Welcome to SimMan 3G #
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Description #
Unit intended to provide the essentials of operating, troubleshooting and maintenance of the Laerdal SimMan Simulator in order for participants to acquire the skills to work with the SimMan Simulator. Participant also will become familiar with the structure and organization of the Simulated Educational Environment.
Learning Objectives #
At the end of the unit participants will:
1. Learn (all levels) about Simulation Lab Set-up and supporting equipment.
2. Learn (all levels) about Simulation Lab Policy and Safety Precautions.
3. Master ( for technicians and instructors only; learners and program coordinators will get familiar) Technical and Functional Aspects of the Simulator
4. Master (for instructors and learners only; technicians and program coordinators will get familiar) Clinical features of the Simulator and possible interventions
5. Master (for instructors only; learners, technicians and program coordinators will get familiar) scenario design and creation in the Simulator
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This section will help you to get familiar with the simulation environment by providing the information on the Laerdal SimMan 3G and medical equipment/supplies that are available during the simulated sessions.
Standard SimMan 3G Equipment
- SimMan 3G manikin
- Laptop PC – Instructor Workstation with headset
- Laptop PC – Patient Monitor
Supporting Equipment
- Crash Cart
- Defibrillator
- IV Pole
Room Policy and Safety Precautions #
This section provides the information on simple care and maintenance steps that will help to ensure manikin stays in good working condition.
Each time you attend the Simulation program and use the simulator:
- Avoid using writing instruments and sharp objects while standing over the patient manikin, to prevent markings, snags and rips in the skin.
- Use only distilled or sterile water for injection.
- Position the manikin horizontally and do not place anything on top of it.
- Avoid improper and aggressive use of equipment in event of difficult airway and intubation.
- While using a defibrillator or pacer, it is better to use lower energy levels.
- Avoid giving fluid or inhalers through the mouth.
- NO FOOD OR DRINK IN SIM Room
Troubleshooting: #
- If anything is not working get a technician.
- If further instruction is needed in how to operate the system, please ask CanHealth staff for more clarification.
Startup Sequence #
1. Power On the SimMan 3G Manikin #
The manikin can run on batteries or on an external power supply.
1. On the right side of the manikin, lift up the skin.
3. Now the SimMan should be blinking and breathing.
2. Power on the Instructor PC and Patient Monitor PC #
1. Start up the Instructor PC Laptop and the Patient Monitor laptop. Login as required.
2. On the Instructor PC desktop, look for the SimMan Laerdal Instructor Application. Double click on it to start the application.
3. Connect to the SimMan 3G manikin when the option becomes available.
4. Select Instructor mode when prompted.
5a. If you want a standard patient, select healthy 3G patient.
5b. If you want to utilize a pre-programmed scenario, choose a scenario from the scenario drop down menu.
6. On the Patient Monitor laptop, login, and double click on the Patient Monitor application on the desktop.
7. Connect to the SimMan 3G manikin when the option becomes available.
SimMan 3G Startup Sequence Video #
Shutdown Sequence #
(For Technicians and Instructors. Learners and Program Coordinators will be familiar only.)
After you have completed your SimMan session, it is important to shut everything down properly for the safety of yourself and others. Furthermore, proper shutdown will extend the lifespan of the SimMan unit. The Shut-Down Sequence, entails a 3 step process which we will perform as follows.
1. Shut down the Patient Monitor Laptop #
1. Shut down the Patient Monitor application.
2. Shut down the Patient Monitor laptop.
2. Shut down the Instructor PC Laptop #
1. Shut down the SimMan 3G application.
2. Shut down the the Instructor PC Laptop.
3. Power Off the SimMan 3G Manikin #
1. Press the power button to power off the SimMan 3G Manikin.
2. If you used a LAN cable to connect to the manikin, please remove the LAN cable and store in a safe place.
3. If you SimMan 3G manikin was operating on batteries, now would be a good time to recharge them. If you were running on AC power, please unplug the AC power.
Congratulations. You have completed the 3 step Shut-Down Sequence for SimMan.
Shutdown sequence video #
SimMan 3G Clinical Features and Possible interventions #
(For Instructors and Learners. Technicians and Program Coordinators will be familiar with.)
This section will make you familiar with the clinical features of SimMan 3G manikin . An advanced patient simulation system, SimMan 3G, representing the physical characteristics of an adult male/female patient, allows the performance of the physical examination, patient monitoring, and interventions.
SimMan 3G Manikin : #
SimMan 3G is a full body, adult male/female manikin that has realistic anatomy and clinical functionality, and provides simulation-based education to challenge and test students’ clinical and decision-making skills during realistic patient care scenarios.
Clincal Features and Possible Interventions #
- Airway Assessment
- Breathing
- Circulation assessment
- Disability assessment (responsiveness)
- Possible clinical interventions
- Patient monitoring
- Administration of the Pharmacological agents
Airway #
The SimMan 3G provides 5 main clinical features. The first feature we will cover is Airway assessment.
AIRWAY ASSESSMENT #
SimMan 3G’s airway is instructor–controlled to allow simulation of various airway complications, including the failure of therapeutic airway devices.
Head of the manikin allows performance of
- head tilt / chin lift and jaw thrust
- cricoid pressure and manipulation
- suctioning (oral and nasopharyngeal)
Upper airway anatomy:
The SimMan 3G provides an anatomically realistic upper airway that includes all of the following features:
- Hard and Soft Palate
- Oropharynx
- Conical Trachea
- Carina
- Nasopharynx
- Laryngopharynx
Critical airway landmarks #
Such as a realistic Tongue, Epiglottis, Aryepiglottic Fold, Laryngeal Inlet, Vocal Cords and Esophagus.
Accurate ventilation interventions:
- Bag-Valve-Mask(BVM) ventilation
- Orotracheal intubation
- Nasotracheal intubation
- Transtracheal intubation
- Retrograde intubation
- Fiberoptic intubation
- Laryngeal Mask Airway(LMA)
- Combitube
- Needle cricothyrotomy
- Surgical cricothyrotomy
Mis-Intubation #
The SimMan 3G manikin accommodates intubation into the esophagus resulting in stomach distension and a lack of chest sounds. The manikin contains two lungs. Intubation that is too deep will result in unilateral lung filling. This usually occurs on the right side, due to the accurate anatomical modeling of the trachiobranchial junction tree.
Airway and trauma features: #
Allows use of a variety of clinical supplies and equipment and include all of the following:
- Tongue Edema – multiple levels
- Trismus
- Pharyngeal swelling
- Laryngospasm
- Upper Airway Obstruction
- Bronchial Occlusion
- Decreased cervical Range of motion
- Decresed right / left Lung compliance
- Teeth – soft or hard set
Airway Assessment video #
Breathing #
The next clinical feature of the SimMan 3G that we will cover is breathing.
The manikin can simulate spontaneous breathing and can be connected to ventilators and used with assisted ventilators.
The SimMan 3G manikin offers :
- Bilateral and unilateral chest rise and fall
- Variable lung compliance : 4 compliance settings from normal to extremely tight
- Normal and abnormal breathing sounds
- 5 anterior and 6 posterior auscultation sites
- Unilateral, bilateral and breathing sounds
- Oxygen saturation and phlethysmogram
- Cyanosis – indicated by blue lights on the lips
- CO2 exhalation for use with third-party ETC CO2 detectors
Breathing Assessment video #
Circulation #
The next clinical feature of SimMan 3G we will cover is Circulation Assessment.
CIRCULATION ASSESSMENT #
1) Pulses:
SimMan 3G has physiologically correct palpable pulses that are synchronized to ECG.
- Bilateral carotid pulses
- Left brachial pulse
- Bilateral radial pulses
- Bilateral femoral pulses
- Bilateral popliteal pulses
- Bilateral dorsalis pedis pulses
- Bilateral posterior tibialis pulses
Please note: There are no pulses on the right brachial artery.
2) Heart sounds
The simulated patient generates heart sounds (including a range of pathological ones) which are synchronized to the cardiac cycle and are audible with a standard stethoscope over every anterior location.
SimMan 3G manikin also offers bowel auscultation sounds, normal and abnormal, that are audible with a standard stethoscope in all four quadrants.
Circulation Assessment video #
Disability assessment #
The next clinical feature of SimMan 3G we will cover is Disability assessment (responsiveness)
DISABILITY ASSESSMENT (RESPONSIVENESS) #
SimMan 3G is equipped with a number of features that allow the neurologic evaluation to establish the patient’s level of consciousness (responsiveness):
1. Vocal response:
Numerous vocal sounds (moan, vomit, cough, etc) and simple pre-recorded sound clips are available.
Using the headset, the instructor/actor can communicate and interact directly through the loudspeaker in the manikin’s head.
2. Eye response:
Pupil size / Eyelid status / Blinking frequency / Light sensitivity – All of these can be controlled in Instruction mode.
3. Motor response:
The information on motor response will be provided by instructor. Seizures and fasciculations can be simulated.
Disability Assessment video #
Possible clinical interventions #
The next clinical feature of SimMan we will cover is Possible Clinical Interventions.
POSSIBLE CLINICAL INTERVENTIONS #
- The SimMan manikin was designed to support a wide range of clinical interventions involving the chest cavity and other part of the body.Chest Compressions: The simulator responses to CPR.
- ECG: The 5-lead ECG is emitted from the appropriate positions on the patient’s chest for display on a standard monitor or oscilloscope. The simulator generates a normal sinus ECG, as well as a broad range of abnormalities such as myocardial ischemia, sinus tachycardia and bradycardia, ventricular fibrillation and asystole.
- Electrical Therapy:
Pacing
Synchronized Cardioversion
Defibrillators: Both Conventional defibrillators (Monophasic & Biphasic Defibrillation) and Automatic external defibrillators ( (AEDs) can be applied to the simulator.
- Pneumothorax
- Stomach Decompression
- Esophageal, Nasal and Oral Intubation
- Cricothyrotomy
- Needle Chest Decompression (we recommend a 22 gauge needle for this purpose).
- Chest Tube insertion
- Folly Catheter insertion
Other features: #
Bowel auscultation sounds in all four quadrants, which adds a very valuable assessment capability for learners.
Video #
Patient Monitoring #
The next clinical aspect of SimMan we will cover is Patient Monitoring.
PATIENT MONITORING #
Patient monitoring features help learners with the all-important skill set of observing patient vital signs. The patient monitor includes the following monitoring capabilities:
- Respiratory rate
- Pulse Oximetry (SpO2)
- Heart rate related to SpO2
- BP – Non-invasive Blood Pressure (NIBP)
- ECG
- CO2 and capnograph waveform
- Temperature (Core temperature, Peripheral temperature)
- SpO2 waveform and numerical display with audio output
- CVP waveform and numerical display output
- ETO2
- CO2
- ET Anesthetic agent
- FI Anesthetic agent
- TOF
- TOF%
- FIN2O
Patient Monitoring video #
Administration of the pharmacological agents #
The last clinical aspect of SimMan 3G we will cover is the Administration of the Pharmacological agents.
ADMINISTRATION OF THE PHARMACOLOGICAL AGENTS: #
- IV access port: manikin’s right arm
- Medications administered through this system are recognized by SimMan 3G RFID system automatically.
- Injection access locations :
- IV access port on the right arm can be replaced
- IO access port on the sternum and left tibia : can be replaced
- IM injection : can be done on the right buttock – but, DO NOT INJECT FLUIDS into this pad.
Administration of the Pharmacological Agents video #
Additional resources: