User Manual
54 Pages
Preview
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User Guide
ALSI USER GUIDE VERSION 3 Learners Screen Quick Reference
Facilitators Screen Quick Reference
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ALSI USER GUIDE VERSION 3
Contents
Introduction... 5 Overview ... 5 System Organisation ... 5 Quick Start ... 5 Quick Picks ... 5 Scenario Building ... 5 The ALSi System ... 6 Key features ... 6 Contents of standard ALSi simulation kit ... 6 Specifications (iPad Air) ... 7 System Operations ... 7 Passwords ... 7 Installing, Starting and Stopping ALSi... 8 Quick Start ... 8 Access Control ... 9 Installing the system... 10 Updating the system ... 10 Exiting ALSi... 10 Step by Step Instructions for using ALSi ... 11 Instructions ... 11 Quick Start ... 11 Quick Picks... 11 Building scenarios ... 12 Running a scenario ... 16 Activating Parameters ... 17 Scenario Functions... 25 Changing scenario parameters on the fly ... 26 Adding new Quick Picks or Investigations on the fly. ... 27 Reordering Quick Picks ... 27 Editing Scenarios ... 28 Duplicating Scenarios ... 28 Emailing Scenarios ... 28 Version 3.0 March 2014
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ALSI USER GUIDE VERSION 3 Importing Scenarios and Terms ... 28 Quick Picks ... 30 What is a Quick Pick? ... 30 Quick Picks locations ... 30 Changing contents in the Quick Pick box ... 30 Examples of how to use Quick Picks... 30 The Facilitator Screen ... 31 Sounds ... 31 Changing Waveforms ... 31 The PEA Button... 31 The Cardio-Pulmonary Resuscitation (CPR) Button... 32 Trending Function ... 32 Virtual Time ... 33 Pacing & Shock Default ... 33 AED Mode - Pads Confirm ... 33 Measurement options... 33 Custom Values ... 33 Learner Screen Functions ... 35 Monitor Screen ... 35 Sounds ... 35 Alarms ... 35 Freeze screen ... 35 Contrast ... 36 NIBP ... 36 Arterial Blood Pressure ... 36 Waveforms... 36 Parameter values ... 36 Defibrillator Screen ... 36 Pacing Screen ... 37 Sync Screen ... 38 AED Screen ... 38 General Settings ... 40 To change the colours of the values and waveforms ... 40 To change other settings ... 41
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ALSI USER GUIDE VERSION 3 To change language or terms used ... 41 Tips and Tricks ... 42 Four-finger Swipe ... 42 Apple TV... 42 Connection ... 42 Bluetooth Speaker ... 43 Troubleshooting ... 44 Reference tables ... 45 Custom Values ... 45 Blood Pressure ... 45 Saturation of Peripheral Oxygen ... 46 End Tidal Carbon Dioxide ... 46 ECG ... 46 Facilitator Screen Quick Reference ... 49 Learners Screen Quick Reference ... 51
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Introduction Overview Welcome to the 3rd generation of ALSi, the best in simulation technology. ALSi allows simulation and scenario based education to be delivered quickly, easily and
intuitively. It is a hyper-flexible patient monitor simulator which uses 2 iPads connected
wirelessly. The system includes, an AED, sophisticated multi-parameter patient monitor and
defibrillator can all be simulated using the touch screen of an iPad.
ALSi can be connected to any manikin and it can be used with standardized patients. It is intrinsically safe as it does not deliver any energy.
System Organisation ALSi uses 2 iPads connected by Wi-Fi or Bluetooth to talk to each other. Wi-Fi can be provided using the supplied Apple Airport Express, Mobile Wi-Fi (Mi-Fi) or using the Personal Hotspot on one of the iPads.
Quick Start You will find a Quick Start section to get you up and running quickly on Page 8.
Quick Picks Read this section on Page 26 as it explain the importance of Quick Picks and will give you a great understanding of how these work.
A Quick Pick is a box that contains all the information that you want to show on the Learner Screen when selected. It can be a parameter or simply turns something on.
Quick picks are very powerful, but also simple to use. There is no limit to the number of Quicks Picks you can create or use in a scenario.
Scenario Building Building Scenarios is explained in detail on Page 12.
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The ALSi System Key features • • • • • • • • • • • • • • • • •
Powerful facilitator screen Sophisticated, realistic vitals monitor Smart and easy to use scenario builder Make changes on the fly in response to learner actions Over 50 ECG waveforms BP, CO2 and SpO2 waveforms and 20 additional parameter settings Realistic trending of vitals Timed or action based changes to events Virtual time and countdown timer AED, Monitor and Defibrillator mode Pacing and Synchronised Cardioversion Adjustable alarms Freeze mode Outdoor contrast mode Instant CPR and PEA simulation Auto NIBP Intrinsically safe
Contents of standard ALSi simulation kit
Monitor Bag
2 iPads (16GB Wi-Fi) (Optional iPad Mini option)
Smart Cover (Colour Varies)
iPad Facilitator Case
Defibrillation Training Pads
(Varies by country)
ECG Cables
SpO2 Cables
NIBP Cuff
Airport Express Wi-Fi
Mi-Fi
EtCO2 Filter Set (Varies by country)
Power System (Varies by country)
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(Varies by country)
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Specifications (iPad Air) Size iPad Weight
469 gms
LCD display
2048-by-1536 resolution at 264 pixels per inch (ppi)
Battery type
Built-in 32.4-watt-hour rechargeable lithium-polymer battery
Battery time
4 - 5 hours continuous use with 100% display brightness
Battery charging
Average 6 hours 0% to 100%
Communication
802.11a/b/g/n Wi-Fi (802.11n 2.4GHz and 5GHz). Bluetooth
Operating Conditions
Operating ambient temperature: 0° to 35° C (32° to 95° F) Non-operating temperature: –20° to 45° C (–4° to 113° F) Relative humidity: 5% to 95% non-condensing
System Operations
iPad User Guide: http://manuals.info.apple.com/en_US/iPad_User_Guide.pdf
Passwords Unless changed, the default password for Apple Accounts and Wi-Fi is iSimulate2012 (case
sensitive).
If the Wi-Fi has been reset back to default the password can be found under the battery of
the portable Wi-Fi device or will be defaulted to password. The login to Wi-Fi mobile devices
is normally admin.
We use the following Wi-Fi units: •
Apple Airport Express
•
NetComm Mobile 3G Wi-Fi Router - 3G24W
•
Telstra M60 Mi-Fi
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Installing, Starting and Stopping ALSi Quick Start The supplied system comes ready to run. To start using the supplied system follow these steps:
Plug in or turn on Wi-Fi on both iPads. Wi-Fi will automatically connect when iPads are powered on. o Both iPads must be on the same network. o The Wi-Fi network may have a Firewall that does not allow the iPads to “see” each other. o Consult your IT Department if the iPads are on the same network, but cannot connect. • Alternatively turn on Bluetooth on both iPads. o In both Facilitator and Student iPad’s go to ALSi settings > General Settings and ensure Bluetooth is switched to the ‘on’ position on both iPads. NOTE: To improve connection, turn off Bluetooth and WiFi in the settings area of the iPad Settings.
•
•
Power up both iPads by pressing and holding over the power button.
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Find the ALSi Icon on the facilitator iPad and press on icon to start application.
•
Accept the disclaimer to continue.
•
Press on Facilitator button.
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•
Select Quick Start or the Scenario you wish to run from the list.
•
This will bring up the start screen for the Facilitator. Note that the connection status is flashing Red as no learner monitor is connected.
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Find the ALSi Icon on the Monitor iPad and press on icon to start application.
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Accept the disclaimer to continue.
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Press on Monitor mode.
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This will bring up a Splash Screen. This means that the system is ready to run.
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Press Start Scenario on the Facilitator Screen when you are ready to start the scenario. This will change this button to Go.
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After the Scenario is started the learner presses on the Power Button to turn on the monitor.
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The display to the learner will vary, depending on the structure of your scenario. To show/hide the various parameters to the learner you touch over the box at the top of each parameter slide bar.
•
Blue – Show on monitor screen Light blue – Numeric values only Grey – Hide on monitor screen
Access Control By default the system does not have any access controls set. Apple account details are supplied on purchase.
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Installing the system ALSi comes pre-installed on systems that are supplied. For users with their own iPads, instructions for installation are provided on purchase. To install the new version on your facilitator iPad: 1. 2. 3. 4.
Go to http://www.isimulateonline.com on the facilitator iPad. Login using the supplied details Go to Downloads a. Download Facilitator on to Facilitator iPad – No serial number required. Accept Install and installation will occur
To install the new version on your learner/monitor iPad: 1. 2. 3.
5. 6. 7. 8. 9.
Go to http://www.isimulateonline.com on the learners iPad Login using the supplied details Go to Downloads a. Download Full version on to Monitor iPad b. This requires the serial number to activate which found under membership keys. i. Green – available ii. White – used iii. Red – unavailable Accept Install and installation will occur Open ALSi Follow instructions and enter Membership Membership Key (single use) Start using ALSi
Updating the system Notifications of updates will be emailed to the specified contacts. Follow the instructions to install new version.
You can check for new versions and update ALSi from Settings on the iPads. Connect to the internet on both iPads. On ALSi go to Settings > General
Settings and press on Software Updates. If an update is available this will be shown in this area. Follow the instructions to update.
Exiting ALSi To exit ALSi on the Learner Screen, double press over the ALSi Icon on the bottom left of the screen. Select Exit which will take you back to the Start Screen. Press the Home Button to completely exit. To Exit from the Facilitator Screen, press over Scenario and then select Exit to Menu. Press the Home Button to completely exit. Version 3.0 March 2014
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Step by Step Instructions for using ALSi Instructions Quick Start See Quick Start.
Quick Picks Quick Pick set value to show your requirements and include: • • • • •
Quick Pick name. Trending Time. Defibrillation enabled. Jump enabled. Parameter values.
Quick Picks can: Quick Pick name can be a state, event or action. Trending changes values over time. Defibrillation enabled will automatically move to the next quick pick when learner shocks. Jump enabled will automatically move to the next quick pick after a pre-set time. Parameter values sets the values for every parameter, including custom values. Parameters Show or Hide will set whether the monitor will show the value or waveform. Tapping the Plus/Minus button will increase/decrease values. Pressing and holding over the Plus/Minus button will rapidly increase/decrease values. Please note: Age and gender are important to ensure that the vocal and voice sounds are
correct.
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Building scenarios This section will take you through the building of scenarios. Scenarios can be as simple or as complex as you require. We will use the provided Welcome to ALSi Version 3 scenario. 1. Start ALSi 2. Open up Settings from the start screen.
1. In the Scenario Library press the Duplicate Icon of ALSi - Welcome scenario. This will create a copy of this scenario which you can modify. 2. In the Scenario Library press the Edit Icon of ALSi - Welcome Copy scenario. •
Name of the scenario – ALSi - Welcome
•
Patient age – 56
•
Patient Gender – Male
•
Custom values – CVP (You can add up to 3 from
the scrollable list) •
Folder – Not assigned. You can create and assign scenario to specific folders.
3. Scenario flow. This scenario has 4 Teaching Points, the first one is bold. • These boxes contain points that you would use as a guide to running the scenario, or as items that you require completed. These could be items such as ABCDE assessment, provide oxygen etc. • If you tap on these you can edit or format the Teaching Point. • You can add a Teaching Point by Selecting the + button. Press on the 4th Teaching Point. This opens the text area. • Select the Add (+) Button and select Duplicate Selected Item. This will duplicate the Teaching Point. • We will now change the text in the duplicated box. Once you select another box the changes will be made. • You can add many different items from this area.
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4. Select the 1st Quick Pick and this will show you the settings for this patient. 5. Change a number of settings in this area to see how this works.
6. Select the 2nd Quick Pick. • Note that only the parameters that we want to change are included with this Quick Pick. This Quick Pick was duplicated, and only parameters that we changed remain. • We have also added a Trending Time of 10 seconds. This means that the parameters that are changed will Trend from the Quick Pick above to the selected Quick Pick. 7. Select the 3rd Quick Pick. • Here we have changed the waveform, heart rate and SaO2.
8. Select the 4th Quick Pick. • Here we have changed the waveform, heart rate and SaO2 to mimic administration of Adenosine. • We have added a 3 second jump. This will automatically move to the next Quick Pick after 3 seconds.
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9. Select the 5th Quick Pick. • Here a number of parameters have been changed to show a successful reversion to Sinus Rhythm after the administration of Adenosine.
10. Select the 6th Quick Pick. • We have added additional waveforms here and given them a value. • We have also selected Show, so that when this Quick Pick is selected it will turn on this waveforms. • This allows you to choose what the learner will see and at what point in the scenario.
11. Select the 7th Quick Pick. • In this Quick Pick we have changed the waveforms that will be shown.
12. We have added an additional Teaching Point. 13. Select the 8th Quick Pick. • In this Quick Pick we have change the ECG waveform to a shockable rhythm and deleted all other parameters. • We have also Defibrillation Enable this Quick Pick. When the learner delivers a shock will cause it to move to the next Quick Pick, in this case it is ROSC.
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14. Select the 9th Quick Pick. • In this Quick Pick we have change the ECG waveform to a AF rhythm and added parameters to provide a ROSC outcome. • We have also added a 10 second trend. This will ensure that the learner will not see a perfusing patient SaO2 trace as it will take 10 seconds before the trend shows output. This should ensure that after a shock the learner commences CPR. 15. We have added 2 more Teaching Points.
16. Select the 10th Quick Pick. • In this Quick Pick we have activated the CVP value. All other parameters will continue to trend or stay the same.
17. Teaching Point 18. Investigations have been added and changed to match requirements. You can have multiple investigations as shown. • The parameters will go Red if out of range. • You can send these to the Learners screen when running the scenario.
19. We will now add an image to our scenario. • Click on the + Button. • Select Create New Image Gallery. You can have as many images as required in this area. • Use this area for 12 Lead ECG, images of wounds, scene images etc.
20. Enter a name for your image. You can also add a description if required.
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21. Click on the + Button in images. This will bring up your Photos. You can only add images that have been added to you Photos on the iPad. • Select the image you require.
22. Repeat to add additional images.
23. Save your scenario • Select the Back button • Press Yes in the Save dialogue box.
24. Select Initial Screen Setup. • In this section you decide what you want to learner to see and values for pacing and shock.
We are now ready to run our scenario.
Running a scenario 1. Press the Play Button to start the scenario. It will go Orange to open the facilitator screen, OR Select the Back Button to go to the main screen.
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2. • • •
•
Select Facilitator. Enter a Facilitator Name if not already done. Facilitator Name must be unique. Select your folder and the ALSi – Welcome Copy. You may need to scroll down to see more scenarios. This will open into the Facilitator Screen.
3. We will also need to connect the monitor as follows: • Find the ALSi Icon on the Monitor iPad and press on icon to start application. • Accept the disclaimer to continue. • Press on Learner Monitor button. • This will bring up the Splash Screen.
Once both screens are connected this will bring up the following screens.
Activating Parameters To activate a parameter the facilitator touches the parameter boxes at the top of each slide bar to activate that parameter. Box colours indicate the following:
Note: To activate a parameter the facilitator touches the parameter boxes at the top of each slide bar to activate that parameter. Box colours indicate the following: Blue – Shown
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Light Blue – Numeric only
Grey - Hidden
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Corresponding Learner Screen
Facilitator Start Screen. Start Scenario Button has not been pushed.
Standby Screen. This screen appears until Start Scenario button is pressed.
Start Scenario activated. Elapsed time starts once Start Scenario is activated.
Start Button becomes available for learner.
Blue parameters are shown. Grey are inactive.
If the learner has not attached any leads no waveforms or values should be activated by the facilitator.
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ALSI USER GUIDE VERSION 3 Facilitator Screen
Corresponding Learner Screen
The Teaching Point has been Tapped to show the task has been completed.
The learner has taken a BP by pushing the NIBP Start.
The Teaching Point has been Pressed and Held to make a comment.
The learner has set NIBP Auto Time a BP by pushing the NIBP Auto Start and select the time.
The Teaching Point has been Pressed and Held to make a custom comment.
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