SmartMan ALS User manual

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ALS Manikin Manual

Products

Advanced Airway CPR Systems

ALS and ALSLV

SmartMan Advanced Airway Manikin Training Systems - pg. 1

Contents

Safety and Regulatory Notices.........................................................................................................................2

FCC Statement...................................................................................................................................................2

1. Introduction.....................................................................................................................................................2

1.1. SmartMan Advanced Airway and Megacode Models ...............................................................................2

2. Specifications.................................................................................................................................................3

2.1 Weight ........................................................................................................................................................3

2.2 Dimension...................................................................................................................................................3

2.3 Usage and Storage ......................................................................................................................................3

3. Preparation for Training................................................................................................................................3

3.1. The PopUp Component .............................................................................................................................4

3.2 USB Connector............................................................................................................................................4

3.3 Carry Bag/Training Mat or Travel Duffle.....................................................................................................4

3.4 Mounting the Legs on the Torso.................................................................................................................5

3.5. Connecting the Manikin to the Computer.................................................................................................5

3.6 Starting the Software..................................................................................................................................5

3.7 Using the Software .....................................................................................................................................5

3.8 Updating the Software................................................................................................................................6

3.9 Carotid Pulse...............................................................................................................................................6

3.10 Adjusting Chest Resistance .......................................................................................................................6

3.10.1 How to Adjust Chest Resistance........................................................................................................6

4. Using the Manikin Training System ............................................................................................................7

4.1 Compressions..............................................................................................................................................7

4.2 Ventilations.................................................................................................................................................7

4.3 Intubation ...................................................................................................................................................8

4.4 CPR..............................................................................................................................................................8

4.5 Checking Pulse ............................................................................................................................................9

5. Cleaning..........................................................................................................................................................9

5.1 Cleaning of the Skull, Neck and Body .........................................................................................................9

5.2 Cleaning of Clothing....................................................................................................................................9

5.3 Cleaning of Carrying Bag and Wheeled Duffle............................................................................................9

SmartMan Advanced Airway Manikin Training Systems - pg. 2

Safety and Regulatory Notices

FCC Statement

(Regarding wireless option ONLY)

SmartMan uses an off the shelf FCC approved wireless router.

(Regarding computer)

SmartMan uses a standard computer, which in most cases is a laptop computer which is approved

and meets on requirements.

1. Introduction

The SmartMan Airway Manikin, SmartMan Airway Low Volume, SmartMan Megacode, and

SmartMan Megacode Low Volume are advanced instructional and training devices. They are

designed to simulate realistic conditions during cardiopulmonary resuscitation. They are designed to

be connected to a PC computer running under the windows operating system. Each of these

manikins provide for physical as well as digital feedback on the computer when performing chest

compressions, ventilations, CPR and other related procedures required during cardiopulmonary

resuscitation. The combination of the physical and digital components are referred to as SmartMan

Training Systems. These systems come in various hardware and software configurations to

emphasize training on particular aspects cardiopulmonary resuscitation.

These manikins simulate a normal adult and provides an excellent lifelike representation of human

anatomy, particularly those features important to training in modern resuscitation techniques.

These manikin training systems are suitable for most aspects of Basic Life Support (BLS), Advanced

Life Support (ALS), and with the Megacode products for Code training.

The low volume enabled manikins have extra sensors to give the ability to register accurate

feedback on very low volumes of air during ongoing chest compressions. This is now required for

some of the latest protocols.

1.1. SmartMan Advanced Airway and Megacode Models

SmartMan Advanced Airway manikins are available in the following hardware/software

configurations:

1) ALS Airway CPR

2) ALS Airway CPR Low Volume

3) Megacode

4) Megacode Low Volume

5) SIM for SCA

These SmartMan models all have different internal configurations and different digital sensors. The

manikins are equipped with a mechanical instrument, digital sensors and a USB connector.

The popup contains the connector to the USB cable and it contains a view port. The view port

provides a general indication that the physical components for chest compressions and ventilations

are working correctly and they give a rough indication of depth of chest compression, volume of

ventilation, and stomach inflation. There is a blind on the popup on the side facing to the head of the

manikin to obstruct the view of these indicators. This can slide to the up or down positions.

SmartMan Advanced Airway Manikin Training Systems - pg. 3

These manikin models are fitted with electronic sensors. These do not require batteries. They utilize

the power from the computer when attached via USB cable.

When used in wireless mode, the sensors are powered by the battery from the router. The wireless

is connected to the USB port in the popup.

When connected to the computer, the SmartMan software appropriate to your particular model will

record the digital data produced as skills are performed. It will display the information related to

parameters important to improving performance skills for CPR. The data is stored on the local hard

drive and can be examined later.

2. Specifications

2.1 Weight

Weights vary depending on which product. Below are approximate weights.

Torso with carrying case/mat: approximately. 12kg / 27lbs

Torso with wheeled duffle: approximately 15kg / 32lbs

Torso: approximately 9kg / 19lbs

2.2 Dimension

Torso: approx. 80 cm

Part/ Material

Basic Unit

Polyethylene

Instrument part

ABS plastic

Skull

PVC, hard

Chest skin

PVC, soft

Face piece

PVC, soft

Head bag, disposable

Polyethylene

Training suit

50% cotton and 50% polyester

Carrying bag/training mat

PVC coated nylon material

2.3 Usage and Storage

Storage temperature (non-condensing): -18 °C (-0,4 °F) to 40 °C (105 °F)

Usage temperature (non-condensing): -5 °C (23 °F) to 40 °C (105 °F)

3. Preparation for Training

The manikin is supplied either in

1) a special carry bag which, when opened, folds out to provide a mat for the trainee during training.

To open, undo the three clips and unfold. If desired, the outer folds can be folded under the central

part. When repacking, these manikins should foam put over the body. The hole geos over the nose

to protect it from being flattened; or

2) a wheeled protective duffle. To open, unzip the duffle, open the top and undo the harness straps

which secure the manikin. A separate kneeling pad is included. When repacking, place the waist of

SmartMan Advanced Airway Manikin Training Systems - pg. 4

the manikin towards the wheels, then reattach the harness. Place the kneeling mat at the end over

the popup so that it is not covering the face.

When supplied as a full body model, the arms and legs will be in separate carry bag.

When supplied with an IV arm, the IV arm will be in a separate carry case.

3.1. The PopUp Component

To pull out the popup, depress the catch in the middle of the black housing at the waist of the

manikin (see picture right). Allow the instrument to pop out. It is on springs and will push upward

when released. Allow it to come fully up.

The USB connector is on the side and there

are markings on each side of the

popup. The side facing the head has a

blind which can be pulled up to

obscure that side (see picture above

left).

An indication that a ventilation has been put into the lungs will be

indicated on the left side of the popup. As you inflate the lungs,

the marker will rise. The correct natural setting before air is put

into the lungs should be at the base of the popup so that very

little of it is visible when at rest. The Line at V1 is only an

indication marker. It does not

represent a specific volume.

Stomach inflation is indicated in the middle. When air goes into the stomach you will hear the

indicator move. If quite a lot of air goes into the stomach, red markers will rise in this area.

Chest compressions are indicated on the right side of the panel. The correct natural setting should

be with this marker up at the top. As you press on the chest the indicator will move downward.

With the popup not pulled out, no damage is done if the chest is compressed.

3.2 USB Connector

To connect the manikin to a computer use the USB-Plug, which is placed on

the left side of the popup. The popup must be in the up position to connect

the USB.

3.3 Carry Bag/Training Mat or Travel Duffle

Carry Bag. Unfold the bag. The manikin can be steadied by

inserting the back of the manikin onto the plastic holder on the back

of the mat.

Travel Duffle. Unzip the top half of the duffle. Release the harness and pull the manikin out from the

plastic molded shell.

SmartMan Advanced Airway Manikin Training Systems - pg. 5

3.4 Mounting the Legs on the Torso

Pull down the trousers from the legs a little to around the top of the hips.

Place the legs in a position so that the 2 dowels on the hip part can slide

into the corresponding dents at the bottom of the manikin’s body.

Press the two Velcro straps firmly to the

body.

To remove legs pull off the Velcro straps and the legs will be

disengaged.

3.5. Connecting the Manikin to the Computer

Bring the popup to the up position by depressing the catch. Plug the USB cable into the popup and

the other end into the computer. Allow a minute for the driver for the manikin to be loaded into the

operating system. Start the software by doubling clicking on the icon on your computer screen.

3.6 Starting the Software

Double click the icon on the screen. The program will verify the connection. If the connection is not

able to be established the software will display an error. If this happens unplug the USB cable at

both ends, wait for 5 seconds, and plug both ends in again.

The software can be used without connecting to the manikin for specific functions such as creating

logins, reviewing results and printing reports.

NOTE: The first time the software is installed on a computer, the system must be connected to the

manikin.

3.7 Using the Software

When the software verifies the connection, you will see the LOGIN MENU. In order to perform any

activity on the system, you must login. You can click on the Practice Session login to go directly to

the Main Menu. You can quickly create your own logins or use an existing login. You do not require

an internet connection to create logins and you do not require a key code to create logins.

MAIN MENU. Once you login you will be at the main menu. Here you will see the Skills Set Menu.

Click on one of the skill areas (Compressions, Ventilations, CPR, Tutor, AdvCPR). When you click

on each of these, the activities which you can perform are displayed. When you select an activity,

click the large green start button to begin performing the skill. Feedback will appear as soon as you

perform any skill.

TRAINER TOOLS. The trainer is able to view all results at any time. To view results there is no need

to be connected to the manikin or to the internet. There is a special Trainer Tools Menu which allows

the trainer to create classes and logins, to copy a list from Word or a txt file, to quickly produce

charts from results, and to create a zip file from results and send them to an email address. To

access the Trainer Tools Menu, login with any login such as Practice Sessions. At the Main Menu

click on the Trainer Tools Button at the right side of the window. To exit the Trainer Tools Menu, click

the Trainer Tools button a second time.

SmartMan Advanced Airway Manikin Training Systems - pg. 6

3.8 Updating the Software

You do not need to be connected to the manikin to update the software.

You must be connected to the internet to update the software.

To update the software, start the software by double clicking on the icon. When you are at the Login

Menu, click the Update button on the right side of the main window. You will be given the option to

update the software or not. If you have not updated the software for a while, there may be several

updates. When one update has finished, it will indicate whether there is another update available or

not. If so repeat the procedure.

3.9 Carotid Pulse

Fit the tube with the bellows onto the tube connector located on the

right side of the black waist housing. The carotid pulse can be created

manually by compressing the bellows.

3.10 Adjusting Chest Resistance

The stiffness of the chest can be adjusted as required by loosening

the thumb screw on the back of the manikin. With the device moved

towards the head, resistance is decreased. With the device moved

towards the waist the resistance in increased.

Approximately 6 N/mm (0.7 kg/mm) and 11 N/mm (1.2 kg/mm), indicate

the force at least resistance and maximum resistance which must be

applied to compress the chest by 1 mm.

Example: Compressing the chest by 40 mm at the lightest setting,

a force of approximately 240 Newton (24 kg) must be applied.

The normal setting is in the middle which corresponds to

approximately 8.5 N/mm (0.85 kg/mm).

3.10.1 How to Adjust Chest Resistance

To move the chest resistance mechanism, it is important to turn the manikin on its side and press

down on the side of the chest to reduce the pressure on the center of the chest. If you fail to take

pressure from the chest, the main spring may not move correctly.

1) Put manikin on its side

2) Press one side of the chest to reduce pressure on the center of the chest

3) Loosen the wing nut

4) Slide the mechanism to the position you want

5) Tighten the nut

When you have finished try a couple of compressions to see that the main spring is a) positioned

correctly and b) the movement mechanism is not sliding. If you feel that the mechanism is moving

the resistance is not correct, perform the following procedure to correct it. Repeat the process but

move the mechanism rapidly toward the head and waist several times to put the main spring back

into the correct position. Then tighten the nut sufficient to secure it from moving when compressions

are performed.

SmartMan Advanced Airway Manikin Training Systems - pg. 7

4. Using the Manikin Training System

4.1 Compressions

Your manikin is designed for practicing external chest compressions. It provides for full depth and

gives you the ability to change the chest resistance to simulate from a

youth or smaller person to an adult or larger person. See instructions

above.

The digital sensors provide for more accurate recording of key

parameters than a person can perceive. It is designed to provide for

optimal training. The software feedback will indicate depth, rate and

release, as well as the degree of non-release, whether it is deeper

than recommended and whether you have hit the bottom.

On the right side of the back panel, the slider will move up and down as you perform compressions.

This will indicate that the chest is connected and is thus moving up and down.

The software will provide a score on the performance which can be considered to be the value of the

performance to the patient. The score and a full analysis are provided as soon as the activity has

completed.

It is possible to turn off the feedback on the screen. This permits a truly objective scoring of the

performance. When the performance has been completed the score and full analysis will be

displayed on the screen.

4.2 Ventilations

The Airway Manikin System is not supplied with a hygienic system, as a resuscitator is normally

used. Mouth-to-mouth or mouth-to-nose ventilation must therefore not be performed.

Ventilation can be performed by using a resuscitator with mask,

ventilation through an endotracheal tube or other modern airway

management devices.

Correct ventilation fills the lungs with air. The manikin’s chest will

expand; you will notice that the sound of the air going into the manikin

is different than if you have a leak; the volume and rate of flow is

displayed on your computer screen.

There are several activities for practicing ventilations in your software.

These is one activity which is designed to improve how you control both the

rate and volume of the BVM.

When performing bag/mask ventilation there is a possibility for stomach inflation, which causes the

manikin’s stomach to rise. This happens if the ventilation is too fast, the volume is too high or if the

head is not tilted correctly.

These manikin systems provide for training in how to establish and advanced airway. The high

fidelity airway requires correct positioning of the head, sighting of the vocal cords, and avoiding of

the esophageal pathway. The software provides for measuring and reporting on accuracy and

efficiency of placement of the advanced airway. This procedure can also be practiced when chest

compressions are ongoing.

SmartMan Advanced Airway Manikin Training Systems - pg. 8

As in real-life situations, ventilating through the intubation tube eliminates the risk of stomach

inflation if the tube is correctly placed. As the manikin is ventilated, you will see the rate and volume

of air displayed in the feedback area on your computer screen.

These manikins also provide feedback on the interaction of the chest compressions and the

ventilations.

For Rescue Breathing and for the CPR breaths activities, the colored bars will also indicate the

volume and rate of air flow as well as the length of the interval between breaths.

4.3 Intubation

These manikins can be used to practice intubating through the mouth (oral intubation). Intubation

through the nose (nasal intubation) is not possible.

The intubation can be performed with modern airway management devices like ET-tube (8 mm I.D.

endotracheal tube is recommended), supraglottic airway, or Combitube™ etc.

The insertion of the laryngoscope and endotracheal tube is to be made very

carefully as if it was a real patient. It is important to lubricate the tongue

from the oral cavity down to the white stripes simulating the vocal chords

using the accompanying water-soluble lubricating gel and

lubricate as often as the tongue parts feel dry. Do not pour

lubricating gel down the tongue but lubricate the parts with a thin

layer of lubricating gel. Furthermore, it is also important to

lubricate the tracheal tube and laryngoscope well with the water

based lubricating gel.

Lack of lubrication can destroy the parts, especially the tongue part, but can also make the face

piece separate from the tongue part.

NOTE: ONLY USE A WATER BASED LUBRICANT

Silicone oil or Silicone spray must not be used as the parts can become sticky and very

difficult to clean.

DO NOT REMOVE THE FACEMASK. The facemask must not be removed by the user.

Disassembly should only take place during service or repair.

With your software you receive feedback on the efficiency of intubation. It is possible to perform

chest compressions while you perform the intubation.

Feedback during CPR on an intubated patient can be optimized by avoiding having the person

performing compressions pushing down on the chest and the person giving the ventilation at the

same time. Your software will indicate when the ventilation and the release of the chest are well

timed or not.

4.4 CPR

These manikin training systems simulate the feel of a patient’s body during CPR. They are designed

with sensors to provide digital feedback on the interaction between the chest compressions and the

ventilations. As in a real person, when the chest compression is released, the negative pressure

produced in the lungs pulls air into the lungs, and when the chest is compressed it pushes air out of

the lungs.

SmartMan Advanced Airway Manikin Training Systems - pg. 9

This must be considered when a person is ventilating. The performance of chest compressions

influences the volume and rate of flow and direction of flow of the air from the ventilation. This is the

case regardless of whether the ventilation is provided by a BVM or Intubation device.

SmartMan measures the dead air space, the amount of air flow created during the release of the

chest compression and the amount of air produced by the ventilation device. The feedback shows

the way the compressions and the ventilations interact so that optimal performance can be achieved.

When performing CPR on an intubated patient, the software will provide feedback to help the two

people work together to reduce the likelihood that the compressions become less effective.

4.5 Checking Pulse

The carotid pulse can be felt on both sides of the neck if

simulated manually by the instructor.

The bulb and tube are connected to the waist of the manikin.

5. Cleaning

5.1 Cleaning of the Skull, Neck and Body

The skull, face piece, neck and body can be wiped with a cloth moistened in a mild detergent and

then wiped once more using a cloth moistened in clean water. When washing never allow detergent

or water to enter the skull, body or instrument unit. If necessary, cover the connection between body

and instrument unit with a cloth.

Marks on the manikin left by lipstick or ball pen can penetrate the material and should therefore be

removed as quickly as possible using alcohol. Ink marks will remain.

To remove grease marks, use a degreaser which is suitable for use on the hands (not those for use

directly on engines or floors). Put a small amount of the degreaser on a cloth and rub the grease

spot. Immediately wipe clean with a moist cloth.

5.2 Cleaning of Clothing

The tracksuit is made of 50% cotton and 50% polyester and is washable at max. 40 °C (104 °F).

5.3 Cleaning of Carrying Bag and Wheeled Duffle

Both the carry bag/mat and the wheeled duffle can be washed in a mild detergent using a cloth or

soft brush, rinsed in clean water, and then dried.

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