Orientation to SimMan™ the Human Patient Simulator By Gail Heimburger, M.Ed. Director Clinical Skills Laboratory University of Cincinnati, College of Medicine

FAQ’s for the first-time users How does the SimMan™ work? What procedures can I do? How will I be evaluated on my skills? Oooooooops…….can I break the SimMan™?

What is the SimMan™? SimMan™ is a fully computer operated total body simulator SimMan™ is totally mobile and can be moved to many different locations

How does the SimMan™ operate? SimMan™ can be operated by: using instructor generated cases teaching “on the fly” by the instructor utilizing standard cases from the simulation community individuals engaged in the practice of skills and/or procedures

What can I do on the SimMan™? Check for radial pulse using the left arm Check for brachial pulse also on the left arm Pulses can demonstrate differences in strength and regularity

Carotid pulse points Carotid pulses are located on both sides of the neck Carotid pulses only last for about 10 beats before needing reactivation

Femoral pulse points Bilateral femoral pulses are palpable Do not use the femoral site for cannulation as this is an electronic pulse point only

Airway management Placement of endotracheal tubes Combitubes Laryngeal mask airways (LMA) Retrograde intubation Fiberoptic procedures Bronchoscopy

Airway management Bag-Valve-Mask devices Jet ventilation Standard ventilators Oral/nasal pharyngeal airways Light wand intubation

Airway complications Tongue edema Laryngospasms Posterior pharyngeal swelling Trismus Decreased cervical range of motion Decreased right and/or left lung compliance

Surgical procedures Needle cricothyroidotomy Surgical cricothyrodotomy Decompression of a tension pneumothorax Chest tube insertion

Features of the chest Bilateral lung sounds Featured sound include rales, rhonchi, wheezes, and pneumonia The chest rises and falls SimMan™ can exhale CO2

Cardiac Exam Cardiac auscultation is possible at several listening points Many different auscultatory events are represented

Blood Pressure Blood pressure can be measured on the left arm with either an aneroid or mercury sphygmomanometer Automated blood pressure is also displayed on the student monitor Korotkoff sounds are available

Other procedures SimMan™ can be defibrillated at 200J, 300J, and 360J He can receive 3 stacked shocks without damage Be sure to yell “CLEAR” before defibrillation!

Other procedures SimMan™ can be used for SQ and IM injections Five injections sites are provided on the manikin

Other procedures Nasogastric tube placement

Other procedures Foley catheter placement

Drug theorapy The right arm provides sites for cannulations, IV infusions, phlebotomy and drug administration

Instructor monitor All manikin functions are visually displayed

Student Monitor All vital signs are visually displayed

Student evaluation A clinical log is recorded for every student The event log is time dated Instructors can use the log in debriefing sessions Log data can be used for self-reflection and evaluation of skill sets Log data may be used for grading purposes

Ooops….can I hurt the SimMan™? Things do break under stress Treat the SimMan™ with the same care that you would use with a REAL patient The SimMan™ is quite hardy and will last many years with proper care

Enjoy using the SimMan™ throughout your medical education experience