Laerdal SimMan - Manual (Page 7)

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- Surgical cricothyroidotomy
- Retrograde intubation
- Fiberoptic procedures
- Light Wand intubation
- Bronchoscopy
e) The manikin has two lungs. Intubation that is too deep will result
in unilateral lung filling. This usually occurs on the right side,
due to the accurate anatomical modeling of the tracheobronchial
junction and bronchial tree.
f) When airway adjuncts are used, ventilation may be made more
difficult by activating decreased lung compliance for either the
right lung or left lung. Activating decreased lung compliance for
both lungs causes airway adjuncts to fail to ventilate.
Important: Mouth-to-mouth/nose/mask ventilation should not be
performed on SimMan. The upper airways must be thoroughly cleaned
and the lungs changed if these techniques are performed on the manikin.
Important: Prior to using airway adjuncts, spray the inside of the pharynx,
nostrils and all airway management devices to be inserted with a liberal
amount of the provided airway lubricant.
Airway Adjuncts – Sizing and Precautions :
ET Tubes - While ET tubes as large as 8.5 may be used, we recomm-
end the use of ET tube size 7.5 to extend the life of the simulator.
We also recommend the use of a malleable stylette. Care should be
taken that the stylette does not extend beyond the end of the tube,
as with any direct intubation.
Laryngeal Mask Airway (LMA) - The Laerdal SimMan will allow use of
the LMA Classic, LMA Unique and LMA Fastrach. Although a #5 LMA
may seal correctly, the airway has been designed for use with a #4
LMA.
CombiTube - The Laerdal SimMan will allow the use of the
CombiTube, as it will successfully ventilate the “patient”. We
recommend the use of the CombiTube trainer, as it will generally
withstand multiple uses. The CombiTube trainer is sized the same as a
large adult CombiTube. Although a small adult size CombiTube may
work with varying success, the CombiTube trainer provides more
cost-effective training and reliability of function.
The instructor can cause any of the ventilation procedure to fail to
ventilate by setting both right and left lung “resistance” to “complete”.
g) Using the computer user interface or the PDA, the following
airway functions may be activated and deactivated:
- Laryngospasm
- Posterior Pharyngeal swelling
- Tongue edema
- Trismus
- Decreased Cervical Range of Motion - DCROM
- Can’t Intubate, Can Ventilate
- Can’t Intubate, Can’t Ventilate
- Verbal response
h) The manikin simulates spontaneous respiration with
the following features:
- Chest rise and fall
- Variable breathing rate
- Apnea
- Variable pulse oximetry display
- Exhalation of air
- Exhalation of CO
2
(instructor-controlled)
- The variable respiratory rate is synchronized to the Simulated
Patient Monitor display and lung sounds
- The tidal volumes dynamically alter in line with the selected
respiratory rate
Calibrating the Patient Monitor
Because the Simulated Patient Monitor uses touch-screen
technology, it must be calibrated before use. To calibrate the
monitor:
a) Double click the “elo” logo in the system tray in the lower right
corner of the screen.
b) Click on the “Align” button in the dialog box.
c) If target indicators appear first on the instructor computer screen
and not on the patient monitor, press “Esc” or wait until they
appear on the patient monitor.
d) Touch each target as it appears on the Patient Monitor.
e) Touch the green check mark after all targets have been touched.
USB Camera
The USB Camera provides enhanced debriefing possibilities. Video
input is synchronized with the SimMan scenario log. To set-up the
camera, see Install Guide and Directions for Use included in your
camera packaging.
Important: Connect the camera via a USB port directly on the laptop.
Do not use the hub as this may cause interference.
In use
Head
a) The head allows for performance of head tilt and jaw thrust
maneuvers; however, the airway is open in all positions.
b) A speaker located in the head allows the instructor to speak
through the SimMan (to simulate a patient) or use pre-defined
vocal sounds.
c) Upper dentures are replaceable. Soft/non-breakable dentures are
pre-installed but can be replaced by a rigid/breakable version for
more realism.
d) To change the pupils: Open the eyelids wide, take care not to rip
the face skin. Using the suction cup provided or the edge of your
finger nail, remove the pupil from the eye socket. Replace with
the pupil of your choice, using the suction cup or press into place
with your finger.
Neck
a) Bilateral carotid pulses.
b) Airway access through simulated crico-thyroid membrane.
c) Decreased Cervical Range of Motion - DCROM
(instructor-controlled).
Airway, Lungs and Airway Management
a) The airway is instructor-controlled to allow simulation of various
airway complications, including the failure of therapeutic airway
devices.
b) Ventilation can be performed using any of the following:
- Bag-Valve-Mask devices
- Jet ventilation
- Ventilator
c) The system does not accept PEEP modes of ventilation.
d) SimMan accepts a wide range of airway management devices and
techniques. Correct form and technique are required to perform
direct laryngoscopy and endotracheal intubation. Correct use of
a variety of airway adjuncts will successfully ventilate the patient
simulator. Some examples are (see notes below for information
on sizing and precautions):
- Oral/nasal pharyngeal airways
- Endotracheal tubes - nasal and oral
- Laryngeal Mask Airways
- CombiTube
- Needle cricothyroidotomy