SimMan 3G Service Manual
SimMan 3G Service Manual
SimMan 3G
TM
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Table of Content
About this manual Other applicable documents 1.0 General product Overview 1.1 SimMan 3G Simulator and System 1.2 Technical Specifications 1.3 Regulatory Information 2.0 Tour of the Simulator 2.1 External Connections and Vascular Access 2.2 Overview for Blood and fluid Outputs 2.3 Overview Pulses 2.4 Internal System Overview 2.5 Speaker and Sound System Overview 3.0 Functional Description 3.1 General Overview, Functions & Electronics 3.2 Compression System 3.3 CO2 System 3.4 Bleeding & Fluid System 3.4.1 Bleeding System Pelvis 3.4.2 Fluid distribution Unit Pelvis 3.5 Lung Module 3.5.1.1 Compliance 3.5.1.2 Restriction 4.0 Functional Verification 4.1 Battery Operation 4.2 Battery change 4.3 Battery Heat warning 4.4 How to access the Test Utility Program 4.5 Test Utility Program 4.5.1 Head 4.5.2 Arm 4.5.3 Valve 4.5.4 Leg 4.5.5 Vital Signs 4.5.6 Sounds 4.5.7 Comp/Vent 4.5.8 Pulses 4.5.9 Versions 4.5.10 Power 4.5.11 Defib/Pacing 4.5.12 Test 4.5.13 Bootloader 4.5.14 Autotest 4.5.15 Debug 4.6 Manikin statistics 5.0 Interconnection System 5.1 Cable Connections between circuit boards 5.2 Base Board cable connections 5.3 Head Board cable connection 5.4 Valve Board cable connections 5.5 Xxx 5.6 Compressor Board cable connections 5.7 Drug registration Board cable connections 5.8 Tubing in Head, air distribution
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6.0 Exploded views 6.1 Head Assembly 6.2 Skull Lower Assembly 6.3 Eye Assembly 6.4 Airway Assembly 6.5 Neck Assembly 6.6 Thorax Right Assembly 1 6.7 Thorax Right Assembly 2 6.8 Thorax Right Assembly, total 6.9 Thorax Left Assembly, total 6.10 Thorax Base plate Assembly, first step 6.11 Thorax Base plate Assembly, with cables 6.12 Thorax Base plate Assembly, w/ Base Board 6.13 Back Cover Assembly, w/speakers 6.14 Torso (back) Assembly 6.15 Torso (front) Assembly 6.16 Compression Spring Assembly 6.17 Compression Plate Assembly 6.18 Chest Assembly 6.19 Torso Assembly, total 6.20 Torso Assembly w/ Pelvis and Stomach, complete 6.21 Left Leg Assembly 6.22 Leg Right Assembly 6.23 Pressure Tank 6.24 Lower Right Leg Assembly 6.25 Compressor Assembly 6.26 Left Arm, BP Arm Assembly, complete 6.27 Left Arm w/pulse skins 6.28 Right Arm, IV Arm Assembly, complete 6.29 Flow meter Assembly 6.30 IV Arm w/antenna Networking and Communication System 7.1 Networking Overview Communication System 7.2 ATTACHMENT ATTACHMENT ATTACHMENT ATTACHMENT I II III IV SimMan 3G Simulator Final Service Test Check List Service Parts SimMan 3G Graphical User Interface - GUI SimMan 3G Troubleshooting Guide
7.0
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The information provided in this manual is limited to what is required for checking, maintaining and repairing of the SimMan 3G manikin. This service manual provides a general understanding of the design and function of the manikin and it associated peripherals as well as information on the mechanical assembly of the manikin. Please note that the Direction for Use manual provided with every new manikin should be consulted for detailed information on use of the product. To be able to read schematics and drawings in detail, this manual includes some pages in which need to be printed in A3 format.
Note
SimMan 3G Direction for use SimMan 3G Quick Setup Guide SimMan 3G Quick Reference Guide SimMan 3G Software User Help Files Laerdal E-learning Lifesaving Products, Laerdal Products Catalogue Service of the SimMan 3G simulator should only be performed by authorized service personnel. Service by others may invalidate the warranty of the product.
Note
Warnings (For a complete list of Cautions and Warnings, see Directions for Use) Defibrillation of the manikin must only be performed on the specified defibrillation connectors. Do not perform more than three defibrillation discharges (max 360J) in sequence. Take all standard precautions when handling defibrillators. Do not open the air compressor with compressed air in the tank; always drain the compressed air before service. The compressor has to be switched OFF when filling the reservoir with fluid or simulated blood.
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1.
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1.3.2.
Safety
Conformity with applicable safety requirements of the EU Directive concerning Low Voltage for the SimMan 3G system have been based on compliance with the relevant safety requirements defined by EN 609501:2005. Manufacturers of peripheral components of the SimMan 3G system have independently declared compliance the safety requirements of the EU Directive concerning Low Voltage and are eligible of carrying the EC mark. Conformity with relevant safety standards recognized by Canadian and US regulatory bodies have been demonstrated through (c) CSA (us) certification of peripheral components in the SimMan 3G system. Applicable Regulations: EU Directive, 2006/95/EC, Low Voltage 29 CFR 1910.301 - Occupational Safety and Health Standards Electrical Safety Canadian Electrical Code, CAN/CSA 22.x Relevant Safety Standards: EN 60950-1:2006 - Information Technology Equipment Safety UL 60950-1 - Standard for Safety Information Technology Equipment CAN/CSA-C22.2 No. 60950-1 - Information Technology Equipment Safety
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1.3.3.
1.3.3.1.
Electromagnetic Immunity
IMMUNITY TEST COMPLIANCE LEVEL ELECTROMAGNETIC ENVIRONMENT GUIDANCE SimMan 3G may sometimes be susceptible to interference from other RF communication equipment interfere. In such instances increase the distance between the SimMan 3G and interfering RF transmitters. Observe precautions for handling of electrostatic sensitive devices during service and maintenance of the manikin.
RF Electromagnetic Fields
Electrostatic Discharge
* NOTE: Compliance level measured with manikin assembled and covered by simulator skins.
Relevant Technical Standards: EN 61000-4-2, Electrostatic discharge immunity tests EN 61000-4-3, Radiated, radio-frequency, electromagnetic field immunity tests
1.3.3.2.
Electromagnetic Emission
EMISSION TEST COMPLIANCE LEVEL ELECTROMAGNETIC ENVIRONMENT GUIDANCE SimMan 3G use RF energy only for its internal function. Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronics equipment.*
Conducted emission
Radiated emission
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* NOTE: Intended radiation from RFID reader and WLAN adapter should be taken into consideration when determining a suitable environment for SimMan 3G to be operated. See Section Radio Frequency Communication.
Relevant Technical Standards: EN 301 489-01/03/17, EMC standard for radio equipment and services; Part 1: Common technical requirements EN 55022, Information technology equipment. Radio disturbance characteristics. Limits and methods of measurement EN 61000-3-2, Limits for Harmonic Current Emission EN 61000-3-3, Limitations of voltages changes, voltage fluctuations and flicker
1.3.4.
RADIATION TEST
COMPLIANCE LEVEL
RADIO FREQUENCY COMMUNICATION ENVIRONMENT GUIDANCE GENERAL Changes or modifications not expressly approved by the party responsible for compliance could void the user's authority to operate the equipment.
Applicable Regulations: EU Directive, 1999/5/EC, Radio and Telecommunications Terminal Equipment (RTT&E) 47 CFR Part 15 Radio Frequency Devices (FCC)
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1.3.4.2.
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Caution Changes or modifications not expressly approved by the party responsible for compliance could void the user's authority to operate the equipment.
1.3.5.
Transportation
Transportation of Lithium batteries is regulated through different regulations. Among the most prominent is the two regulations listed below. The rechargeable Lithium Ion Battery Pack installed in SimMan 3G has found to comply with applicable requirements of UN Manual of Test and Criteria.
Relevant Regulations UN Manual of Test and Criteria, Part III - Sub Section 38.3 - Lithium Batteries 49 CFR Part 173.185 - Lithium batteries and cells NOTE: Additional local regulations for transportation may apply for transportation of Lithium Batteries. Inform transport agency about product containing Lithium batteries.
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2.
BP Cuff Refill Unit Blood Compressor /Regulator /CO2 bottle Refill Unit Fluid Intra Muscular Injection (IM Pad)
Fig. 1
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Fluid port, sweat Fluid port, eyes Fluid port, nose Fluid port, ears (both ears) Fluid port, mouth Blood port 1 Blood port 2
Blood port 3
Fig. 2
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Brachial Pulse (Left) Radial Pulse (Right) Femoral Pulse (Right) Radial Pulse (Left) Femoral Pulse (Left)
Fig. 4
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Jaw Antenna
Eye Modules
Compression module Lung modules Flowmeter Position sensor IV Arm Antenna RFID Sub assembly
- Antenna select Board - Drug. Reg Board and
+ + -
Valve Board
Batteries
Compressor
M
Compressor Board
Fig.5
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Figure 6 illustrates Heart sounds locations: 1. 2. 3. 4. 5. RUSB Aortic LUSB Pulmonary LLSB Tricuspid Apex Mitral BP (Blood Pressure)
Fig. 6
Fig. 7
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Figure 8 illustrates the two microphones located in the ears, and the vocal speaker in the head. Vocal speaker Microphone (2)
Fig. 8
1 3 4
1. 2. 3. 4. 5.
RU LU RM RLL LLL
Right Upper Lobe Left Upper Lobe Right Middle Right Lower Lobe Left Lower Lobe
Fig. 9
6 7. 8. 9. 10. 11.
LU RU LM RM LL RL
Left Upper Lobe Right Upper Lobe Left Middle Lobe Right Middle Lobe Left Lower Lobe - Right Lower Lobe
Fig. 10
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3.
FUNCTIONAL DESCRIPTION
TORSO 1) Defib sternum 2) Compression detection (depth and rate) 3) Sternal IO 4) Pneumathorax 5) ECG 6) Lung Compliance 7) Lung Resistance 8) Ventilation 9) 11 x Lung Speakers 10) 4x Heart Speaker 11) System on Module (SoM) PCcard
RIGHT 1) 2) 3) 4) 5) 6) 7)
LEG ECG Right Leg Fluid Bag Popliteal pulse Pressure Tank Leg PCB Compressor/pump Cooling fan??
PELVIS 1) 2) 3) 4) 5) 6) 7) 8) 9) 10)
USB WLAN dongle Right Lung Speaker (lower) Left Lung Speaker (lower) Defib Apex 4x Bowel sound Fluid Manifold Pneumatics Manifold Valveboard PCB 2x Femoral pulse IM Pad
Fig. 11
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HEAD 1) 2) 3) 4) 5) 6) 7)
2x Eye module: Active eyes w/lids pupils responding to light Head speaker Head control card Head manifold Jaw Antenna Board 1 x Antenna for airway event registration Trismus bladder
NECK 1) 2)
RIGHT ARM 1) 4x Antennas for Drug registration 2) IV module PCB 3) Right Radial pulse 4) Convulsion Right Arm
LEFT ARM 1) Brachial pulse 2) BP speaker 3) Left Radial pulse 4) Convulsion Left Arm
Fig. 12
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Fig. 31
Fig. 32 On the depth gauge there is placed a label with a pattern on it. The pattern has a period of 0.916mm, where the black stripes are 0.487mm wide and transparent parts are 0.429mm wide. When you perform CPR, the opto switch read the pattern and then calculates the depth.
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Fig. 33
On the depth gauge there is placed a label with a pattern on it. The pattern has a period of 0.916mm, where the black stripes are 0.487mm wide and transparent parts are 0.429mm wide. When you perform CPR, the opto switch read the pattern and then calculates the depth. The opto switch has two channels, A and B. it will always be 90 degrees phase lead between them, and by checking (in software) which channel is first, you can tell the direction of the movement.
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Fig. 34 The two lungs are placed in the torso, and they are used when baging the manikin. They can be set to have different compliance and restriction settings. The change of compliance will make the lung feel more/less stiff when baging, and restriction will simulate narrowing passage of air to the lungs. There are two air in/out. One (the biggest) for air that is coming from the airway when baging. The other one (small) goes into a pressure sensor on the valveboard for reading the pressure in the lung. This value will be converted to a signal used to control chest rise.
Fig. 35
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3.3.1.
Compliance
When activating the compliance you activate one or both solenoids which will hook the spring(s). There are four settings: 1. 2. 3. 4. No springs are hooked Left side spring is hooked Right side spring is hooked Both springs are hooked
When baging and compliance are activated, the spring(s) will hold the lung plate upper, and make it harder to get air into the lungs. The two springs are different in strength and therefor number 2 and 3 will give different feedback when baging.
Hook Fig. 36
Spring
Solenoide
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3.3.2.
Restriction
When changing the restriction setting, the stepper motor will rotate and then turn on lung valve cylinder. The lung valve cylinder has four positions: 1. 2. 3. 4. Fully open Increased High resistance Closed
This way you change decrease/increase the airflow into the lung when baging.
Air in/out
Pressure movement
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Fig. 38
Fig. 39
SimMan Compressor:
Regulatorbox:
Fig. 40
Fig. 41
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Air pressure in Blood out (venous) Valve Blood out (arterial) Valve Pressure Tank Bag with simulated blood Flow meter
Tubing
Fig. 42 Warning: Compressor has to be OFF when filling fluid to the tank.
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3.5.1.
Fig. 43
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3.5.2.
Fig. 44
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4.
FUNCTIONAL VERIFICATION
This functional verification helps to confirm the proper operation of the SimMan 3G manikin and options.
Fig. 13 Power Save* Charge Error** Almost complete*** No charge**** - Blinking light - One or both batteries missing - Not recommended to charge the batteries for too long - Because of no power input, or that batteries are fully charged. If the manikin is charged from a low-voltage source, running and charging the manikins is not possible simultaneously.
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Fig. 14 Log in: Administrator Password: SimMan3G (if required) 4. 5. 6. 7. 8. 9. 10. Click Connect Now you will see the Remote Desktop of the SimMan 3G (this can take a while) Double click Stop Update Service This will stop the manikins control program. Double click on SimMan 3G Test Utility Just click connect in the Connect to Manikin window Then you will access the Test Utility program, and after a few seconds the manikin will start breathing NOTE: If the simulator will be turned off, you have to exit the Test utility via remote desktop and click Start update service
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4.6.1.
Head
Fig. 15 Sent and Received packages This indicates there is communication internally in manikin Lost packages May happen and will indicate if any communication is lost (high number could indicate problems) a. Blink i. ii. iii. b. Eyelid i.
Blink eyes manually activate a blink Left/Right eye choose one or both Auto and seconds - set the seconds between each blink position You can set the eyelid position in three different positions; Open, Half open or closed ii. Choose which eye you want to test c. Iris size/mode
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i. Check the iris size with choosing different sizes auto/ manual/reduced speed ii. When both eyes (Left and Right) are selected check the synchronization of the iris size iii. Light sensor value indicates incoming light d. Iris adaption i. Direct sets the aperture for direct light ii. Normal sets the aperture in ambient light iii. No light sets the aperture in no light e. Reset i. Calibrate calibrate the eyelid position ii. Reset You can reset eyelid/iris f. Jaw trust/Neck tilt i. Jaw sensor value - Observe the jaw trust function by thrusting the jaw ii. Neck sensor value - Check the neck sensor by tilting the neck g. Complications - you can observe the different functionalities and check for various settings for the following functions, the value indicates the amount of the complication (100=max): i. DCRM ii. Laryngospasm iii. Pharyngeal iv. Tongue v. Trismus vi. Cyanosis h. Iris offset adjustment input from Jan Arild i. Left Eye Constricted ii. Right Eye Constricted iii. Left Eye Dilated iv. Right Eye Dilated i. Events lists the recent events
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4.6.2.
Arm
Fig. 16 j. DrugEvent i. Arm tagid; place one RFID tag in the right IV arm catheter area (max 0.2m from catheter) and observe the tag id is detected in the Arm tagid window ii. Head tagid; place one RFID tag in the jaw area and observe the tag id is detected in the Head tagid window (max 0.2m from jaw) iii. Injected vol (L); inject 10 ml distilled water in the IV catheter and read the given volume. If the volume given differ more than 10% from the volume detected, go to Test tab and initialize and calibrate the flow meter
k. Convulsions i. Convulsions left (RPM); test the motors in the convulsion module for different settings and observe the convulsions in the left arm ii. Convulsion right (RPM); test the motors in the convulsion module for different settings and observe the convulsions in the right arm iii. Check if the same setting in both arms gives similar convulsions
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4.6.3.
Valve
Fig. 17 Bleeding/fluid i. Bleeding strength; you can choose what strength you want to test in either port 1 and/or 2, or ports 3 and/or 4. Then you can test either arterial or venous bleeding. 1. In this window you can read the amount of blood volume given and the flow. 2. Tank status will give you the current status. 3. Bl. Hose press. Will give you the pressure in the blood reservoir b. Check for fluid on/off in the different areas: ii. Nose iii. Ear iv. Mouth v. Eye vi. Urine vii. Froth viii. Sweat c. Stomach valve a. Closed will inflate stomach bladder if ventilation is done too fast or with too much force b. Open stomach bladder will deflate d. Airway complications i. Resistance check for the normal/increased/high/closed settings ii. Compliance check for normal/level 1/level 2/ level 3 iii. Pneumathorax check both bladders at max l.
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4.6.4.
Leg
Fig. 18 In this window you can check the pressure in the compressor, and if it is ON or OFF. The regulation mode indicates if Manuel or Automatic pressure regulation. Caution: In manual mode the compressor will run continuously until it is stopped manually.
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4.6.5.
Vital signs
Fig. 19 a. Breathing function: i. Breath rate: set a breathing rate and check if it is correct ii. Breathing strength: set the breathing rate for Normal, X or Y iii. Apnea - If you choose apnea the simulator should stop breathing. Use this when doing ventilation. b. BP/HR: i. BP Sys set the blood pressure systolic pressure ii. BP Dia set the blood pressure diastolic pressure iii. Heart rate set the heart rate
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4.6.6.
Sounds
Fig. 20 a. b. c. d. e. f. Lung sounds set the sound and volume for the different speakers Vocal Set the volume level for the vocal sounds Link this links all settings to all speakers Heart sound set the sound and volume for the different speakers Link this links all settings to all speakers Bowel sounds - Set the bowel sound and volume - Repeat bowel sounds with adjustable delay (set in seconds) g. BP Cuff i. Auscultation Gap Jan Arild ii. Ascultate Jan Arild
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4.6.7.
Comp/Vent
Fig. 21
4.6.8.
Pulses
Fig. 22 a. Check for detection when doing palpation for the different pulses b. Check for you feel the pulses
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Fig. 23 a. No data received indicates if disconnected or faulty board b. Lists of the different versions of the circuit boards and its software version, in the manikin c. Reset Node Communication A reset will reread the versions
4.6.10. Power
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Fig. 25
a. Defib i. Defib energy measured energy ii. Defib type b. Pacing i. Pacing threshold level for pacing capture
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Fig. 26 a. Reset b. RS495 Node Comm. ii. Reset Node Communication iii. Read Sumlog c. Calibration iv. Calibrate BP Cuff calibrate if necessary v. Calibrate Valve Board calibrates offset vi. Calibrate Stomach If calibration needed apply 56cmH2O to esophagus and stomach sensor vii. Init Flow Sensor if flow meter is stuck use this to reset the piston in flow meter, follow instruction viii. Calibrate Flow Sensor follow instruction d. Debug for test purpose only ix. Antenna sel manual mode x. RFID xi. IV Flow meter Configuration xii. Flow meter piston position xiii. Invert direction xiv. Enable reading e. IV Board Power Save Mode xv. Get Power Save Mode
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4.6.14. Autotest
Fig. 28 Autotest
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Fig. 29
b. Debug i. Start Log ventilation data ii. Start Log compression data
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Fig. 30
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5.
INTERCONNECTION SYSTEM
5.1 Cable Connections Between the Circuit Boards
Following schematics and figures are representing the total infrastructure and interconnection system in the manikin.
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5.5. Cables
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6.
EXPLODED VIEWS
Following figures illustrates Exploded views of the different parts and modules in the manikin. NOTE: The BOM reference numbers on the illustrated pages are NOT spare part numbers that can be ordered. The drawings and numbers are for illustration only. Please refer to the pages XX YY for Replacement & Service Parts.
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6.9. Torso
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6.10.
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6.11.
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6.12.
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6.13.
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6.14.
Chest Assembly
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6.15.
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6.16.
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6.17.
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6.18.
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6.19.
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6.20.
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6.21.
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6.22.
Power Panel
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6.23.
Fluid Panel
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6.24.
Pelvis Assembly
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6.25.
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6.26.
Stomach Assembly
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6.27.
Leg Right
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6.28.
Pressure Tank
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6.29.
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6.30.
Compressor
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6.31.
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6.32.
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6.33.
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6.34.
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6.35.
IV Arm w/Antenna
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Intranet
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Figure X: Overview of the communication system The Baseboard has two communication links for communication with other devices: Ethernet: Communication channel for talking with server software on System on Module (SOM) RS485 bus: Communication channel for embedded node devices
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TEST
Head/Neck Assembly: Inspect head skin for overall appearance Perform direct laryngoscope, inspect: epiglottis, vocal cords, upper trachea, esophageal area for damage, rupture or leakage. Inspect teeth and neck assembly for overall appearance Airway/Breathing - Decreased Cervical Range of motion - Trismus - Pneumothorax left/right - Inflation - pressure detection - Lung pressure detection - 4 level left/ right airway resistance - Pharyngeal swelling - Laryngospasm - Tongue edema - swollen tongue (2 levels) - Exhale CO2 - 4 level lung compliance - Stomach distension - Controllable open/closed airway; automatically or manually controlled - Stomach pressure detection - Head tilt/chin lift - Jaw thrust w/articulated jaw - Detection of proper head position - Bag-mask ventilation - Esophagus/esophagus pressure detection Confirm variable respirations are present when increased/decreased from test utility Confirm apnea causes no breathing when
PASS/FAIL
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TSM Draft When simulator producing spontaneous respirations, confirm presence of respiratory sounds from simulators Confirm presence of capnograph waveform on patient monitor to match each respiratory cycle Chest Movement: Confirm detection in test utility of: - Single precordial thump? - CPR compressions - Bag-valve-mask while ventilating Confirm that CPR artifacts is being produced on the patient data display monitor when chest compressions are being performed Right leg Assembly: Inspect skin for holes or damage Inspect leg-to-pelvis attachment (thigh joint connectors, connectors for tubes and cables) to allow correct movement Inspect ankle joint Inspect handler for tank drain valve Torso Assembly: Inspect skin for overall appearance. Check that that ECG studs and defib. connectors are clean. - Chest drain pleura in place, left - Chest drain pleura in place, right Inspect for overall external appearance Ensure head assembly-to-torso hardware is tight and that head rotates freely from side to side and forward and backward. Inspect chest plate for overall appearance and free movement into and out of torso cavity Inspect torso-to-pelvis attachment screws. Each should be properly secure (check with screwdriver). Pelvis Assembly: Inspect for overall appearance Right arm Assembly: Inspect skin for holes or damage. Inspect arm-to-torso attachment screw to allow full articulation. Left arm Assembly Inspect skin for holes or damage. Inspect arm-to-torso attachment screw to allow full articulation Power Panel (Right side) Page 94 of 127
TSM Draft Check connectors and cables for damage and for easy connection to mating parts Fluid Panel Check connectors for damage and for easy connection to mating parts Sound (BP) Confirm presence of BP sound in left arm. Sound should be present at set systolic pressure and diminish to absent at diastolic. SpO2: Verify that the red light is illuminated on the probe when the unit is plugged into the Patient Monitor. Confirm that when the SpO2 probe is plugged in and not on SimMan3G finger, there is no waveform or numerical value produced on the patient data display monitor. Confirm that when the SpO2 probe is plugged in and on SimMan3G finger, a waveform or numerical value is produced on the patient data display monitor. ECG and Electrical Therapy: Confirm presence of ECG at lead and at hands free (sternum and apex). White lead on patients right shoulder, black lead on patients left shoulder and red lead on patients left lower torso. With running rhythm set at VF, waiting rhythm at NSR, and ignore shock is active, confirm that defibrillation at 360J WILL NOT move waiting to running rhythm. Three (3) shocks at the defibrillators maximum Joule (minimum 200J) are to be delivered as rapidly as possible. With running rhythm set at VF, waiting rhythm at NSR, and shock enabled, confirm that defibrillation at a minimum of 50J WILL move the waiting rhythm to the running rhythm. With the running rhythm set at NSR at 40, and pacing disabled, confirm that pacing at 200mA WILL NOT capture With the running rhythm set at NSR at 40, pacing threshold set at 40mA, and pacing enabled, confirm that pacing greater then 80mA WILL produce capture and create a pulse rate matching that set on TCP device. Eyes - Wide open - Closed Page 95 of 127
TSM Draft - Partially open - Normal speed of response to light - Sluggish speed of response to light - Pupil diameter automatically responds to light: Synchrony/asynchrony - Blinking - Normal - Winks Breathing - Simulated spontaneous breathing - synchronized with respiration rate - Normal and abnormal breath sounds - 5 anterior auscultation sites - 6 posterior auscultation sites - Unilateral & lobar breath sounds - Oxygen saturation & Plethysmogram - Bilateral and unilateral chest rise and fall - linked to airway complications settings - CO2 exhalation - linked to the student action of measuring CO2 Cardiac - 12 lead dynamic ECG display - Extensive ECG library with rate from 0-220 - Heart sounds four anterior locations Circulation - Pulses synchronized with ECG - Posterior tibialis - Dorsalis - Popliteal - Femoral Left - Femoral Right - Radial - Brachial - Carotid - Checkpoint: relative pulse strength (peri vs. central) - Pulse strength variable with BP Other - Head sounds - Head microphone Page 96 of 127
TSM Draft - Convulsions - Patient Voice/Throat Sounds - Custom sounds - Pre-recorded sounds played - Instructor can simulate patients voice wirelessly - Bowel Sounds speaker in each quadrants - Bleeding - Integrated system allows simulation of bleeding throughout manikin - Arterial and venous - Secretions from eyes, ears, nose, mouth, forehead, urinary output - Blood, Mucous, CSF, etc. - Urine output variable - Instructor communication Multiple instructors can communicate using integrated voice over IP communications - Cyanosis CPR: Compliance with 2005 Guidelines - CPR compressions generate palpable pulses, Blood pressure wave form, and artifacts on ECG - Realistic depth of compressions (6 cm) - Detection of depth and frequency of compressions - Detection of leaning - Real time feedback on quality of CPR - Hand position detection - Defibrillation and cardioversion - Pacing - Reading of cardiac rhythms via 4 connector 3-lead ECG monitoring Circulation - Palpation is detected & logged - Vital signs automatically respond to bleeding & therapy (Auto Mode only) - BP measured manually by auscultation of Korotkoffs sound (left arm) - Tibial IO module in place - Sternal IO module in place
RFID detection - Automatic drug recognition system identifies drug within the specified IV area & measures dose - Automatic drug recognition system identifies actions Page 97 of 127
Other - Bleeding treatment (bandage, pressure point, tourniquet, pliers) - Urine Catheterization (Foley) - Connect fluids from external sources - Debriefing functionality - Webcam integration - Debrief Viewer Test Performed by: ______________________ (Print name) ______________________ (Signature) Date:________
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ATTACHMENT 1
21260150
S21222
21260250
S21223
21260350
21260450
1007014
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21260550
21260650
N0831
21260750 21260850
21260950
21261050
FST1011
SAPS Head Board (NOTE: comes without air distribution unit and tubes)
21261250
N0739
CAROTID
L
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61450
21261650 21261750
N1187
Y Cable microphone
N0977 (10)
Plug (ear)
21261850
N1186
21262150
N0724 N0722
Neck Assembly
21262450
S21221 N1114
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21262550
21262650
N1031
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Torso
21272050
N1000
21272150
N1033
21272250
N1025
21272450
N1023
21272550
N1024 N0837
21272650
N1008
21272750
N1020
21272850 21272950
N1007 N1027
TSM Draft
N1036 N1159
8767 (10) Need Photo 2707 (10) Need Photo 2995 (10) Need Photo 2708 (10)
ECG connector Defib. connector Connection Peg ECG Connection Peg Defib
21273550 21273650
N1021
N1022 21273850 21273950 21274050 21274150 21274250 21274450 21274450 Need photo FST1009 N0968 N0969 N0984
Cable, ECG to defib sternum SAPS Base Board Cable, Baseboard com. to Head Cable, Baseboard com. to Valve Board Cable, Baseboard com. to Right Arm Cable, Baseboard On/Off switch Need Photo Cable, Baseboard to external Ethernet Cable, Baseboard to External Power
Need Photo
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21274550
N0999
21274650
N1001
21274750
N1006
21274850
7020 (10)
21274950
N1065
21275050
N1125
Antivibration Kit (for fan) Gap pad (between a CPU and heat sink)
21275150
N1188
Need Photo
N1247
N0870
TSM Draft
N0882
N0883 Need Photo S21234 Need Photo 2154 (4) Need Photo FST1009
Optical switch Compression Assy Pulse Unit (pkg 4) Base Board, SimMan 3G
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Pelvis
212-68050
N1101 (10)
212-68150
N1017
212-68250
N1109
Stomach valve
212-68350 212-68450 Check if already existing Cat. # 212-68550 Check if already existing Cat. #
N1040
Stomach foam
1005066 S
1005065 S
212-68650
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212-68950
N0997 (5)
212-69050
N1092 (10)
212-69150
N1103 (10)
212-69250
N1250
212-69450
N1266 (10)
212-69850
N1198 (10)
212-69950 N1201 (10) N1096 (5) Fluid tank connector female (pkg 10) Check valve fluid (pkg 5)
212-70050
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212-
N1031 (5)
212-70350
FST1010
212-70450
N0992
Leg
212-70550
N1102
Proportional valve
212-70650 212-70750
Blood tank connector pelvis male (pkg 10) Blood tank connector pelvis female (pkg 10)
212-70850
N1045
212-70950
N1066
212-71150
N1105
Pressure regulator
212-71050
N1167
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Arms
Cat. no BOM Photo Description
21263050
Hand Right 21263250 N0631 N1050 (10) N1051 (10) Pulse Skin Small (radial pulse) Pulse Skin Large (brachial pulse)
N1004
Cable, BP_speaker 21263650 N1018 21263750 Cable, Left Convulsion adapter to IV-PCB
N0895
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Convulsion Assy complete 21263850 S21252 N0629 N0630 N0657 (antenna wire) N0860 (4) FST 2007
21263950
21264050
N0936
IV Filter house
FST2011
Cable, Power (Drug Reg. Board to Base Board) N0896 Cable, Left Convulsion to adapter N0894 N0658 Need photo Cable RF Ant. Select board to Jaw Ant. Board Sound reduce foam (flow meter) N0750
21264650
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Legs
Cat. no BOM Photo Description
21265050
21265150
N0710 N0778 N0783 N0840 (2) N0780 N0800 N0681 N0799 Need photo
21265250
Drain block Drain valve N0783 Connecting tube N0840 T-connection N0780 Drain tube N0800 Compressor tube N0840 T-connection N0681 Knee module N0799 Pressure tube
N0708 Foot Right Core Need photo N1053 TBD S21271 Need photo Need photo Foot right skin Ankle joint complete Pressure tank Assy complete
21266150
21266250 212-
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65250 N0840 (2) N0780 N0800 N0681 N0799 Need photo compressor to leg)
21266650
21266750
N1195 (10)
21266850
S21273
21266950
N1156
21267050
21267150
N1005
N1134 N1054
Need photo
N0953
Need photo
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ATTACHMENT IV Graphical User Interface GUI Auto Mode: running validated built in patient cases GUI in Auto Mode:
1 3 2 8
5 6
Screen sections include: 1. Program menu bar 2. Learner events 3. Instructors patient monitor 4. Patient status and Airway status 5. Technical status 6. Performance 7. Simulation control and session log 8. Common learner events
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1 2 3
11
4 10 5 6 7
Screen sections include: 1. Program menu bar 2. Learner events 3. Instructors patient monitor/Cardiac controls 4. Eyes 5. Airway and breathing 6. Circulation & fluids 7. Sounds 8. Technical status 9. Performance 10.Simulation control and Session log 11.Common learner events
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1 5 2
6 4
10
Screen sections include: 1. Program menu bar 2. Learner events 3. Instructors patient monitor/ Cardiac controls 4. Eyes 5. Airway and breathing 6. Circulation & fluids 7. Sounds 8. Technical status 9. Performance 10.Simulation Control and Session Log
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Breathing No chest rise Only unilateral chest rise Resistance will not change Check if manikin is in sleep mode due to recent inactivity, reactivate the manikin Check for leakage in chest rise bladders Check if tubes are disconnected from chest rise bladders Check if tubes are kinked Check if air from compressor, and check if the condensation relief valve is closed If recently used, compressor may be overheated and is cooling down, wait 20 minutes Restart manikin
- Valve could be clogged/broken - Leakage in chest rise bladder - Servo motor for lung assembly stuck - Lost communication with valve board (Reset valve board and see if it calibrates) Check for lung silicone string in the lung assembly intersects between the lung bladders folds Silicone tubing has been forced down causing conflict between hook and lung plate top. Lift silicone tubing up Lost communication with valve board (Reset valve board and see if it calibrates) If there is shallow chest movements and the internal compressor never stops running Compressor is worn, replace compressor Kinked tubing or leakage Check settings in GUI Page 119 of 127
TSM Draft CO2 exhalation - If no CO2 present it might be the valve not working (in pelvis) - Kinked tubing - Empty CO2 tank?
No Oxygen saturation and waveform No Cyanosis Not possible to do chest tube insertion Broken cable in head (under face skin) LEDs loosen and fallen behind airway Problems with communication with head
Airway Complications No detection of Head position No Tongue edema - Kinked tubing - Check communication with head - Kinked tubing - Check communication with head - Leakage in bladder - Broken valve - Check communication with head - Kinked tubing - Check communication with head - Leakage in bladder - Kinked tubing - Check communication with head - Leakage in bladder - Kinked tubing - Check communication with head - Leakage in bladder - Kinked tubing - Check communication with head - Leakage in bladder
No Laryngospasm
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Pulses Pulse does not work - Check if broken cable - Check circuit board - Carotid pulses: Baseboard - Femoral pulses: - Brachial: IV Board - Left Pedal Pulses: Baseboard - Right Pedal Pulse: Compressor board - Pulse unit might be stuck, change pulse unit - Pulse driver on baseboard - Broken cable Skin may be too tight over pulse units, readjust skin and restart manikin NOTE: These pulses are programmed to be weaker than central pulses like carotid and femoral pulses, and can be harder to detect/feel - Compressor board failure
Pulse is working, but palpation is not detected on Instructor PC Cannot feel pedal pulses
Debrief Viewer Web-camera doesnt record video capture for use in the debriefing Check that the web-cameras USB-cable is plugged into the Patient Monitor PC. Connect to the same USB connector every time Check the Profile Editors webcamera settings. Ensure that the settings match with how the webcamera is connected. Ensure that there are not other active USB cameras on the PC Ensure that the computer to which the web-camera is attached Page 121 of 127
TSM Draft is available when going to debrief Check that the name of the Patient Monitor PC being used corresponds with the settings in the profile in use
WLAN Connection between the PCs and the manikin is frequently lost The WLAN might interference with other radio traffic or noise (e.g. Bluetooth, cell phones) Could try to change WLAN channel (ref. DFU). Also see the SUN site for more help in choosing the best channel Avoid solid material (especially metal) blocking the signals Windows Vista have features for power management, there are settings that controls the WLAN adapter. Please configure it for Maximum performance When the manikin is stationary, customer could consider using wired network between the manikin and PCs
The manikin works with LAN cable, but not with WLAN
If it is possible to connect the manikin on WLAN using another computer, the problem most likely relates to the actual computer - Check if WLAN is enabled on the computer 1. Check that any button on the computer that controls WLAN is set to enable or on 2. Check that WLAN is not disabled by the driver - Check that the adapter is set up with the correct TCPIP settings. Default is using DHCP (Obtain an IP address automatically) - The WLAN adapter drivers and utilities might be equipped with Page 122 of 127
TSM Draft features that allow intelligent control of the radio. These sometimes decide to shut down the adaptor for some reason. Typically this happens after the computer has been in sleep mode or similar. Disable such features. Consider removing OEM utilities all together and rather use Windows built-in features instead. If it discovers other WLAN networks, but not the manikin, start looking for problems in the manikin: - Check if the WLAN adapter inside the manikin is properly connected to the USB cable connector marked WLAN and not the auxiliary USB connector - Check the networks settings by attaching an empty USB memory stick to the auxiliary USB connector and remove it after 30 sec. An xml-file should be created on the memory stick. Open the file using text editor (Notepad etc) and check that networks settings are correct - As a last resort you may restore the manikin to fabric defaults. This could be done by attaching the external optical drive to the auxiliary USB connector and inserting the recovery DVD. Then start up the manikin. The recovery process will take a considerable time. Vocal feedback will be played through head speaker. Once recovery is finished you may have to update the SW using the Update Manikin feature.
The problem often is related to security keys - SimMan 3G uses WPA authentication by default. The Page 123 of 127
TSM Draft default password is SimMan 3G You might have a problem with a WLAN profile, please delete existing WLAN profiles associated with the manikin and try reconnecting Make sure that the SimMan 3G manikin and the PC are powered on From the PC, run cmd (Windowsbutton + R), type cmd and press enter Type ping-t 192.168.170.1 (with wireless connection) or 192.168.169.2 (with cable connection)
NOTE: The same numbers apply for all manikins You will get error messages if you are missing connection, retry or contact 3rd Line Support, R&D Laerdal.
RFID No RFID Tag is detected - Could be interrupted of metal, move manikin and try again - Lost communication with IV arm - Tag not working, try another tag - Problems with antenna select board Could be from a wrong batch, not programmed - Jaw antenna: Check if antenna wire is properly connected - Antenna in IV Arm: Check if properly soldered on circuit board - Check for moisture/water/corrosion in IV arm - Tune antennas Page 124 of 127
A certain RFID Tags is not detected RFID Tags are difficult to detect
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SOUNDS No Vocal Sound No Heart Sound No Lung Sound No Korotkoff Sound - Check cabling - Check cabling - Check cabling - Check cabling - Correct pressure applied?
Eyes Eyes always closed Pupils do not respond to light, when running Healthy Patient Check communication with head Check settings in GUI If eyelid is loose you will have to restart the headboard/manikin Check communication with head Check settings in GUI Shaft has loosened from cog wheel. Replace eye module Recalibrate or restart manikin/headboard Check settings in GUI Check communication with head Check settings in GUI Pupils are stuck, replace eye module
Eyes always open Strange sound from eye module Pupils not synchronized when running Healthy Patient
- Try to push in eyelid shaft - Check for friction between eyelid and skin
Secretions No secretions from Ears Check tubing from pelvis and for kink in head Check valve Page 125 of 127
TSM Draft No secretions from Nose Check restriction manifold in head (under face skin)
Check tubing from pelvis and for kink in head - Check valve - Check restriction manifold in head (under face skin) Check tubing from pelvis and for kink in head Check valve Check restriction manifold in head (under face skin) Check tubing from pelvis and for kink in head Check valve Check restriction manifold in head (under face skin) Particles in valve, flush in opposite direction
Blood/ Fluid /Secretions/ Urine Can not turn urine off Particles in valve, flush opposite direction
CPR Not detected on Instructor PC when doing CPR Check cabling Check for damage on compression sensor unit
IV Access Not possible to do injection Do not force injection! (could cause leakage inside arm) Try initialize and calibrate via Test Utility Page 126 of 127
TSM Draft IV-fluids and drugs are incorrectly measured Reset arm/manikin If still not working open arm and look for any damages in IV system/Flow meter Check if is possible to inject only through IV Catheter, if not replace IV Catheter If the problem is not the IV Catheter replace the Flow meter Clean the IV arm with distilled water and ethanol solutions (ref. DFU) Recalibrate the flow meter (on Instructor PC, go to ToolsMaintenance-Calibrate IV Flow meter)