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IngMar Medical 212-11955 User Manual

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  • Page 1 USA Toll Free: 1-800-583-9910 | International: +1 (412) 441-8228 | service@ingmarmed.com...
  • Page 2 Document History Revision History Date Authors Rev. 1 4/6/2017 Michael Bails Rev. 2 4/14/2017 Michael Bails Rev. 3 4/24/2017 Michael Bails Rev. 4 7/14/2017 Michael Bails Rev. 5 9/11/2017 Michael Bails Rev. 6 12/13/2017 Michael Bails...
  • Page 3 EGAL NFORMATION Product Warranty Educational tools and test instruments manufactured or distributed by IngMar Medical come with a limited warranty, covering materials and workmanship, for a period of one year from the date of shipment, except for products with stated warranties other than one year. Software, fuses and batteries are excluded from this warranty. System components such as computers are supplied with the factory warranty of the original manufacturer. IngMar Medical reserves the right to perform warranty service(s) at its factory, at an authorized repair center, or at the customer's installation. IngMar Medical's obligations under this warranty are limited to repairs, or at IngMar Medical's option, replacement of any defective parts of the purchased equipment, without charge, if said defects occur during normal service. Claims for damages during shipment must be filed promptly with the transportation company. All correspondence concerning the equipment must specify both the model name and number, and the serial number as it appears on the equipment. Improper use, mishandling, tampering with, or operation of the equipment without following specific operating instructions will void this warranty and release IngMar Medical from any further warranty obligations. The above is the sole warranty provided by IngMar Medical, Ltd. No other warranty, expressed or implied, is intended. Representatives of IngMar Medical are not authorized to modify the terms of this warranty. For factory repair service, call: Toll free: 1-800-583-9910 International: +1 (412) 441-8228 Facsimile: +1 (412) 441-8404 or contact us via e-mail at: service@ingmarmed.com Our shipping address: IngMar Medical, Ltd. 5940 Baum Blvd Pittsburgh, PA 15206 USA Please note that a valid service return order (SRO) no. is always required before sending in any products for repair, calibrations, or updates. 3...
  • Page 4 Limitation of Liability IngMar Medical Ltd.'s liability, whether arising out of or related to manufacture and sale of the goods, their installation, demonstration, sales representation, use, performance, or otherwise, including any liability based upon above defined product warranty, is subject to and limited to the exclusive terms and conditions as set forth, whether based upon breach of warranty or any other cause of action whatsoever, regardless of any fault attributable to IngMar Medical, and regardless of the form of action (including, without limitation, breach of warranty, negligence, strict liability, or otherwise). THE STATED EXPRESSED WARRANTIES ARE IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, WARRANTIES OF MERCHANTABILITY, FITNESS FOR ANY PARTICULAR PURPOSE, OR NONINFRINGEMENT. IngMar Medical, Ltd. shall not be liable for, nor shall buyer be entitled to recover, any special incidental or consequential damages or for any liability incurred by buyer to any third party in any way arising out of or relating to the goods. Trademarks SimMan® is a registered trademark of Laerdal Medical Corporation. Windows® and Visual Studio® are registered trademarks of Microsoft Corporation. Smooth-Bor® is a registered trademark of Smooth-Bor Plastics All other trademarks or registered trademarks are property of their respective owners. Copyright © 2017, IngMar Medical, Ltd. No parts of this document may be reproduced, stored in a retrieval system, translated, transcribed, or transmitted, in any form, or by any means, without identifying its authorship as IngMar Medical, Ltd.
  • Page 5 Software License Agreements Acknowledgement of this license agreement is also part of the host software installation process: LICENSE AGREEMENT BY INSTALLING AND USING THE SOFTWARE, YOU INDICATE ACCEPTANCE OF THE FOLLOWING TERMS AND CONDITIONS. ENTIRE AGREEMENT YOU ACKNOWLEDGE THAT YOU HAVE READ THIS AGREEMENT AND UNDERSTAND THIS AGREEMENT (THE “AGREEMENT“) IS THE FINAL, COMPLETE AND EXCLUSIVE STATEMENT OF THE ENTIRE AGREEMENT BETWEEN INGMAR MEDICAL, LTD (“INGMAR“) AND YOU. THIS AGREEMENT SUPERSEDES ANY PRIOR AND CONTEMPORANEOUS PROPOSALS, PURCHASE ORDERS, ADVERTISEMENTS, AND ALL OTHER COMMUNICATIONS IN RELATION TO THE SUBJECT MATTER OF THIS AGREEMENT, WHETHER ORAL OR WRITTEN. NO TERMS OR CONDITIONS, OTHER THAN THOSE CONTAINED IN THIS AGREEMENT, AND NO OTHER UNDERSTANDING OR AGREEMENT WHICH IN ANY WAY MODIFIES THESE TERMS AND CONDITIONS, SHALL BE BINDING UPON INGMAR UNLESS MADE BY A WRITTEN AGREEMENT, EXECUTED BY DULY AUTHORIZED REPRESENTATIVES OF BOTH INGMAR AND YOU. SOFTWARE AND DOCUMENTATION LICENSE 1. IngMar hereby grants you a non-exclusive, non-transferable license to use the enclosed computer instrumentation software (the “Software“) and any associated printed documentation (the “Documentation“), subject to the limitations set forth in this Agreement (the “License“). All right, title and interest to the Software and the Documentation are, and shall remain, in IngMar and/or its licensor. You have no right of access to the source code of the host system software (the software running on your PC). You are entitled to updates or upgrades of the Software or Documentation only as set forth in your purchase agreement for RespiScope 2. You may not alter, assign, decompile, disassemble, distribute, lease, modify, reverse engineer, sublicense, transfer or translate in any way the Software or Documentation except as provided in the following clauses: i) You may permanently and simultaneously transfer all of the Software, Documentation and the License if: a) you deliver to the transferee the Software and Documentation (including updates and upgrades) supplied by this Agreement; b) notify IngMar in writing of such transfer; and c) destroy any archival/backup copy. A transfer immediately terminates the License. You agree that the transferee must expressly accept all terms and conditions of this Agreement. 3. YOU MAY NOT COPY THE SOFTWARE OR DOCUMENTATION; provided, however, that you may make one (1) copy of the Software for archival/backup purposes. 4. If either the Software or Documentation is used in any way not expressly and specifically permitted by this License, then the License shall immediately terminate. Upon the termination of the License, you shall thereafter make no further use of the Software or Documentation, and you shall return to IngMar all licensed materials, postage prepaid. 5. THE SOFTWARE IS NOT INTENDED TO BE USED FOR ACTUAL ANALYSIS AND DIAGNOSIS OF MEDICAL CONDITIONS OF HUMANS OR ANIMALS. WARRANTIES 1. LIMITED WARRANTY ON MEDIA. For a period of thirty (30) days following the date of delivery to you as the original licensee, if evidenced by your receipt as such, (the “Warranty Period“) IngMar warrants the flash memory device on which the Software is embodied (if Software was delivered to you on a USB flash drive) to be free from defects in materials and workmanship under normal use. The warranty is personal to you, and no warranty is made to your transferees. THE FOREGOING WARRANTIES ARE THE SOLE WARRANTIES ON THE MEDIA AND ARE IN LIEU OF ALL WARRANTIES OF ANY KIND, SUCH AS WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE. 2. NO WARRANTY ON SOFTWARE OR DOCUMENTATION. INGMAR LICENSES THE SOFTWARE AND DOCUMENTATION SOLELY ON AN “AS IS“ BASIS WITHOUT WARRANTIES OF ANY KIND, SUCH AS WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE. THE ENTIRE RISK OF QUALITY AND PERFORMANCE IS WITH YOU. IF EITHER THE SOFTWARE,...
  • Page 6 REMEDY FOR DEFECTIVE MEDIA Your sole and exclusive remedy in the event of a defect in a warranted item is expressly limited to replacement of the defective media. To receive a replacement USB flash drive, you must send the defective flash device, with proof of purchase, to IngMar at the address indicated below, postage pre-paid and postmarked within the Warranty Period. IN NO EVENT SHALL INGMAR BE LIABLE FOR ANY OTHER OBLIGATIONS OR LIABILITIES INCLUDING, WITHOUT LIMITATION, LIABILITY FOR DAMAGES (WHETHER GENERAL OR SPECIAL, DIRECT OR INDIRECT, CONSEQUENTIAL, INCIDENTAL, EXEMPLARY), OR FOR ANY CLAIM FOR THE LOSS OF PROFITS, BUSINESS OR INFORMATION, OR DAMAGE TO GOOD WILL EVEN IF INGMAR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. IN ANY EVENT, INGMAR'S MAXIMUM LIABILITY SHALL BE LIMITED TO THE AMOUNT OF THE PURCHASE PRICE. U.S. GOVERNMENT RESTRICTED RIGHTS LEGEND The Software and Documentation have been developed exclusively at private expense, and are provided with RESTRICTED RIGHTS. Use, duplication or disclosure by the Government is subject to restrictions as set forth in subparagraph (c) of the Rights in Technical Data and Computer Software clause at DFARS 252.227-7013 or subparagraphs (c) (1) and (2) of the Commercial Computer Software-Restricted Rights at 48 CFR 52.227-19, as applicable. IngMar is the Contractor, and is located at 5940 Baum Blvd, Pittsburgh, PA 15206. EXPORT RESTRICTIONS The program or underlying information or technology may not be installed or otherwise exported or re-exported where prohibited by law. MISCELLANEOUS This Agreement shall be considered severable, and if for any reason any term or condition is determined to be invalid, illegal or unenforceable under current or future law, such invalidity shall not impair the operation of, or otherwise effect, the valid terms and conditions of this Agreement, so long as the intent of this Agreement is maintained. This Agreement shall be governed by, construed and enforced in accordance with the laws of the Commonwealth of Pennsylvania, with the exception of its conflict of law provisions. The parties consent to the personal jurisdiction of the Commonwealth of Pennsylvania and agree that any legal proceedings arising out of this Agreement shall be conducted solely in such Commonwealth. No action, regardless of form, arising out of this Agreement may be brought by either party more than one (1) year after a claim has accrued.

  • Page 7: Table Of Contents

    Table of Contents Legal Information .......................... 3 Safety Considerations ...................... 9 ........................ 9 PERATOR AFETY ........................ 1 0 NTENDED An Introduction to the ASL 5000 Lung Solution ..............11 ......................... 1 4 OMPONENTS ASL 5000 Lung Solution Setup ....................15 .................. 1 5 OMPUTER INIMUM EQUIREMENTS .................... 1 5 UNG DAPTER NSTALLATION 3.2.1 General Considerations ........................ 1 5 3.2.2 Lung Adapter Components .
  • Page 8 ...................... 5 0 UNG ODEL ONTROL .................... 5 3 REATH FFORT ONTROL Troubleshooting ........................55 .................. 5 5 UNG OLUTION SOFTWARE INSTALLER FAILS 5000 .................. 5 5 ONNECTING TO IMULATOR 5000 ............ 5 5 ON THE FRONT OF THE REMAINS ILLUMINATED...

  • Page 9: Safety Considerations

    AFETY ONSIDERATIONS T.T Operator Safety For correct and effective use of the product it is mandatory to read and to observe all instructions, WARNINGS, and CAUTION statements in this manual. If the product is not used as instructed, the safety protection provided may be impaired. ARNING Indicates a potentially harmful condition that can lead to personal injury. CAUTION Indicates a condition that may lead to equipment damage or malfunction Indicates points of interest or emphasis for more efficient or convenient operation. 9...

  • Page 10: Intended Use

    T.V Intended Use The ASL 5000 Lung Solution enhances the Laerdal product by merging the best-in-class ASL 5000 Breathing Simulator into the Laerdal LLEAP simulation environment. This integration improves the true-to-life experience with realistic airway response to ventilators, anesthesia machines, CPAP, etc. A hardware component, which can be a permanent installation, allows the user to switch between the standard SimMan® 3G configuration and the enhanced ASL 5000 configuration with a simple turn of a selector module. A software component provides a series of tiles or windows which are added directly to the LLEAP software space. These tiles give the user direct control of the ASL 5000 using LLEAP’s existing Airway & Breathing tile or the new ASL tiles. The ASL 5000 Lung Solution is designed for use with the following SimMan family members: SimMan® 3G, SimMan® Essential, SimMan® Essential Bleeding, and SimMan® 3G Trauma. The software provided for the Lung Solution is design for LLEAP version 6.3 or greater. Please contact IngMar Medical (info@ingmarmed.com) for details on future integration into additional Laerdal manikin simulators. LLEAP software and firmware are directly accessible from the Laerdal website www.laerdal.com. Please verify the software and firmware are up-to-date before using the Lung Solution. ARNING The use of supplemental oxygen is prohibited with the SimMan® 3G product. The ASL 5000 Breathing Simulator allows use of Oxygen-rich gas with the SimMan® 3G disconnected (ASL 5000 as a stand-alone simulator only).

  • Page 11: An Introduction To The Asl 5000 Lung Solution

    5000 NTRODUCTION TO THE UNG OLUTION The ASL 5000 Lung Solution creates a direct integration between the ASL 5000 Breathing Simulator and Laerdal SimMan® 3G manikin simulators. Once installed, the user can experience a high-fidelity respiratory system added to the many features already available with the SimMan® 3G platform. This includes the ability to ventilate the patient with wide ranges of resistance, compliance, and spontaneous breathing parameters. The ASL 5000 can hold PEEP and is able to exert and receive large volumes (up to 2.5L of tidal volume). The Lung Adapter can be left in place as a permanent fixture. Once installed, the system can be easily switched between the ASL 5000 lung mode and the standard SimMan® 3G mode. Figure 2-1 - Lung Adapter The Lung Solution software enhances realism in the LLEAP environment by providing five (5) additional tiles for working with the high-fidelity lung simulator. These tiles are displayed below. ASL Session Control – This tile controls the connection to the ASL 5000, displays connection status, and controls the simulation with Play, Pause, and Stop functionality. Figure 2-2 - ASL Session Control 11...
  • Page 12 ASL Quick Choice Menu – This tile provides predefined patient types and disease states. The tile gives the user easy access to various patient disease states with the ability to adjust the severity. Simply click on a Disease State, click apply and adjust the severity. Patients can also be made passive (sedated) via the Spontaneous Effort switch. Figure 2-3 - ASL Quick Choice Menu ASL Monitor – This tile provides feedback from the lung simulator in terms of pressure, flow, and volume waveforms. The tile also displays relevant breathing parameters like PEEP, PIP, Tidal Volume, etc. In addition to the waveforms, this tile gives a graphical and animated representation of the equation of motion of air in the system (as a teaching tool). Figure 2-4 - ASL Monitor...
  • Page 13 ASL Lung Model Control – This tile controls the airway resistance and lung compliance of the ASL 5000. The user can select a simplified lung model consisting of a single resistance and compliance. Switching to the Advanced mode, the user can create a more complex dual lung model, which can include (but is not limited to) inspiratory and expiratory resistance. Figure 2-5 - ASL Lung Model Control ASL Breath Effort Control – The integration of the ASL 5000 into the SimMan® 3G platform further enhances the simulation by providing spontaneous breathing effort. Like the Lung Model Control tile, this tile has basic settings for Breath Rate and muscle pressure, the driving force for volume in the lungs. Switch to the Advanced option and create a complex muscle pressure. Figure 2-6 - ASL Breath Effort Control 13...

  • Page 14: Components

    The Lung Model and the Breath Effort Control tiles include a feature called Breaths Per Change (BpC). This feature brings more realism to changes in the model by transitioning from one state to the next over the selected number of steps. The user can control the progression of a change based on the selection. In the figure below, a change will transition over 4 breaths. Figure 2-7 Breaths Per Change V.T Components The ASL 5000 Lung Solution has three major components, a Lung Adapter, a software installer, and the IngMar Medical ASL 5000 Breathing Simulator. The Lung Adapter creates a manually controlled bypass in the air circuit directly to the ASL 5000. The Lung Adapter includes a selector-switch to easily toggle between the SimMan® 3G lungs and the ASL 5000. The Lung Adapter is designed to provide a user- friendly installation and does not require removal once it is installed. Because the software is designed as an add-on to the LLEAP environment, the user can access any of the ASL 5000 respiratory tiles via the file menu, “View” dropdown. Figure 2-8 – ASL 5000 Tile Access Each of the IngMar Medical tiles provides direct control of the ASL 5000. This includes changing a predefined disease state or directly controlling lung mechanics. At any time during a simulation, the user can process real-time changes to the patient and observe a direct reaction from an external device (ventilator, CPAP, etc.). To improve the simulation experience, IngMar Medical has created respiratory-centered views for existing LLEAP “Themes” relative to the Adult patient model.

  • Page 15: Asl 5000 Lung Solution Setup

    These include the following LLEAP Themes: • Healthy patient • Adult -> Respiration -> Asthma • Adult -> Respiration -> Morphine Overdose • Adult -> Respiration -> Pneumothorax 3 ASL 5000 UNG OLUTION ETUP b.T Computer Minimum Requirements Windows 7 or 10 (Windows XP, 8 and 8.1 are not recommended) Intel i5 (or comparable) 4GB RAM minimum 500 GB HD b.V Lung Adapter Installation CAUTION Please do not use sharp tools around the Lung Adapter installation that could damage cables or cause leaks in the lines and tubing. It is recommended that a Laerdal technician performs the Lung Adapter Installation. 3.2.1 General Considerations Before installing the Lung Adapter, please make sure to read all instructions to avoid any potential problems. The Lung Adapter consists of three (3) main metal components as well as various tubing connectors / adapters that create the internal bypass to the ASL 5000 Breathing Simulator. These are all pre-connected in the Lung Adapter for easy installation as shown in Figure 3-1. In addition to these internal components, there are also external tubing / fittings for the connection out to the ASL 5000 from the manikin (Figure 3-2). 15...

  • Page 16: Lung Adapter Components

    3.2.2 Lung Adapter Components Figure 3-1 - Lung Adapter Internal Components Pre-connected internal components include the following: 1. Selector 2. Right lung manifold 3. Left lung manifold 4. Smooth-Bor® tubing from right lung manifold with aluminum coupler 5. Smooth-Bor® tubing from left lung manifold with aluminum coupler 6. Bypass right lung pressure tubing (pre-connected from Selector to manifold) 7. Bypass left lung pressure tubing (pre-connected from Selector to manifold) 8. Pressure line to SimMan® 3G right lung 9. Pressure line to SimMan® 3G left lung 10. Large diameter tubing to ASL port 11. Connector for SimMan® 3G right lung pressure sensor line 12. Connector for SimMan® 3G left lung pressure sensor line...

  • Page 17: Preparing The Simman® 3G

    Figure 3-2 - External Connectors / Plugs External tubing and adapters, include the following 1. 60” (152.4 cm) cuffed tubing 2. 22mm x 22mm straight adapter 3. 15mm x 22mm elbow adapter 4. Bag including: plugs for simulations without the ASL 5000, USB drive that includes the User Manual and software installer The remaining components include the ASL 5000 Breathing Simulator and an Ethernet patch cable to connect between the ASL 5000 and the SimMan® 3G. 3.2.3 Preparing the SimMan® 3G To install the Lung Adapter into the SimMan® 3G, the user must first remove a piece of tubing and plastic elbow connected to each internal lung. To do this, open the SimMan® 3G by unzipping over the left shoulder and then along the left side of the body: 17...
  • Page 18 Figure 3-3 - Unzip Left Shoulder Figure 3-4 - Unzip Left Side Open the skin to show the stomach and chest assemblies. Lift the stomach and chest to gain access to the lung assemblies. Pull the stomach line from the white clamps for easier access. Figure 3-5 - Move Chest and Stomach Plates Figure 3-6 - Release stomach line from clamps...
  • Page 19 The port that connects the SimMan® 3G to the ASL 5000 is located on the manikin’s left side. Figure 3-7 - ASL Port - External Figure 3-8 - ASL Port - Internal Locate the SimMan® 3G lung components as shown in Figure 3-9 and 3-10. Airway / Trachea Lines Pressure Lines Figure 3-9 - Right Lung Airway Tubing Figure 3-10 - Left Lung Airway Tubing 19...
  • Page 20 Prepare the Right Lung by pulling the pressure line and the breath air line from the SimMan® 3G lung ports (Figure 3-11 and 3-12). Holding the plastic elbow, pull enough of the airway branch from behind the plastic shield to handle the branch tubing. Disconnect the plastic elbow from the airway branch line (Figure 3-13 and 3-14). These pieces should be placed somewhere for safekeeping. Figure 3-11 - Right Lung Pressure and Airway Tubes Figure 3-12 - Pull Pressure and Airway Tubes Figure 3-13 - Right Lung Plastic Elbow Figure 3-14 - Pull Plastic Elbow from Airway Branch...
  • Page 21 Prepare the Left Lung by pulling the pressure line and the breath air line from the SimMan® 3G lung ports (Figure 3-15 and 3-16). Holding the plastic elbow, pull enough of the airway branch from behind the plastic shield to handle the branch tubing. Disconnect the plastic elbow from the airway branch line (Figure 3-17 and 3-18). These pieces should be placed somewhere for safekeeping. Figure 3-15 - Left Lung Pressure and Airway Tubes Figure 3-16 - Pull Pressure and Airway Tubes Figure 3-17 - Left Lung Plastic Elbow Figure 3-18 - Pull Plastic Elbow from Airway Branch 21...
  • Page 22 CAUTION The plastic elbow, because it is a barbed fitting, is more difficult to remove. Please use caution when removing these items from the branch tubing. Once the lung components are removed, the SimMan® 3G is prepared for the installation of the Lung Adapter as shown in the figure below. Pressure Lines Airway / Trachea Lines Figure 3-19 - SimMan® 3G Prepared for Lung Adapter...

  • Page 23: Installing The Lung Adapter

    3.2.4 Installing the Lung Adapter All connectors and tubing of the Lung Adapter are labeled for convenience as shown in the figures below. Figure 3-20 - Lung Adapter with Labels Figure 3-21 – Selector Top Close-up Figure 3-22 - Selector Bottom Close-up In addition to the labels on the tubing, the following Left and Right lung images show coloring of the pressure and airway lines for easier understanding. 23...

  • Page 24: Right Lung

    3.2.4.1 Right Lung Figure 3-23 - Right Lung Adapter Installation 1. Plug the SimMan® 3G pressure line that was removed from the lung port (Figure 3-12) into the right lung barbed fitting on the bottom of the Selector labeled “R” (see Figure 3-22) 2. Press the right lung manifold (labeled “R”) onto the SimMan® 3G right lung pressure and airway port (SimMan® 3G lungs not shown in the figure) 3. Plug the line labeled “To Right Sensor” into the SimMan® 3G right lung pressure port replacing the line removed in Figure 3-12 4. Plug the aluminum coupler from the smooth bore tubing (labeled “To Right Trachea”) into the right lung airway branch and tuck the branch tubing behind the SimMan® 3G plastic shield 5. Plug the free end of the large diameter tubing (labeled “To SimMan Port”) to the internal ASL port (ASL port is shown in Figure 3-8) The Smooth-Bor® tubing (4) can be twisted to fit within the SimMan® 3G confined space (Figure 3-23 is an example of how to twist the tubing).

  • Page 25: Left Lung

    3.2.4.2 Left Lung Figure 3-24 - Left Lung Adapter Installation 1. Plug the SimMan® 3G pressure line that was removed from the lung port (Figure 3-12) into the right lung barbed fitting on the bottom of the Selector labeled “R” (see Figure 3-22) 2. Press the right lung manifold (labeled “R”) onto the SimMan® 3G right lung pressure and airway port (SimMan® 3G lungs not shown in the figure) 3. Plug the line labeled “To Right Sensor” into the SimMan® 3G right lung pressure port replacing the line removed in Figure 3-12 4. Plug the aluminum coupler from the smooth bore tubing (labeled “To Right Trachea”) into the right lung airway branch and tuck the branch tubing behind the SimMan® 3G plastic shield The Smooth-Bor® tubing (4) can be twisted to fit within the SimMan® 3G confined space (Figure 3-24 and 3-25 provide an example of how to twist the tubing). 25...
  • Page 26 Figure 3-25 - Completed Lung Adapter Figure 3-26 - Completed Installation Set to ASL Mode...
  • Page 27 To assure minimal leaks through the lines from the mouth to the ASL 5000 lung, add a zip-tie to the connection between the large diameter tubing and the internal ASL port. Zip tie Figure 3-27 - Zip-tie to avoid leaks 27...

  • Page 28: Switching Between Simman® 3G (Sim) And Asl 5000 (Asl)

    3.2.5 Switching Between SimMan® 3G (SIM) and ASL 5000 (ASL) 3.2.5.1 Selector Plate Open the SimMan® 3G as per the instructions in Figures 3-3, 3-4, 3-5 and 3-6. Figure 3-28 - Selector Plate 1. With the thumb and a finger, hold the bottom of the selector using the crescent-shape cutouts. 2. Pull up on the knob to separate the top and bottom of the Selector, allowing the top of the Selector to rotate. 3. Turn to the ASL or SIM mode. 4. Push the top and bottom of the Selector together to make a secure connection. CAUTION Do not try to unscrew the knob from the Selector. The top plate will rotate once it is pulled away from the bottom plate.

  • Page 29: Asl 5000 Operation (Switching From Sim To Asl)

    The coloring in the figures below are for easier understanding only 3.2.5.2 ASL 5000 Operation (Switching from SIM to ASL) • Set the selector to ASL. The indicator hole next to the ASL label should be green • Remove the external plug (#4 Figure 3-2) • Insert the elbow from the external tubing into the ASL port (See #3 Figure 3-2 and Figure 3-7) • Insert other end of the external tubing into the ASL 5000 simulator (#2 Figure 3-2) • Close the SimMan® 3G skin around the external tubing Figure 3-29 - ASL Option 3.2.5.3 ASL 5000 Operation (Switching from ASL to SIM) • Set the selector to SIM. The indicator next to the SIM label should be green • Insert the external plug (#4 Figure 3-2 also see Figure 3-44 below) • Close the SimMan® 3G skin Figure 3-30 - SIM Operation 29...

  • Page 30: Lung Solution Software Installation

    b.b Lung Solution Software Installation The software provided with the Lung Solution enhances the respiratory capabilities of the SimMan® 3G by adding a series of tiles directly to the LLEAP software. These tiles give the user the additional feature of a high-fidelity lung simulator. The installer will be provided to the user via a USB drive (#4 Figure 3-2) or through a web-based link. LLEAP 6.3 or greater must be installed prior to installing the Lung Solution software. An error will result if LLEAP is not installed first 3.3.1 Installing the Software Whether received via a USB drive or link, place the ASL 5000 LLEAP Plugin.exe onto the Desktop of the computer running LLEAP. Double-click the installer icon to begin the installation. Figure 3-31 - Installer Icon Check the box to agree to the license terms and conditions, then click “Install” Figure 3-32 - Agree to Terms Checkbox If a popup asks to allow the app from an unknown publisher, click to allow:...
  • Page 31 Figure 3-33 - Allow Unknown App When the installer is complete, a popup will notify the user: Figure 3-34 - Successful Installation 31...

  • Page 32: Completing The Setup

    b.h Completing the Setup Once the software is installed and the manikin has been prepared with the Lung Adapter, the ASL 5000 Breathing Simulator can be connected to run the enhanced respiratory simulations within the LLEAP software environment. 3.4.1 Preparing the Simulation Environment Prior to zipping the side skin, plug the 22mm elbow adapter into the external ASL port. Figure 3-35 - External Airway Port Close the SimMan® 3G by first replacing the stomach line into the clips on the underside of the chest plate. The SimMan® 3G can then be zipped closed.
  • Page 33 Figure 3-37 - Replace stomach and chest plate Figure 3-36 - Move stomach line back into clips Figure 3-38 - Zip skin along manikin's left side Figure 3-39 - Zip skin over manikin's left shoulder 33...
  • Page 34 Figure 3-40 - System Setup Once the SimMan® 3G network is configured, connect an Ethernet cable directly from the ASL 5000 Ethernet port to the SimMan® 3G LAN port on the manikin’s right side. To SimMan To ASL 5000 Figure 3-41 - ASL 5000 Ethernet Port Figure 3-42 – SimMan® 3G LAN Port Power the SimMan® 3G and wait for it to complete its boot process. Once the SimMan® 3G is ready, turn on the ASL 5000 (green switch on rear of ASL). The ASL 5000, when initially powered, illuminates a red push-button LED on the front of the system. This remains illuminated for 30 seconds and will turn off. Once the LED is off, the ASL 5000 is in its ready state. The red push-button must be in the recessed position for proper operation. If the red LED does not turn off after powering the ASL 5000, push the button to assure it is in the correct recessed position.

  • Page 35: Returning To The Standard Simman® 3G Configuration

    Figure 3-43 - ASL 5000 and Red LED 3.4.2 Returning to the Standard SimMan® 3G Configuration The standard SimMan® 3G configuration for simulations not requiring the enhanced respiratory option requires the following steps. • Unzip the side skin of the manikin and remove the 22mm elbow adapter • Switch the Selector to SIM mode • Insert the red external plug that comes with the Lung Adapter and zip the side skin Figure 3-44 - External Plug for SIM Mode 5000 LLEAP SING THE ILES IN h.T The LLEAP Environment with ASL jkkk Tiles With the Lung Adapter installed inside the SimMan® 3G, the LLEAP interface now has the enhanced respiratory features of the ASL 5000 Breathing Simulator. Get started by loading the LLEAP software with the additional ASL tiles. As stated above in the Overview (Section 2.1), each ASL 5000 tile is accessible via the View Menu option. The instructor can place the ASL 5000 tiles into convenient positions within the LLEAP view. IngMar Medical has created respiratory-centered views for some of the themes defined in the LLEAP Select Theme window. The following figures display the LLEAP default themes and the respiratory-centered themes available: 35...
  • Page 36 Figure 4-1 - LLEAP Healthy Patient Theme Figure 4-2 - Respiratory-centered Healthy Patient Theme...
  • Page 37 Figure 4-3 - LLEAP Asthma Patient Theme Figure 4-4 - Respiratory-centered Asthma Patient Theme 37...
  • Page 38 Figure 4-5 - LLEAP Pneumothorax Patient Theme Figure 4-6 - Respiratory-centered Pneumothorax Patient Theme...
  • Page 39 Figure 4-7 - LLEAP Morphine Overdose Patient Theme Figure 4-8 - Respiratory-centered Morphine Overdose Patient Theme 39...

  • Page 40: The

    Please refer to the LLEAP tutorials for information about working with tiles and themes. Details can be found at www.laerdal.com h.V ASL Session Control 4.2.1 Connect / Control buttons Figure 4-9 - ASL Session Control The ASL Session Control tile includes control of the ASL 5000 and simulation session. 1. The (Play) button mimics the function of the same button in the LLEAP Session Control 2. The (Pause) button mimics the function of the same button in the LLEAP Session Control. It also sets the ASL 5000 breath effort to zero (a passive lung) to avoid any ventilator alarms. 3. The (Stop) button ONLY stops the ASL 5000 lung. The LLEAP simulation is unaffected. 4. The (Connect / Disconnect) button connects to an instance of the ASL 5000 (Standalone, ASL with s/n, or ASL with IP address) 5. The Status and Device monitors provide connection feedback to the user 4.2.2 Configure Button Clicking the Configure button opens the ASL Configurator window. This window is used to set the connection type and the volume conversions to be used. Figure 4-10 - Configuration Tool...
  • Page 41 Click to adjust volumes based on the volume/gas correction factors planned for the upcoming simulation. Figure 4-11 - Volume Conversion Options The volume conversions are based on the gas correction factors as defined below: • As Measured – Geometrical volume including compressible gas in the lung (default setting) • ATPD: Ambient temperature (variable) and pressure (variable), dry (no humidity) • BTPS: Body Temperature (37 °C or 310 K) and pressure (generally same as ambient), saturated (47 mmHg or 6.2 kPa) • STPD: Standard temperature (0 °C or 273 K) and pressure (760 mmHg (101.33 kPa) or 100 kPa (750.06 mmHg)), dry (no humidity) • SPD (T=20): Standard pressure (760 mmHg (101.33 kPa) or 100 kPa (750.06 mmHg)), dry (no humidity) at a temperature of 20°C Click to configure the connection type, Stand-alone or Ethernet. When the software is first installed, the system will be configured with the connection setting set as Stand Alone. This option provides a software-only based simulation with the ASL 5000 tiles. This is for demonstration and testing purposes for the instructor. Figure 4-12 - ASL Configurator in Stand Alone Mode 41...
  • Page 42 When connecting to the physical ASL 5000, click the Ethernet egg, then click to open the Ethernet configuration. Ethernet mode has three (3) options for setup: • Using the ASL 5000 4-digit serial number by moving the switch to Use ID (recommended) • Using a defined IP address by moving the switch to Use IP (IP address set by network) • Using a static IP address by clicking (manually assigning IP address for ASL 5000) Figure 4-13 - ASL Configurator in Ethernet Mode Figure 4-14 - ASL Configurator Ethernet Options The Static IP Config option directly assigns an IP address to the ASL 5000. If this option is used, the software will search for the first connected ASL 5000 and set the IP address to the address defined by the user. Figure 4-15 - Static IP Configuration CAUTION The Static IP option configures the ASL 5000 with an IP address. Only trained technicians should use this option. Assigning an address that is not compatible with the network would make the ASL 5000 unreachable.

  • Page 43: Asl 5000 Firmware Updates

    4.2.3 ASL 5000 Firmware Updates The ASL 5000 Breathing Simulator runs on a version of firmware that is verified each time a connection is made to the LLEAP software. In most cases, the ASL 5000 has the correct firmware and the connection to the lung is established. The user may, however, be prompted to update to a newer version of firmware. When clicking the (Connect/Disconnect) button, the following prompt will open. Figure 4-16 - Firmware Update Prompt Click to allow the upload to take place. This brings up details about the firmware update. Figure 4-17 - Firmware Update Details Click and the upload process will begin. Once complete, the user will be prompted to restart the ASL simulator as well as close and restart the LLEAP software. Figure 4-18 - Firmware Update Complete CAUTION Do not turn off the ASL 5000 Breathing Simulator during a firmware update. 43...

  • Page 44: Asl Quickchoice Menu

    h.b ASL QuickChoice Menu The ASL QuickChoice Menu tile provides an array of preconfigured patient types and disease states. The Quick Choice Menu is a great starting point for working with the SimMan® 3G and the ASL 5000 through the LLEAP software interface. Figure 4-19 - ASL QuickChoice Menu 1. Select a Patient Type and disease state by clicking the appropriate “eggs”, then clicking...
  • Page 45 Figure 4-20 - Quick Choice Normal Patient Figure 4-21 - Quick Choice Asthma Patient 2. The Selected Patient will be highlighted in green 3. When selecting a disease other than Normal, the user can adjust the severity of the disease 4. At any time during the simulation, the patient can be set to become completely passive by switching the Spontaneous Effort switch from Active to Inactive The table below provides the lung settings for all the patient models in the Quick Choice library: Table 1 - Patient Model Definitions Adult Normal Compliance Resistance Patient Effort Rise % Release % Rate Healthy 25% 10% Adult Asthma Compliance Insp/Exp Patient Effort Rise % Release % Resistance Rate Mild 30/50 20% 15% Moderate 40/90 35% 20% Severe 50/120 20%...
  • Page 46 Adult ARDS Compliance Resistance Patient Effort Rise % Release % Rate Mild 35% 10% Moderate 20% Severe Adult COPD Compliance Insp/Exp Patient Effort Rise % Release % Resistance Rate Mild 15-Dec 4.5 20% 15% Moderate 21/23 35% 30% Severe 21/23 35% 42% Adult ILD Compliance Insp/Exp Patient Effort Rise % Release %...
  • Page 47 Figure 4-23 - Custom Disease States Delete any unwanted custom disease states by clicking the file name and pressing the delete key. This will open prompt confirming the deletion. Figure 4-24 - Deleting Custom Disease State 47...

  • Page 48: Asl Monitor

    h.h ASL Monitor The ASL Monitor tile includes two views for the instructor, the Monitor view and the Equation of Motion view. The Monitor view is a very useful tool for analyzing the waveforms and readings directly from the lung. These include pressure (cmH2O), flow (L/min) and volume (mL) waveforms. Important lung parameters are also monitored on a breath-by-breath basis. Figure 4-25 - ASL Monitor View 1. Pressure waveforms include airway (external), muscle (spontaneous breathing), and internal lung pressures. 2. Flow is the total flow in the system. 3. Volume waveforms include total, right, and left lung volumes. 4. At any time during the simulation, click to freeze the waveform view for debriefing purposes. 5. Seven (7) breath parameters provide lung details essential to an informed simulation. The Tidal Volume calculation is based on the maximum volume over baseline (e.g. volume due to the presence of PEEP). 6. Switch between the Waveform Monitor view and the Equation of Motion educational view.
  • Page 49 The Equation of Motion (EOM) view provides a different way to look at the patient breathing. This is a real-time analysis of the mechanics of breathing represented by the components of the EOM. Figure 4-26 - Equation of Motion View Figure 4-27 - Single Breath Equation of Motion 1. Definition of the Equation of Motion where Pmus is spontaneous muscle pressure, Pvent is external pressure sensed by the ASL 5000. C is lung compliance in mL/cmH2O and R is airway resistance. 2. The left side of the equation is shown in the top graph. 3. The right side of the equation is shown in the bottom graph. 4. Animations of spring-mass theory and flow direction for a useful analogy 5. At any time during the simulation, click to freeze the waveform view for debriefing purposes. 6. Switch between the real-time view and a snapshot of the last recorded breath. 7. Follow the changes in a single breath for better understanding of how pressures, flows and volumes relate to the patient conditions (Resistance and Compliance). 49...

  • Page 50: Control

    h.j ASL Lung Model Control The ASL Lung Model Control tile provides direct control of the patient’s lung characteristics, ranging from single or dual lung models to inspiratory versus expiratory resistance. Figure 4-28 - Simple View Lung Model Control 1. Resistance knob: the user can also double click the number inside and directly type a value. Resistance range is from 6 – 150 cmH2O/L/s 2. Compliance knob: the user can also double click the number inside and directly type a value. Compliance range is from 0.5 – 250 mL/cmH2O 3. BpC slider is used to adjust the number of breaths used to transition from an existing value to the new set value (e.g. Set compliance from 50 to 10 with 5 BpC, it will gradually reduce its value). 4. Switch from the Simple view to the Advanced view to access the more complex capabilities of the lung simulator which includes:...
  • Page 51 5. Lung Model main characteristics 6. Advanced Resistance Settings 7. Advanced Compliance Settings Figure 4-29 - Advanced View Lung Model Control 8. Clicking the expansion in the top right of each Advanced field will open the respective control for editing. 51...
  • Page 52 Figure 4-30 - Advanced Lung Model Control 1. Switch between a One or Two compartment model 2. Set inspiratory airway resistance to Equal or Unequal Figure 4-31 - Advanced Resistance Control Figure 4-32 - Advanced Compliance Control 1. Define inspiratory versus expiratory tracheal resistance 2. Define inspiratory versus expiratory right branch resistance 3. Define inspiratory versus expiratory left branch resistance 4. Define right lung compliance 5. Define left lung compliance...

  • Page 53: Ontrol 5

    h.l ASL Breath Effort Control The Breath Effort Control tile controls the ASL 5000’s spontaneous breathing capabilities. Figure 4-33 - Simple Effort Control 1. Patients muscle effort (negative pressure inside the lungs creating flow into the mouth). Effort range is from 0 - 100 cmH O. A value of 0 represents a passive/paralyzed patient. 2. Patient breath rates range from 3 to 100 breaths per minute. 53...
  • Page 54 Figure 4-34 - Advanced Breath Effort Control 1. Breath Rate (breaths per minute) 2. Pause % (percent of total breath time between insp. vs exp. muscle pressure) 3. Insp. and Exp. Muscle Pressure 4. Insp. and Exp. Rise Time (percent of total breath time for rise to peak muscle pressure) 5. Insp. and Exp. Hold Time (percent of total breath time for holding peak muscle pressure) 6. Insp. and Exp. Release Time (percent of total breath time for release of muscle pressure) 7. Graphical representation of spontaneous pressure profile over the defined breath rate...
  • Page 55 ROUBLESHOOTING The following conditions are problems that can be easily identified and remedied by the user. For any help/support related to the ASL 5000 please send an e-mail to: support@ingmarmed.com. j.T Lung Solution software installer fails Problem When installing the Lung Solution software, the installer fails. Resolution Make sure LLEAP is installed prior to running the Lung Solution installer. Once this is verified, try to run the installer again. j.V Connecting to ASL jkkk Simulator Problem ASL 5000 is configured to a serial number or IP address and the Status remains as “Unconnected” Resolution Check all connections. Make sure the SimMan® 3G is properly configured in AP or Client mode. Check to see that the computer running LLEAP is receiving an IP address from SimMan® 3G or the external router network. This can be done by opening the command prompt and typing “ipconfig.” Contact your Laerdal representative if the problem persists. j.b Red LED on the front of the ASL jkkk remains illuminated Problem The red LED on the front of the ASL 5000 remains on after starting the simulator Resolution The red LED is a push button switch. If the LED does not turn off after 30 seconds, make sure the LED is slightly depressed. If the LED is flush with the black housing, the motor inside the unit is disabled. Once the switch is slightly depressed, cycle the power to the ASL 5000. If problems persist, please contact your Laerdal representative. 55...
  • Page 56 © 2017, IngMar Medical, Ltd. ISO 9001: 2015 registered ISO 17025: 2005 accredited www.ingmarmed.com...

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