect on physiology than anesthesia machine settings because mixing in the breathing circuit is not simulated NOTE M se does not verify a 100 96 sum of all fractions because this would require all fractions to be set Default 096 Range 0 0096 8 0096 291 M se Parameter Descriptions CAE Fidelis Lucina Cardiovascular Basic Parameters Cardiovascular Parameters Basic 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 300 mmHg Diastolic 10 mmHg 300 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 volum
273. ssure defines the mean arterial pressure MAP at which the baroreceptor inhibitory activity on the heart and systemic vasculature is minimal When a simulated patient s MAP decreases below baseline pressure the baroreceptor response exerts inhibitory controls on the MAP e g increase in heart rate in an attempt to return the MAP to the patient s baseline pressure However these controls have a lower limit and this minimum pressure is defined as the baroreceptor minimum pressure In other words as the MAP decreases the physiological controls i e baroreceptor response work to bring the pressure back toward baseline primarily by increasing the heart rate For every 5 mmHg decrease in MAP the heart rate may increase by 2 beats per minute in an attempt to keep the MAP in check However there is a lower limit minimum pressure after which these controls are no longer effective Once the MAP reaches the baroreceptor minimum pressure there is no additional increase in heart rate if the pressure continues to fall For example should the pressure continue to fall the heart rate would not show a corresponding increase The MAP set point is exactly between baroreceptor maximum pressure and baroreceptor minimum pressure Default 72 mmHg Range 20 mmHg 160 mmHg Left Ventricle Contractility Factor The Left Ventricle Contractility Factor parameter adjusts the contractility of the left ventricle and has a direct effect on cardiac output
274. stalling the Blood Tank de 46 Installing the Boggy Contracted Uterus With Bag sessesssesssessssossseosessseosososesossseosossssosseose 48 Installing the Postpartum Invertible Uterus ssesssososssoeososssssossssoseseessososososososssssosossssessee 54 Postpartum Backplate Installation ccs p RERO REDE POUR A ERREUR 59 LB RR 61 Starting the ein 61 Navigating the Home Page user niin n A PU OD ERR A HORDE FERE AFEHK TUR EC KU 63 The SCE epe 64 The SCE Operating Mode GOD uccidere aste dat pmi re ary Ortu b s deb Rare c 67 The SCE Summary PEL otov npa RETO OSEE DARE HAOR DM UU RAD O 68 Running M SCE ss em R 69 SCE MITIS 72 Using the Patient Status Display C 73 ThE Event LG rosca HOC EAE inc bna bread Ex DNO Bo D ard 75 Displaying Patient RecUR S us aoo oae idbasives in DR died CI RUER cave eaiaucaa vated PR PO ERO ERU QEON 75 NOTE Only one patient record can be displayed at a time enn 7 Adding a Scenario to a Running SCE asi ooi a ERG FN DEA UAE FED IPIE PED QUE S Uer 78 Changing Physiology and Controlling Delivery eese rennen nnn tnnnnnnnn 79 Selecting CTG Monitor Options iiio side ox RO epe t Hu Pape YR UIRRUpH YURUAR AR SHEER URS R E 97 SCE Time COHN GIS sesso cee gba da UN END RU quA DR ON FURIR M DD ERR DAR HU ronan 98 The Bat
275. states from the Scenario Screen 1 From the Run screen click the desired loaded scenario The Scenario Management pop up menu appears The Show Show Scenario Anaphylaxis Scenario Beginning Anaphylaxis 00 01 05 option 4 Beginning Anaphylaxis Mild Anaphylaxis J Conditions Moderate Anaphylaxis boan Severe Anaphylaxis BP Hypertension Condition Improves BP Hypotension Desaturation Play Heart Rate Bradycardia Pause Heart Rate Tachycardia ER Medications Acetaminophen Albuterol Amiodarone The Scenario Management Pop Up Menu 2 From the menu select Show Scenario The Scenario screen appears displaying the scenario The Pause Play Button The Jump to State ie eal k py Collapse All wj Expand All ane ys m pr sj A E Eg ds pud indow Button Selected state a States The Scenario Screen At the top of this screen the Scenario Time and State Time are visible Additionally users can pause and continue playing the scenario by clicking the Scenario Pause and Play button on the top of the screen 3 Click the Jump to State button 91 Using M se CAF Fidelis Ludna The Jump to State menu appears displaying the available states e Beginning Anaphylaxis Mild Anaphylaxis Moderate Anaphylaxis Severe Anaphylaxis Epinephrine Administered Condition Improves The Jump to State Menu 4 Select the desired state The scenario transitions to the selected stat
276. sterior quadrants The default volume level is 5096 231 Using Lucina Heart Sounds CAE Fidelis Lucina 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 Heart sounds can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select Heart Sounds The Heart Sounds menu appears Breath Sounds Audible Breathing Sounds UA Synchronized Vocal Clip Neonate Cry Selection Fetal Heart Sound Location All Heart Sounds Heart Mitral Sounds Heart Aortic Sounds b Normal Heart Pulmonic Sounds Heart Tricuspid Sounds The Heart Sounds Menu Click any of the drop down menus to change the type of sound Click and drag the slider beneath the drop down menu to adjust the volume The default volume level is 5096 232 ZW CAE Healthcare Using Lucina Audible Breathing Sounds Audible breathing sounds such as wheezing and gasping can be heard without the use of a stethoscope Audible breathing sounds can be adjusted by clicking the Sound Control icon on the Run screen When the Sounds panel appears select Audible Breathing Sounds The Audible Breathing Sounds menu appears Breath Sounds Heart Sounds The dropdown Audible Breathin
277. t Compression Compression Depth Compression Depth inches Compression Rate Compression Rate per minute Chest Recoil Compression Release Compression Fraction Proportion of time in which chest compressions are performed Depth Variability Standard Deviation of Compression Depth inches CAE Healthcare Display Definition Ventilation Ventilation Volume Ventilation Rate Ventilation Volume mL Ventilation Rate breaths min I E Ratio Minute Ventilation Inspiratory Expiratory Ratio Minute Ventilation L min Alveolar Ventilation Patient Vitals Alveolar Ventilation L min Blood Pressure Arterial Blood Pressure CePP Cerebral Perfusion Pressure CoPP Coronary Perfusion Pressure SpO2 Oxygen Saturation EtCO2 End Tidal Carbon Dioxide CPR Live Data Compression Depth Ventilation Volume Compression Depth inches Ventilation Volume mL CPR Summary Chest Compression Rate Compression Rate per minute Chest Compression Depth Average Chest Compression Depth Variability Compression Depth Average inches Standard Deviation of Compression Depth inches Chest Compression Recoil Chest Compression Fraction Compression Release 96 Proportion of time in which chest compressions are performed 96 Ventilation Volume Average Ventilation Volume Average L min Ventilation Rate Ventilation Rate bre
278. t a group 3 In the Conditions panel click the Add button The New Condition Name dialog box appears 4 Enter a name for the condition in the New Condition Name dialog box 5 Click Save The condition is added to the selected Condition category and group 6 From the Conditions panel select the new Condition 7 Clickthe Edit Parameters button The Parameters screen appears 8 From the Parameters screen select the desired Condition parameters 9 Click Complete The condition is saved with the selected parameters New condition categories and groups can also be added by clicking the Add button in the Condition Categories and Condition Groups panels Use the Delete and Rename buttons in each panel to delete or rename a Condition group or category NOTE CAE Healthcare conditions groups and categories cannot be deleted or renamed 14 ZW CAE Healthcare Using Mise Patient Records Patient records can be uploaded to Muse for display in the TouchPro software Once uploaded a patient record is available for use with any SCE Patient Records are managed from the Patient Records panel on the Content Management tab of the System Administration screen A patient record The Upload Patient Records The Patient Records Panel The following patient record file types can be uploaded to Mise JPG or JPEG images GIF images PNG images e XPS images PDF documents MPEG videos MOV videos MP3 audi
279. t penetrable by two fingers 70 effacement soft intermediate 2cm 70 dilated 2cm 70 effacement soft intermediate 3cm 90 dilated 3cm 90 effacement soft intermediate 4cm 90 dilated 4cm 90 effacement soft intermediate 5cm 90 dilated 5cm 90 effacement soft anterior Default Closed NOTE Only the italic bolded cervices comes standard with the mannequin the others can be purchased separately as an optional kit Presentation The Presentation parameter is relevant for all operating modes except Postpartum This parameter allows the selection of the fetal presentation which includes None Use when presentation is not relevant Vertex and Breech Default Vertex Initial Station The Initial Station parameter is relevant only for Vaginal Delivery Active Phase and Cesarean Section operating modes This parameter indicates the starting station for the fetus For Vaginal Delivery the simulator will automatically locate the fetus in the indicated starting position once the configuration phase is completed In the Active Phase and Cesarean Section operating mode the selected Initial Station is simply communicated to the user in the configuration instructions for manual positioning of the fetus Default 3 Range 3 3 322 ZW CAE Healthcare M se Parameter Descriptions Vertex Rotation Type The Vertex Rotation Type parameter is only relevant for the Vaginal Delivery operating mode Thi
280. t 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 6 IRREPARABLE HARM 6 1 Licensee acknowledges that the Embedded Software and
281. t the desired file and click Open or OK The file is uploaded and is available to use during simulation M se can store at least 2GB of patient record and vocalization files depending on the disk space available To ensure adequate space please delete files when they are no longer needed 146 ZW CAE Healthcare Using Mise To delete a vocalization file 1 From the Vocalization List panel select the vocalization to delete 2 Click Delete The vocalization is deleted and is no longer available to use during simulation Individual vocalization files can also be previewed or renamed by selecting the vocalization and clicking Rename or Preview 147 UsngM se CAERidels Luna User Accounts To access the User Accounts panel from the System Administration screen click the User Accounts button The User Accounts panel appears From the User Accounts panel users can create edit and delete users The User Accounts button admin Email admin meti com Confirm Password The user list Group Administrator Privileges syst The user fields The Edit button The Delete button The New Lum button The User Accounts Panel NOTE User Accounts functions are available only to users with the User Management or System Management privilege Creating a User To create a new user 1 From the User Accounts panel click New The New Account Creation panel
282. te e Static Cervix retention plate Essential Set of Static Cervices Closed without effacement and permeable by 1 finger firm posterior Closed 50 effaced permeable by one finger medium posterior 4 cm dilated and 90 effaced soft intermediate Leopold fetus Leopold tub Prepartum abdomen with abdomen storage rack NOTE To help prevent damage apply a light dusting of baby powder to the storage rack and always store the abdomen on the rack when not in use The storage rack The Abdomen and Storage Rack ZW CAE Healthcare Equipment Overview Vaginal Delivery Kit The Vaginal Delivery Kit contains the following items Uterine funnel with delivery cervix Delivery fetus Placenta Intact Placenta Fragmented Placenta fragment Umbilical cord Delivery abdomen Lubricant cottonseed oil Lubricant spray bottle Postpartum Kit The Postpartum Kit contains the following items Postpartum Birth Canal with Boggy Contracted Uterus Blood Tank e Trauma Fill Tank Accessories The accessories for the Fidelis Lucina include Four ECG posts e Pacing defibrillation disks NIBP Adapter Kit IV priming syringe e Priming tube Roll of hook and loop fastener for forceps Genitourinary GU Filling Tool e Blood tank adapter e Condensation drain IV Tubing Single Replacement Kit e Wireless Voice Link Kit Optional Equipment The following equipment is available to
283. ted point in the timeline NOTE The SCE time continues moving forward and does not reset to the bookmarked time The Battery Status Icon To view the battery charge status of the maternal or fetal mannequin click the respective battery status icon in the lower left corner of M se The maternal j The fetal battery battery status icon status icon The Battery Status Icons Fully Charged When the battery charge on either mannequin reaches 30 percent or less the battery status icon turns red The maternal The fetal battery battery status icon status icon The Battery Status Icons Low Battery 99 Using M se CAF Fidelis Ludna When the battery charge on either mannequin reaches 10 percent or less the battery status icon displays a red caution symbol The maternal The fetal battery battery status icon status icon The Battery Status Icons Low Battery Traction Feedback Traction Feedback is accessible from the Run screen and can be used to monitor traction force applied to the fetus s neck and head To view Traction Feedback and toggle the traction warning tone on or off click the Traction Feedback button at the bottom of the Run screen j Traction Feedback The Traction Feedback Button The Traction Feedback window appears Traction raai The Close button UA The Warning Tone switch s row The Traction Feedback Window The Tract
284. tem Settings panel from the System Administration screen click System Settings The System Settings panel appears Content Management System Configuration Disk Space 109 56 GB available 65 free System Time Thu May 22 14 04 00 GMT 0400 2014 Data Management BackUpData RestoreData Product Licensing License Manager Language Change Language Cardiotocograph CTG Configuration CTG Settings Performance Metrics FetalTraction Error Log View Errorteg ExportErrortog The System Settings Panel System Settings The System Settings button The System Settings panel NOTE System Settings functions are available only to users with the System Management privilege 152 CAE Healthcare Using M se 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 Users should back up data to protect and store content and user data To back up data 1 On the System Settings panel click the Back Up Data button Back Up Data The Back Up Data Button A Save dialog box appears 2 Select a location to save the backed up data 3 Click Save IMPORTANT To protect content and user information data should be backed up weekly Restoring Data Users can res
285. terus The Mannequin s Torso 59 Configuring the Mannequin CAE Fidelis Lucina IMPORTANT The boggy contracted uterus bag should be installed and used with the boggy postpartum uterus at all times The Boggy Contracted Uterus Installed With Bag The backplate is now installed for a postpartum SCE 60 ZW CAE Healthcare Using Muse USING MUSE The Mise software is a browser based application that can communicate directly with the simulator With the software users can run SCEs create scenarios and SCEs import and export educational content and perform administrative functions NOTE For optimal Muse performance no other software programs should be open while Mise is running IMPORTANT Only one Mise application window or tab and one TouchPro window or tab can be used per Instructor Workstation at a time IMPORTANT Do NOT use any of the browser s navigational tools i e back and forward buttons while operating Muse Starting the Application Once the simulator is powered on and the Instructor Workstation is connected to the simulator network the Muse software can be launched To launch the software 1 Using the Laptop or Tablet Instructor Workstation launch the web browser The Mise Start Screen appears License Manager Eu TouclPro Patient Monitor TouchPro un CTG The M se Start Screen 2 Select M se 61 UsngM se CA Fidelis luna The Login screen appears
286. tery Stats I600iscasotakrotatescen mte rear da binas red EUR Gn PONES AER 99 Table Of Contents CAE Fidelis Lucina lcrwi dam H 100 The CPR D E coats atten 101 Using the Event Recorder to Save States s ssscssssscssessssessessssssccsssecssssesssecsssscessecssssesssscssssecssseesses 102 Creating a New Patient asas eapite dette repre ci hd e HE iEn t nue DH 104 iQuE gi E T 107 The Medication MODICO uasa REA Rn iU o peri RR rs a posso o ON 108 Returning to the Home POUR oai RR RAS MODE HUE REDE RM RH n bl DE 109 Stopping the SC Esses pra dile dra ax ERE FED RARO rn DD rd Pub ndr 109 Developing ii sais 111 Creating a NACE oisssaiidoan iati idem tod ainieO eru RIEN SOEUR on HMM Neb 111 MESCE Edito S o cone PERENNE MEBUI HEISE MERC 113 Editi Patient s Profile cssc italia aetas da rud dn m tier a 114 Creating a New Scenario scias ctia a ecu pts cac cu cucauescocs tuc tron b pU Oi Casncetuaceaes 123 Editing a SCE MAING aros RR a GU DOR O M AIO 124 Modifying Scenario Sabes oie RO ERU UA DORRHRN RO UN OD RU NONU EROR RURTE HQ ED UE 128 Deleting Scenario States uoces oda bO pde ptm Lepidi paa Co PUn APRI BIER ht 133 Deleting Parameters and TraltsitlofiS iiosenopineitri o modb P edbXxe dtd cba eter 133 Saving the Scenarierne RR OE D UR RR R CI Pre Er 134 Emptying the TEaSIL s coiocnniitei piat atta ab P Pad IE EN a Rae 135 Saving States tothe State L IDEA
287. the Patient Status Display or the TouchPro Patient Monitor The response to clini cal intervention must be controlled by the instructor VIEW Neurological PARAMETER S ICP None required By default neuromus cular blockade is mod eled based on patient physiology The mod eled neuromuscular blockade value can be overridden by manu ally selecting a value If the NMB value is set greater than 3096 the eyes will automatically close VIEW Neurological PARAMETER S NMB None required 201 Using Lucina CAE Fidelis Lucina Neurological Features Anatomy Physiology an p Description Software Control Manual Control and Clinical Signs Temperature Body and blood tem perature can be set using the temperature parameters Body and blood temperature can be displayed on the Patient Status Dis play None required Eyes Each eye has reactive pupils and eyelids that blink and close The settings for pupil diameter light reactivity and blinking are located on the Neurological view o Boi es The Apply to The Pupil Diameter menus Pn SC Pply NE Both Eyes b 5mm 5 mm The Blinking menus sS i option P Auto b Auto Eyes Blink Speed P Normal The Blink Speed menu Yes Reactive pupils Yes Light reactivity options Brisk Light Reactivity Speed Brisk Seizures off ICP Modeled NMB Modeled Temperature Body 36 5 Te
288. the Condensation Drain Hose included with the inventory kit The Condensation Drain Hose 2 Bring the hose and a small bucket to the simulator location 3 Bend right knee to lift the thigh to at least a 45 degree angle 4 Power on the simulator but do not start M se Allow enough time for the internal compressor to pressurize the system The pump will turn off automatically 5 Power off the simulator 6 Place the tubing end of the Condensation Drain Hose into the small bucket and then connect the gray fitting onto the simulator s EXT AIR port located on the left side of the simulator with a push and twist motion There will be a sudden release of pressure into the bucket Any condensation within the system will drain with this exhaust The EXT AIR port The Battery Compartment and Ports 7 Disconnect the Condensation Drain Hose from the simulator 257 Care and Maintenance CAE Fidelis Lucina Replacing the Standard Birth Canal Follow these steps to ensure proper removal and installation of the Standard Birth Canal It is recommended that at least two people perform the procedure Please read these steps completely prior to beginning procedure The Standard Birth Canal Front and Back View To remove the birth canal 1 Remove any installed cervix or backplate The Uterine Funnel With Dynamic Cervix 258 CAE Healthcare Care and Maintenance 2 Remove the screw from the Genitourinar
289. the selected baseline settings Selecting Labor and Delivery Options From the Patient Baseline screen labor and delivery options such as delivery type fetal station and fetal presentation can be selected To access labor and delivery options from the Patient Baseline screen click the Childbirth Configuration icon m se a Patient Baseline r The Childbirth Bu Configuration icon The Patient Baseline Screen The labor and delivery options appear The Operating Mode parameter d Comte has The labor and i e 3 E delivery options e ve dre Lema hee da V m 0 ui e i The Childbirth Configuration Options Screen The Operating Mode parameter is used to set the SCE to include vaginal or Cesarean delivery or to take place only in the prepartum or postpartum stage 116 ZW CAE Healthcare Using Mise CTG Data The patient s CTG data is displayed on the SCE Editor and can be reviewed using the CTG Review buttons in the lower left corner of the CTG strip CTG data as A hs N obe The CTG Review buttons The SCE Editor The CTG data represents the fetal heart rate and uterine activity measured by electrical monitors prior to the start of the SCE This data can be reviewed on the CTG monitor while the SCE is running CTG data can be added to a custom SCE in one of two ways 1 By selecting an existing SCE with the des
290. these general simulator care guidelines to protect and care for the simulator 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 and urinary catheters with cottonseed oil spray and NOT a water based 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 the bleeding genitourinary or IV features on the maternal mannequin have been used drain and clean the simulator as described in the following pages Failure to drain and clean the systems may cause problems with the system Prior to any simulation CAE Healthcare suggests applying a light coat of lubricant cotton seed oil on the hip skin between the torso and thighs to help prevent rubbing or pinching Wipe any excess oil to prevent dripping Storing the Simulator When in regular use the maternal fetal simulator breakdown procedure and general cleanup are sufficient to prepare the simulator for storage In addition be certain to follow these instructions Storage temperature should not exceed 12
291. 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 Embedded 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 MEPGTC sublicense encumber the Embedded Software or Data c not modify the Product in any way combine with other programs or reverse engineer screen scratch decompile or disassemble any Embedded 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 n
292. tore data when the backed up data needs to be replaced on the software Restoring data only restores the last backup and does NOT merge the backup data with the current data To restore backup data 1 On the System Settings panel click Restore Data Restore Data The Back Up Data Button 153 Using M se CAF Fidelis Luna The System Restore warning box appears stating that restoring data erases all current data and asks if you want to continue System Restore Warning Restoring data will permanently delete all current data Do you want to continue r Q r E r The System Restore Warning Box IMPORTANT Restoring data ERASES all current data and replaces it with the backed up data 2 Click Yes A select file dialog box appears 3 Locate the appropriate bak backup file to restore 4 Click Select The data is restored Product Licensing To view product licensing information for your simulator or to enter a license key to activate your software click License Manager Language To change the language of the M se software 1 From the System Settings panel under the Localization heading Click Change Language The Change Language dialog box appears 2 Select a language from the dialog box 3 Click Accept The M se user interface changes to the selected language NOTE Only the English version of the User Guide is available via the software regardless of the M se l
293. ts Library when creating a new SCE 105 Using M se CAE Fidelis Lucina NOTE If the newly created base patient is used in a new SCE SCE patient any changes made to the newly created base patient at a later date will not affect that SCE patient Save a Copy EST M Create a new SCEwith your New Patient Mary Stanette Momtobe Mary Base Patient New Patient Saved Changes Made ta Mary s Base Line l E Changes will NOT automatically apply gt Create a new SCE with your to Existing SCEs using Updated Patient Mary Mary asa Base Patient Mary with New Patient Mary Base line Saved New Patient Saved The New Patient Diagram 106 ZW CAE Healthcare Using Muse Resetting a Patient Resetting a Patient brings the Patient back to its original physiological state before any scenarios were applied or modifications were made Any running scenarios are paused However the SCE time is unaffected Additionally the reset appears in the Event Logs NOTE If baseline physiology settings have been selected they are removed when the Patient is reset To reset a Patient 1 While running an SCE click Patient at the bottom of the Run screen The Patient Button The Patient pop up menu appears Save The Patient Pop Up Menu The Reset button 2 Click Reset The Reset the Patient dialog box appears stating that the patient s physiology will be reset to its state at load time and all running
294. u to adjust the volume 237 Using Lucina CAE Fidelis Lucina This page intentionally blank 238 ZW CAE Healthcare Care and Maintenance CARE AND MAINTENANCE Maintaining the Fidelis requires careful treatment of the electronic and mechanical components Each time the Fidelis is assembled or disassembled make sure all components are properly handled and correctly removed from or placed into storage NOTE Certain hardware components within the Fidelis simulator and Instructor Workstation are not user serviceable Consult CAE Healthcare Customer Service to address any hardware maintenance concerns CAE Healthcare Assurance Programs General Information CAE Healthcare patient simulator products come with a one year Assurance support and maintenance plan All plans begin at the date of shipment or CAE Healthcare installation You may upgrade your first year plan to an enhanced plan and receive remedial and planned maintenance To prevent equipment downtime and delays after the plan expires CAE Healthcare encourages customers to purchase extended Assurance plans for all subsequent years Units Out of Plan For units no longer under an Assurance plan that require repairs the Time and Materials service plan applies For more information see Time and Materials section of this Care and Maintenance section To place an out of plan unit under a support and maintenance plan CAE Healthcare reserves the right to have the patient sim
295. uid in the front of the vaginal opening Draining the Blood Tank To drain the blood tank 1 Empty the trauma fill tank and connect the blue line to the mannequin BLOOD FILL port Do not connect the yellow line 2 Ensure the yellow pressure relief knob on the trauma fill tank is open so that the tank is able to vent during the subsequent process 3 Disconnect the uterus bleed port clear tubing from the mannequin 4 From the Instructor Workstation click on the System Administration icon in the upper right corner of the M se home screen The System Administration Button The System Administration screen appears 253 Care and Maintenance CAE Fidelis ucina 5 Click on the Maintenance tab The Maintenance tab Weeding System Hush The Flush The Maintenance System button panel The Maintenance Panel The Maintenance panel appears 6 Click the Flush System button The fluid from the mannequin s blood tank should start flowing back into the trauma fill tank 7 Observe the blood tank output line When air bubbles have stopped moving the tank is empty 8 Click the Finished button 9 Disconnect the trauma fill tank from the mannequin 10 Empty the trauma fill tank 11 Rinse thoroughly and allow the tank to dry Draining the Bleeding System To drain the bleeding system 1 Disconnect the blood tank from the mannequin 2 Empty the trauma fill tank and overflow bottle 254 ZW CA
296. ular click the heart For Fluids click the Fluids Control icon For Sounds click the Sound Control icon 199 Using Lucina CAE Fidelis Lucina Neurological Features Lucina can simulate a variety of neurological clinical indicators such as seizures and reactive eyes Neurological features are controlled from the Neurological view in M se To access the Neurological view from the Run screen click the brain on the homunculus The Neurological parameters appear Apply To Both Eyes gt 5mm b 5mm b Auto b Auto Eyes Blink Speed P Normal ve Reactive pupils e Brisk Light Reactivity Speed Brisk Seizures ICP Modeled NMB Modeled Temperature Body 36 5 gt Temperature Blood 37 0 y The Neurological View 200 ZW CAE Healthcare Anatomy Physiology and Clinical Signs Neurological Features Description Software Control Manual Control Each eye has reactive pupils and functional eyelids that blink and close The response to clini cal intervention must be controlled by the instructor VIEW Neurological PARAMETER S Eye Controls None required The mannequin can simulate seizures with rhythmic movement of the arms and rapid blinking The response to clini cal intervention must be controlled by the instructor VIEW Neurological PARAMETER S Sei zures None required Intracranial pressure value can be set and displayed on
297. ulator 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 plan The repairs required as the result of the examination will be quoted on a time and material basis Plan Period Assurance plans are not ordinarily offered for periods of less than one year However multiple year plans may be arranged for up to an additional three years Discounts are available for purchase of multiple year plans Limitations of Plan 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 Assurance plan applies to repaired or replaced materials for the balance of the applicable period of the original support and maintenance plan 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 support and maintenance plan whichever is greater 239 Care and Maintenance CAE Fidelis ucina CAE Healthcare shall not be liable under this Assurance plan for incidental or consequential damages or in the event of any unauthoriz
298. uration as outlined in the Mannequin Setup window For detailed information on each step in the Mannequin Setup window see the Configuring the Mannequin section of this user guide IMPORTANT You MUST set up the mannequin as directed in the Mannequin Setup window before proceeding to the next step Failure to do so may result in damage to the mannequin and undesired behavior during simulation 5 Click Continue 96 ZW CAE Healthcare Using M se The Mannequin Setup window closes and the Postpartum icon appears above the indicator no Q s7The Postpartum icon The Run Screen The patient is logged as postpartum in Muse and the postpartum phase begins Selecting CTG Monitor Options CTG monitor options such as which probes are attached loss of signals and noise offset can be selected using the CTG monitor parameters To access the CTG monitor parameters from the Run Screen click the CTG Configuration icon next to the homunculus The CTG Configuration icon The Homunculus 97 Using M se CAF Fidelis Luna The CTG monitor parameters appear FHR Probe b us UA Probe b toco MHR Probe gt Connected MSPO2 Probe gt Connected MNIBP Probe Connected Temp Probe P Connected FHR Signal Loss UA Signal Lost TOCO Offset MHR Graph MHR Overrides FHR MSPO2 Printing gt 10 minutes Frequency MNIBP Printing Frequency gt 30 minutes The CTG Monitor Parameters SCE Ti
299. ure 328 ZW CAE Healthcare Display Physiological Variable pH pH PvCO2 Venous Partial Pressure Carbon Dioxide PvO2 Venous Partial Pressure Oxygen RR Respiratory Rate SpO2 Oxygen Saturation TAxilla Axillary Temperature TBlood Blood Temperature TBody Body Temperature Travel Travel of Fetus Down Descent Mechanism 3 to 20 TRectal Rectal Temperature UA BE Umbilical Arterial Base Excess UA CaO2 Umbilical Arterial Oxygen Content UA PCO2 Umbilical Arterial Partial Pressure Carbon Dioxide UA pH Umbilical Arterial pH UA PO2 Umbilical Arterial Partial Pressure Oxygen UV BE Umbilical Venous Base Excess UV CvO2 Umbilical Venous Oxygen Content UV PCO2 Umbilical Venous Partial Pressure Carbon Dioxide UV pH Umbilical Venous pH UV PO2 Umbilical Venous Partial Pressure Oxygen VT Tidal Volume 329 CAE Fidelis Volume Widget Displays Physiological Variable Lung Volume Lung Volume Other Widget Displays Display Physiological Variable FHR Fetal Heart Rate IUP Intrauterine Pressure TUA Transabdominal Uterine Activity UA CTG Uterine Activity CTG FHR CTG Fetal Heart Rate CTGUA CTG Uterine Activity 1 minute APGAR 1minute 5 minutes APGAR 5 minutes CPR Monitor The following definitions apply to the parameters in the M se CPR Monitor window Display Definition Hand Position Hand position Ches
300. uscular blockage is set to greater than 3096 the eyes will remain closed when seizures are activated For more information on the ICP NMB and Temperature parameters see the M se Parameter Descriptions section of this user guide 203 Using Lucina CAE Fidelis Lucina Respiratory Features Lucina has an anatomically realistic upper airway that supports endotracheal tube placement right mainstem intubation laryngoscopy airway adjuncts positive pressure ventilation mechanical ventilation and a variety of other airway management techniques The simulator also demonstrates exhalation and chest excursion Respiratory features are controlled from the Respiratory view in M se To access the Respiratory view from the Run screen click the lung on the human form The basic Respiratory parameters appear To view additional parameters click the Basic Additional switch The Basic Additional f Basic switch oft Bronchial Occlusion BL Respiratory Rate Modeled Respiratory Rate Factor 1 80 Shunt Fraction 0 08 SPO2 Modeled NMB Modeled Tidal Volume Modeled Intrapleural Vol Left 0 Intrapleural Vol Right 0 Fraction of Inspired O2 21 7 The Respiratory View 204 CAE Healthcare Respiratory Features Anatomy Physiology 2 M I Control and Clinical Signs anual Contro Description Software Control Alveolar and arterial gas concentrations appropriately reflect the efficacy of ventila
301. using an external Wireless Voice Link WVL Speech Sounds The Speech Sounds features in M se can be used to make the mannequin vocalizations such as pain ratings various phrases and utterances such as screaming and panting Custom vocalizations recorded by the user and uploaded to M se from the System Administration menu can also be played from the Speech Sounds menu To play a vocalization click the Speech balloon The Speech Sounds menu appears Customized Vocalization I m having trouble breathing A custom vocalization Factory Vocalization AWWebi pa 0000 A lot pain Comes and goes pain Could you say that again Don t touch me Give me an epidural Good afternoon Factory vocalizations Hello How far along am I How much longer I can t feel my legs I don t feel the baby I feel I m tearing I feel so nauseated I feel very weak I want to push Can I push T ll try I m a bit nervous The Speech Sounds Menu Select the desired vocalization The vocalization plays and the list disappears 229 Using Lucina CAE Fidelis Lucina To replay the last vocalization click the Play button in the Speech balloon rr HURTS E V The Play button JI ES v The Speech Balloon with Play Button Wireless Voice Capability In addition to the pre programmed speech any response can be transmitted through the mannequin
302. value is Modeled by default Default Modeled Range 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 numeric value is assigned to this parameter the degree of NMB is set to that level For example 8096 NMB causes the simulator to set the degree of NMB to 8096 regardless of the presence or absence of neuromuscular blocking drugs Clinically the spontaneous tidal volume is markedly reduced If NMB is set to greater than 3096 the eyes will automatically close when in the Auto mode 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
303. view Background Preparation and Notes buttons under the Content Management heading Content Management Overview Background Preparation Notes The Content Management Buttons Each button accesses a screen that allows users to enter information for the chosen section Overview Background Preparation or Notes Click the Edit button of each section on the SCE Editor to access a rich text editor that enables data entry 118 ZW CAE Healthcare Using M se IMPORTANT Text can be copied and pasted into the fields from TextEdit or Notepad only The Rich Text Editor Click Save when all data for the field has been entered SCE Configuration Setting up the Conditions the TouchPro software and the Patient Status Display is achieved by clicking the buttons under the SCE Configuration heading in the SCE Editor SCE Configuration Condition Setup TouchPro Setup Patient Status Display The SCE Configuration Buttons Condition Setup Screen and Creating Quick Links Click Condition Setup to access the Condition Setup screen From the Condition Setup screen conditions medications and interventions can be preconfigured for the SCE creating Quick Links 119 UsngM se CAERidels luna On the Condition Setup screen Conditions Medications and Interventions buttons are available To navigate through available conditions and interventions click the Conditions Medications and Interventions
304. y GU tank left side of mannequin torso The GU screw The GU Tank 3 Remove the GU tank from the torso and pull tubing completely out of birth canal The GU tank 4 The GU tube inside birth canal The GU Tank and Tube NOTE GU tube outline is for reference only The GU tube is inserted into the top left side of the birth canal and runs down and through the birth canal to the exterior GU opening 259 Care and Maintenance CAE Fidelis Lucina 4 Lift and remove the birth canal top grooves only from the left and right sides NOTE Gently stretch the mannequin skin away from the torso to allow room for birth canal removal The top grooves The ischial spine posts The Birth Canal Top Grooves 5 Locate the ischial spine posts on the bottom left and right sides of mannequin torso squeeze and pull the birth canal one side at a time to remove completely from the posts The ischial spine post The Mannequin Torso 260 CAE Healthcare Care and Maintenance 6 Remove the bladder from the inside bottom of birth canal leaving bladder attached to mannequin torso The bladder The Mannequin Torso 7 Twist and remove the rectal plug from back of lower torso NOTE Lift mannequin to one side for access to plug The rectal plug The Mannequin Torso Back 261 Care and Maintenance CAE Fidelis Lucina 8 Squeeze and remove the rectal extension located on the b
305. y an SCE are palpable by default When a pulse is palpated the event is recorded on the Events Log and the Simulation Session for later review To disable a pulse 1 Click the pulse location on the human form GA amp N i li es amp e An enabled pulse 1 A disabled pulse The Pulses 212 ZW CAE Healthcare Using Lucina The menu for the selected pulse appears Brachial Pulse Deficit Left Pulse Enable K Pulse Intensity A Pulse Menu 2 Click the Pulse Enable switch to turn the pulse Off 3 Click Accept The pulse is disabled The pulse can be enabled again by accessing the pulse menu and clicking the Pulse Enable switch to turn the pulse On A pulse deficit occurs when the systolic arterial blood pressure falls below the default threshold indicated in the table below Palpable Pulse Thresholds Carotid Radial Brachial Dorsalis Pedis Pulse deficit and intensity can be modified from the pulse menu for each pulse 213 Using Lucina CAE Fidelis Lucina 4 Lead ECG A 3 lead or 4 lead ECG is emitted from the appropriate positions for display on a standard monitor A contact is available on the maternal mannequin s chest for each of four cables Lead port Lead port Lead port Lead port The 4 Lead ECG Ports The simulator generates a normal sinus ECG as well as a broad range of abnormalities such as myocar

User Guide Maternal Fetal Simulator

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