Infant Airway Management Trainer Directions for Use

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Contents Cautions and warnings... 2 Introduction... 3 Instructions for use... 3 Maintenance... 4 Parts list... 6 Product specifications are subject to change without notice.

CAUTIONS AND WARNINGS Material compatibility Do not allow the manikin's skin to come in direct contact with ink or photocopied paper, as this can cause permanent stains on the skin. Using protective gloves when handling the trainer will also reduce the risk of staining. However, avoid coloured vinyl or latex gloves as these may cause discolouration of the trainer's skin. The face skin and airways must not be stored together with parts made in soft PVC, as this can damage the material used for the new parts. Upper airways Always make sure that the airways and tube have been properly lubricated before practising intubation on the trainer. This is important both to provide the proper realism and to reduce the risk of damaging the manikin's upper airways.

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INTRODUCTION The Laerdal Infant Airway Management Trainer is mounted on mounting base, and simulates a 3 month old infant head. It is designed to provide the following common diagnosis and treatment modalities: Airway management - Ventilation via bag-valve-mask - Endotracheal and nasotracheal intubation - Bilateral lung movement and stomach distention - Oral/Nasal Airways - Insertion of LMA (Laryngeal Mask Airway)

Head tilt In the neutral position, the airways are open. If ventilated via bag-mask in this position, air will enter the lungs. If a too rapid ventilation is performed, causing an air pressure in excess of 10 mm Hg, stomach distension will occur. Hyperextension of the head/neck will not cause the airways to close.

Getting started Before use, perform the following preparations:

Lubrication of the airway During this procedure, wear protective gloves to avoid contamination. Spray into the mouth/airway using the lubricant spray (supplied with trainer). Also lubricate the tip of the endotracheal tube and laryngoscope blade before performing endotracheal or nasotracheal intubation.

Jaw thrust The trainer also allows jaw thrust to be performed. Performed in the flexed position, the airways will open and allow ventilation by bag-mask.

INSTRUCTIONS FOR USE Ventilation

Insertion of LMA Insertion of LMA can be practiced. A size 1 LMA is recommended.

Airway open/closed - Stomach distension In the flexed position, with the head resting forward onto the chest, the airways are closed. If an attempt is made to ventilate the manikin via bag-mask between this position and the neutral position, air will not enter the lungs. If an air pressure of more than 10 mm Hg is applied, stomach distension can be observed on the trainer. 3

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stomach part. The trainer will expel all air back through the mouth and nose. Airway hygiene Please note that if mouth-to-mouth or mouth-tonose ventilation has been performed, a thorough cleaning of the upper airways, and a replacement of the lungs and stomach are necessary. See section "Cleaning upper airways". However, we recommend that this trainer not be used for mouth-to-mouth or mouth-to-nose ventilation. MAINTENANCE Lubrication It is essential that the upper airways are properly lubricated in order to obtain the intended realism and durability. Take care to lubricate the airways, endotracheal tube and laryngoscope blade as described in section "Lubrication of the airways" on page 3 before using the manikin.

Intubation The trainer can be intubated via the oral and nasal routes. A 3,5 mm tube is recommended to avoid backward air leakage. A No. 1 laryngoscope blade is recommended. If intubated too deeply, the tube will pass into the right mainstem bronchus, causing ventilation to the right lung only.

Replacing or cleaning the face skin To remove

Important: Always make sure that the airways and tube have been properly lubricated before practising intubation on the trainer. This is important both to provide the proper realism and to reduce the risk of damaging the upper airways. Use the lubricant spray supplied with Infant Airway Management Trainer.

1. Detach face from retainer at each ear. 2. Lift off face. To clean Clean face skin as follows: - Immerse face skin into a disinfectant solution*. - Scrub stubborn stains when necessary and leave for 10 minutes. - Rinse with fresh water. - Allow face skin to dry.

The cricoid pressure technique (Sellick manoeuvre) can be realistically performed on the Infant Airway Management Trainer.

*Note: Virkon can be used. Depending on local policies you may prefer to use a freshly prepared sodium hypochlorite solution. Local cleaning and handling procedures must then be followed.

Lungs, stomach The trainer contains two separate lungs and a stomach. They are designed to provide movement during ventilation of either lung or distention of the stomach. To expel air from the stomach, simply press on the

Alternatively replace with new face skin (Cat.No. 08 33 10).

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To install

1. Fold face upward to avoid direct finger contact with mouth and nose area.

- With the stomach positined outside the ”body”, fold the lungs back into the body

- Connect the two lungs to the carina (Y-piece).

2. Unfold face over head.

3. Fasten retainer at each ear.

- Mount the stomach pressure valve band over the two tabs.

Replacing the lungs/stomach To remove - Remove stomach pressure valve band. - Unsnap and discard the lungs and stomach.

Cleaning upper airways To remove To install - Unpack new lung/ stomach (Cat. No. 250-20250).

- Press down tab on inner neck connector and pull head away from body part. - Remove face skin as described in "To remove" in section "Replacing or cleaning the face skin". - Unsnap and discard the lungs and stomach.

- Connect stomach to oesophagus end of head/airway assembly.

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To clean - Open and empty the cleaning kit basin (optional Cat. No. 081500).

PARTS LIST 250-20150 250-20250 250-20350 250-20450 250-21050 081500 082022 083300 083310 083320 252090

- Place the trainer head face down in the cleaning basin.

- Connect the two lung tube connectors to the double Y-piece in the tube system. - Connect the oesophagus to the single connection in the tube system. - Insert the cleaning syringe into the valve opening and place the free end of the tube system into the basin. - Fill the basin with liquid to just underneath the edge. Circulate liquid through the manikin airways by pumping the syringe plunger. - Use this setup to go through the following steps: 1. Use a Disinfectant solution*. Airways should remain completely filled for at least 10 minutes. 2. Use fresh water to remove disinfectant solution. After each step lift the head clear of the liquid to allow drainage. 3. Allow to dry completely before reconnecting head to body part. * Virkon can be used. Depending on local procedures you may prefer to use a sodium hypochlorite solution freshly prepared for single class use.This solution should have at least 500 ppm free available chlorine, i.e. 22 ml of 2.5 - 5.0 % household bleach per 500 ml of water. Local cleaning and handling procedures must then be followed.

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Body part Lungs/stomach (pkg. 3) Base plate Cover Airway Lubricant (45 ml) Cleaning kit Stomach valves (pkg.10) Head cpl. Face skin Head without face skin Airway lubricant (180 ml)

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