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IngMar Medical Laerdal ASL 5000 Lung Solution User Manual

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Summary of Contents for IngMar Medical Laerdal ASL 5000 Lung Solution

  • Page 1 USA Toll Free: 1-800-583-9910 | International: +1 (412) 441-8228 | support@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 Rev. 7 9/24/2018 Michael Bails, Brian Linn Rev.

  • Page 3: Legal Information

    IngMar Medical, LLC from any further warranty obligations. The above is the sole warranty provided by IngMar Medical, LLC. No other warranty, expressed or implied, is intended. Representatives of IngMar Medical, LLC are not authorized to modify the terms of this warranty.
  • Page 4 PARTICULAR PURPOSE, OR NONINFRINGEMENT. IngMar Medical, LLC 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.
  • Page 5 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 Medical, LLC 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.
  • Page 6 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 Medical, LLC is the Contractor, and is located at 5940 Baum Blvd, Pittsburgh, PA 15206.

  • Page 7: Table Of Contents

    Table of Contents Legal Information ..........................3 Safety Considerations ......................9 ........................9 PERATOR AFETY ........................10 NTENDED An Introduction to the ASL 5000™ Lung Solution ..............11 ® .................... 11 DAPTER FOR THE ™ ................... 12 DAPTER FOR THE ™...
  • Page 8 4.3.2 Connecting SimBaby™ / SimMan® ALS / Nursing Anne™ where the ASL 5000™ requires a unique IP address 42 4.3.3 Connection using SimBaby™ / SimMan® ALS / Nursing Anne™ as Virtual Simulator (Local Computer) with a Physical ASL 5000™ Breathing Simulator ....................46 Using the ASL 5000™...

  • Page 9: Safety Considerations

    AFETY ONSIDERATIONS 1.1 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.

  • Page 10: Intended Use

    The software provided for the Lung Solution is designed for LLEAP version 6.3 or greater for the SimMan® manikins and 6.7 or greater for SimMan® ALS, SimBaby™ and Nursing Anne™ manikins. Please contact IngMar Medical, LLC (sales@ingmarmed.com) for details on future integration into additional Laerdal manikin simulators.

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

    ASL 5000™ L NTRODUCTION TO THE OLUTION The ASL 5000™ Lung Solution creates a direct integration between the ASL 5000™ Breathing Simulator and Laerdal SimMan®, SimBaby™ and Nursing Anne™ manikin simulators. Once installed, the user can experience a high-fidelity respiratory system added to the many features already available with these manikin simulators.

  • Page 12: Lung Adapter For The Simbaby

    2.2 Lung Adapter for the SimBaby™ As of LLEAP software version 6.7, the SimBaby™ includes internal components to detect if an ASL 5000™ Breathing Simulator is being used. The Lung Adapter for this manikin requires no internal reconfiguration as compared to the SimMan® manikin family. A 15mm side port next to the RJ45 Ethernet connector provides the link between the SimBaby™...

  • Page 13: Lung Solution Windows

    2.4 Lung Solution Windows The Lung Solution software enhances realism in the LLEAP environment by providing six (6) additional windows that work with the high-fidelity lung simulator. These windows are explained below. ASL Session Control – This window controls the connection to the ASL 5000™ and the volume/gas conditions (e.g.
  • Page 14 ASL Lung Model Control – This window 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 view, the user can create a more complex dual lung model, which can include (but is not limited to) variations in inspiratory versus expiratory resistance.
  • Page 15 The Lung Model and the Breath Effort Control windows 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 breaths. The user can control the progression of a change based on the selection.

  • Page 16: Components

    2.5 Components The ASL 5000™ Lung Solution has three major components: Lung Adapter hardware (as applicable to the manikin), software installer, and ASL 5000™ Breathing Simulator. The Lung Adapter creates a bypass from the internal manikin lungs to the ASL 5000™. For the SimMan® family of compatible manikins, the Lung Adapter includes a selector-switch to easily toggle between the SimMan®...
  • Page 17 Figure 2-12 - ASL Default Layout To improve the simulation experience, IngMar Medical has also created a custom view for the Respiratory themes provided by LLEAP, called “IngMarUnhealthy”. These include: • Adult -> Respiration -> Asthma • Adult -> Respiration -> Morphine Overdose •...

  • Page 18: Asl 5000™ Lung Solution Operation For Simman® Family

    3 ASL 5000™ L ® F OLUTION PERATION FOR AMILY 3.1 Switching Between SimMan® (SIM) and ASL 5000™ (ASL) 3.1.1 Selector Plate Open the SimMan® and locate the selector plate. Figure 3-1 - Selector Plate 1. With the thumb and a finger, hold the bottom of the selector using the crescent-shape cutouts.

  • Page 19: Asl 5000™ Operation (Switching From Sim To Asl)

    3.1.2 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 orange / red plug • Insert the 90° elbow, from the external tubing, into the ASL port •...

  • Page 20: Preparing The Simman® For Use

    3.2 Preparing the SimMan® for use 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. 3.2.1 Preparing the Simulation Environment Prior to zipping the side skin of the manikin, plug the 22mm 90°...

  • Page 21: Preparing The Network Configuration

    3.2.2 Preparing the Network Configuration It is assumed that for SimMan, LLEAP version 6.3 or later is installed, or for SimMan ALS, LLEAP version 6.7 or later is installed. It is also assumed that the latest ASL 5000™ LLEAP plugin is installed prior to configuring the connection Once the SimMan®...

  • Page 22: Connection Using Simman® In "Ap" Mode (Not Simman®Als)

    3.2.2.1 Connection Using SimMan® in “AP” Mode (not SimMan®ALS) 1. Connect an Ethernet cable from the LAN port of the SimMan® to the Ethernet port of ASL 5000™ To SimMan To ASL 5000™ Figure 3-6 - Ethernet Cabling 2. Turn the SimMan® power ON and wait until the system has completed its booting process 3.
  • Page 23 7. Configure the ASL 5000™ connection settings in ASL Session Control window Click Configure Click Connection Settings Click Okay Click Ethernet Figure 3-9 - Configuring Ethernet Connection 8. Click on Device ID: 9. Type the ASL serial number into the Device ID: field 10.
  • Page 24 12. Complete the connection Press Connect to establish connection Unconnected Connecting Connected Figure 3-11 - Connecting to ASL by Serial Number 13. The ASL 5000™, when connected, makes an audible “wiggle” as part of its initialization 14. On the “ASL Session Control” or LLEAP “Session Control” windows, click the button to start a simulation...

  • Page 25: Connection Using Simman® In "Client" Mode (Not Simman®Als)

    3.2.2.2 Connection Using SimMan® in “Client” Mode (not SimMan®ALS) 1. Connect an Ethernet cable from ASL 5000™ to a numbered port on an external router 2. Connect an Ethernet cable from ASL 5000™ to a network (via wall jack, for example) To ASL 5000™...
  • Page 26 ASL Session Control Figure 3-14 - IngMarDefault Layout 8. Configure the ASL 5000™ connection Settings in the ASL Session Control window Click Configure Click Connection Settings Click Okay Click Ethernet Figure 3-15 - Configuring Ethernet Connection...
  • Page 27 9. Click Device ID: 10. Type the ASL serial number into the Device ID: field 11. Ignore the IP: field and the Static IP button 12. Click Done Type ASL serial number (found on rear of ASL) Do Not Use Click Done Figure 3-16 - Selecting ASL by Serial Number 13.

  • Page 28: Connection Using Simman® In "Client" Mode, When The Asl 5000™ Requires A Unique Ip Address (Not Simman®Als)

    3.2.2.3 Connection Using SimMan® in “Client” Mode, when the ASL 5000™ requires a unique IP address (not SimMan®ALS) In some configurations, the customer may require all devices on their network be given specific IP addresses. Once the IP address is known, follow the steps below for a successful connection. 1.
  • Page 29 ASL Session Control Figure 3-20 - IngMarDefault Layout 8. Configure the ASL 5000™ connection settings in the ASL Session Control window Click Configure Click Connection Settings Click Okay Click Ethernet Figure 3-21 - Configuring Ethernet Connection...
  • Page 30 9. Click Network Address: 10. Type the IP address provided by the customer into the Network Address: field 11. Ignore the Device ID: field and the Static IP button 12. Click Done Type IP address provided by customer Do Not Use Click Done Figure 3-22 –...

  • Page 31: Connection Using Simman® As Virtual Simulator (Local Computer) With A Physical Asl 5000™ Breathing Simulator (Not Simman®Als)

    3.2.2.4 Connection Using SimMan® as Virtual Simulator (Local Computer) with a Physical ASL 5000™ Breathing Simulator (not SimMan®ALS) LLEAP can control the ASL 5000™ while running as a Virtual Simulator. The same requirements hold for the ASL 5000™ where it must have an IP address provided by any of the methods defined above. The computer running the LLEAP software MUST be connected to the same network as the ASL 5000™...
  • Page 32 8. Select one of the compatible manikin simulators Figure 3-25 - LLEAP Available Manikins 9. From the View menu, open the IngMarDefault layout to view the six (6) ASL windows 10. Locate the ASL Session Control tab which will share the window with LLEAP’s Session Control ASL Session Control Figure 3-26 - IngMarDefault Layout...
  • Page 33 11. Configure the ASL 5000™ connection Settings in the ASL Session Control window in any of the configurations from the options above. 12. Make sure the “Manikin Attached” toggle is in the OFF position (not green) as shown in the image below Figure 3-27 –...

  • Page 34: Returning To The Standard Simman® Configuration

    3.2.3 Returning to the Standard SimMan® Configuration The standard SimMan® 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 •...

  • Page 35: Asl 5000™ Lung Solution Operation For Simbaby™, Simman® Als And Nursing Anne

    4 ASL 5000™ L ™, OLUTION PERATION FOR ® ALS ™ URSING The SimBaby™, SimMan® ALS and Nursing Anne™ have the same general functionality when connecting to the ASL 5000™ Breathing Simulator. Preparation for the SimMan® ALS was explained in Section 3 of this manual.

  • Page 36: Simbaby™ Without Asl 5000™ Operation

    4.1.2 SimBaby™ without ASL 5000™ Operation • Remove the 15mm elbow connector from the side port of the SimBaby™ Figure 4-4 - Remove 15mm Adapter • Insert rubber plug into side port of SimBaby™ Figure 4-5 - Insert Rubber Plug 4.2 Preparing Nursing Anne™...

  • Page 37: Network Configuration For Sim Baby ™ / Sim Man ® Als / N Ursing Anne

    SimBaby™ / SimMan® ALS / Nursing Anne™ do not have an internal router that can be placed in AP or Client mode. The manikins can operate wirelessly or can be connected directly to a network via an Ethernet cable. If using an external router, IngMar Medical, LLC recommends the following minimum specifications: • Support 802.11n minimum, 802.11ac preferred •...

  • Page 38: Connecting Simbaby™ / Simman® Als / Nursing Anne™ Using The Asl 5000™ Serial Number

    4.3.1 Connecting SimBaby™ / SimMan® ALS / Nursing Anne™ Using the ASL 5000™ Serial Number 1. Connect wirelessly or use an Ethernet cable from the Ethernet port on the right side of the SimBaby™ / SimMan® ALS / Nursing Anne™ to one of the following options a.
  • Page 39 ASL power switch Wait for red light to turn (rear of system) OFF for system ready Figure 4-8 - ASL Power and Ready State 5. From the View menu, open the IngMarDefault layout to view the six (6) ASL windows 6.
  • Page 40 7. Configure the ASL 5000™ connection Settings in the ASL Session Control window Click Configure Click Connection Settings Click Okay Click Ethernet Figure 4-10 - Configuring Ethernet Connection 8. Click Device ID: 9. Type the ASL 5000™ serial number into the Device ID: field 10.
  • Page 41 12. Complete the connection Press Connect to establish connection Unconnected Connecting Connected Figure 4-12 - Connecting to ASL by Serial Number 13. The ASL 5000™, when connected, makes an audible “wiggle” as part of its initialization 14. On the “ASL Session Control” or LLEAP “Session Control” windows, click the button to start a simulation...

  • Page 42: Connecting Simbaby™ / Simman® Als / Nursing Anne™ Where The Asl 5000™ Requires A Unique Ip Address

    4.3.2 Connecting SimBaby™ / SimMan® ALS / Nursing Anne™ where the ASL 5000™ requires a unique IP address 1. Connect wirelessly or use an Ethernet cable from the Ethernet port on the right side of the SimBaby™ / SimMan® ALS / Nursing Anne™ to one of the following options a.
  • Page 43 ASL power switch Wait for red light to turn (rear of system) OFF for system ready Figure 4-14 - ASL Power and Ready State 5. From the View menu, open the IngMarDefault layout to view the six (6) ASL windows 6.
  • Page 44 7. Configure the ASL 5000™ connection Settings in the ASL Session Control window Click Configure Click Connection Settings Click Okay Click Ethernet Figure 4-16 - Configuring Ethernet Connection 8. Click Network Address 9. Type the IP address provided by the customer into the Network Address: field 10.
  • Page 45 12. Complete the connection Press Connect to establish connection Unconnected Connecting Connected Figure 4-18 - Connecting to ASL by IP Address 13. The ASL 5000™, when connected, makes an audible “wiggle” as part of its initialization 14. On the “ASL Session Control” or LLEAP “Session Control” windows, click the button to start a simulation...

  • Page 46: Connection Using Simbaby™ / Simman® Als / Nursing Anne™ As Virtual Simulator (Local Computer) With A Physical Asl 5000™ Breathing Simulator

    4.3.3 Connection using SimBaby™ / SimMan® ALS / Nursing Anne™ as Virtual Simulator (Local Computer) with a Physical ASL 5000™ Breathing Simulator LLEAP can control the ASL 5000™ while running as a Virtual Simulator. The ASL 5000™ must have an IP address provided by any of the methods defined above.
  • Page 47 6. Select the SimBaby™, SimMan® ALS or Nursing Anne™ option as it is the only compatible manikin Figure 4-20 - Select Option 7. From the View menu, open the IngMarDefault layout to view the six (6) ASL windows 8. Locate the ASL Session Control tab which will share the window with LLEAP’s Session Control ASL Session Control Figure 4-21 - IngMarDefault Layout...
  • Page 48 9. Configure the ASL 5000™ connection Settings in the ASL Session Control window in any of the configurations from the options above 10. Make sure the “Manikin Attached” toggle is in the OFF position (not green) as shown in the image below Figure 4-22 –...

  • Page 49: Using The Asl 5000™ Windows In Lleap

    View Menu option. The instructor can place the ASL 5000™ windows 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...
  • Page 50 Figure 5-2 - Respiratory-centered Healthy Patient Theme Figure 5-3 – LLEAP Asthma Patient Theme...

  • Page 51: Asl Session Control

    Figure 5-4 – Asthma Theme with IngMarUnhealthy Layout Please refer to the LLEAP tutorials for information about working with windows and themes. Details can be found at www.laerdal.com 5.2 ASL Session Control 5.2.1 Connect / Control buttons Figure 5-5 - ASL Session Control The ASL Session Control window includes control of the ASL 5000™...

  • Page 52: Configure Button

    3. The (Stop) button ONLY stops the ASL 5000™ lung. The other components of 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.
  • Page 53 5-7 - Total Volume Toggle OFF - Showing Tidal Volume When the toggle is ON, the waveforms change to be representative of the various compartments of the lung. This includes Total Volume (including volumes related to air-trapping) as well as left and right lung volumes (if a 2-lung model is being used).
  • Page 54 Tidal volume is represented by the change in volume that is not affected by PEEP or air-trapping within the lung. Thus, Tidal Volume always returns to zero on the y-axis. Total volume is a more detailed representation of what is actually happening in the lung. Total volume includes the offset due to PEEP or air-trapping.
  • Page 55 Figure 5-10 - ASL Configurator in Stand Alone Mode When connecting to the physical ASL 5000™, click the Ethernet egg, then click Okay to open the Ethernet configuration. Ethernet mode has three (3) options for setup: • Using the ASL 5000™ 4-digit serial number by clicking Device ID: (recommended) •...

  • Page 56: Asl 5000™ Firmware Updates

    5.2.3 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.

  • Page 57: Asl Quickchoice Menu

    5.3 ASL QuickChoice Menu The ASL QuickChoice Menu window provides an array of preconfigured patient types and lung disease states. The Quick Choice Menu is a great starting point for working with the SimMan® family, SimBaby™ and Nursing Anne™ with the ASL 5000™ through the LLEAP software interface. The SimBaby™...
  • Page 58 Figure 5-18 - ASL QuickChoice Menu 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 clicking the Apnea switch...
  • Page 59 The table below displays the lung settings for all the patient models in the Quick Choice library: Table 1 - Patient Model Definitions Adult Normal Compliance Resistance Patient Rate Effort Rise % Release % Healthy Adult Asthma Compliance Insp/Exp Patient Rate Effort Rise % Release %...
  • Page 60 Baby BPD Compliance Resistance Patient Rate Effort Rise % Release % Mild 60/120 Moderate 80/150 Severe 120/180 In any given simulation, the instructor may believe that the lung diseases provided by the software do not fully represent the teaching goals. For example, an asthmatic patient model should have a much higher inspiratory resistance than what the QuickChoice model provides (see Severe Adult Asthma in the table above).
  • Page 61 Figure 5-20 - Custom Disease States Delete any unwanted custom disease states by clicking the file name and pressing the delete key on a keyboard. This will open prompt confirming the deletion. Figure 5-21 - Deleting Custom Disease State The QuickChoice window gives the user the ability to import and export custom lung models.
  • Page 62 Exporting a model: After a model is created and saved as a custom model, click the button from the Custom Model window. This opens the Export Custom Lung Models window. Figure 5-22 - Export Custom Models Click the model to export from the Available Models. Clicking the right-facing arrow will shift the selected models to the Models to Export field.
  • Page 63 Importing a Model: The process for importing a lung model is similar to exporting. Click the button which opens a navigation window. Browse and select the [filename].pat and click Open. Figure 5-25 – Importing Lung Models The Import Custom Lung Models window opens. Figure 5-26 - Import Custom Models Click the model to import from the Available Models.

  • Page 64: Asl Monitor

    5.4 ASL Monitor The ASL Monitor window includes two views for the instructor, the Monitor view and the Equation of Motion view. The Monitor view is a useful tool for analyzing the waveforms and readings directly from the lung. These include pressure (cmH2O), flow (L/min) and volume (mL) waveforms. Relevant lung parameters are also monitored and are updated upon the completion of a patient breath.
  • Page 65 Figure 5-29 - ASL Monitor View 1. Pressure waveforms include airway (external), muscle (spontaneous breathing), as well as left and right internal lung pressures 2. Flow is the total flow in the system 3. Volume waveforms include total, right, and left lung volumes as well as a representation of air trapping (or breath-stacking) due to PEEP or lung mechanics (resistance or compliance) 4.

  • Page 66: Asl Equation Of Motion

    5.5 ASL Equation of Motion The Equation of Motion (EOM) window gives the user 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 5-30 - Equation of Motion Window 1.

  • Page 67: Asl Lung Model Control

    5.6 ASL Lung Model Control The ASL Lung Model Control window provides direct control of the patient’s lung and airway mechanics related to resistance and compliance. This includes single or dual lung models and inspiratory versus expiratory resistance. Figure 5-32 - Lung Model Control 1.

  • Page 68: Advanced - Single Compartment Lung Model

    5.6.1 Advanced – Single Compartment Lung Model Figure 5-33 - Lung Model – Simplified Lung Model 1 Compartment with Equal Resistances 5.6.2 Advanced – Two Compartment Lung Model, Equal Resistance (Rin = Rout) Figure 5-34 - Lung Model - 2 Compartment with Equal Resistances...

  • Page 69: Advanced - Single Compartment Lung Model, Unequal Resistance (Rin ≠ Rout)

    5.6.3 Advanced – Single Compartment Lung Model, Unequal Resistance (Rin ≠ Rout) Figure 5-35 - Lung Model - 1 Compartment with Resistance_in not equal to Resistance_out 5.6.4 Advanced – Two Compartment Lung Model, Unequal Resistance (Rin ≠ Rout) Figure 5-36 - Lung Model - 2 Compartment with Resistance_in not equal to Resistance_out...

  • Page 70: Asl Breath Effort Control

    5.7 ASL Breath Effort Control The Breath Effort Control window controls spontaneous breathing and breath rate. Figure 5-37 - Simple Effort Control 1. Muscle Pressure knob: Patient muscle pressure (negative pressure inside the lungs creating flow into the mouth). The user can also double-click the number inside and directly type a value.
  • Page 71 Figure 5-38 - 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. Muscle Pressure (maximum negative muscle pressure in the lung) 4. Insp. Rise Time (percent of total breath time for rise to peak negative muscle pressure, similar to i-time) 5.

  • Page 72: Troubleshooting

    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. 6.1 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.
  • Page 73 © 2020, IngMar Medical, LLC. www.ingmarmed.com...

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