Next - Typical Simulator Applications Download a Video Clip from promotional CAE-Link video. (N.B. size 1.2 MB) Components of the EagleSim Realistic Simulator Mannequin full-size human model anatomical airway realistic mouth, pharynx, larynx, trachea, mainstem bronchi and esophagus - operator-controlled airway swelling / laryngospasm - devices to limit motion of the mannequin's neck and jaw -window to perform cricothyrotomy - able to intubate with standard ET tubes, double-lumen ET tubes, and CombiTubes mechanical lungs - ventilate passively through hand ventilation or a mechanical ventilator - ventilate spontaneously under control of the computer based on mathematical models - operator can adjust compliance of the lungs separately - can simulate a pneumothorax CO2 is infused into the mechanical lungs under computer control, simulating end-tidal concentrations in scenarios such as hypotension, air embolism, malignant hyperthermia bilateral anterior chest and axillary speakers providing heart and breath sounds detectable with a stethoscope - can mimic wheezing on command pillow-mounted speaker which allows the operator to speak as the patient palpable pulses at both carotid and radial arteries points on the mannequin' s arm where IV fluids can be given mechanical right thumb that responds to a standard nerve stimulator eyelids that open, close and blink under physiological control or by operator pupils that provide normal and abnormal reactions to light stimuli Interface Cart generates electrical signals that are then sent to standard anaesthesia monitors, mimicking the signals picked up from a real human patient, thus giving true-to-life data representation library of digitized sounds to portray heart beats, breathing, wheezing, etc integrated gas analyzer that samples airway gases to determine agents and gases delivered to the mannequin agent and gas concentrations are then used by the physiological models to control patient status connected to a drug recognition system - drug injection ports recognize computer-chip encoded syringes and flowmeters can determine the volume of fluid injected the computer calculates the simulated dose of drug alters the simulation automatically to reflect the effect of the drug and relays information to the operator's workstation Operator's Workstation runs simulation in real-time allowing operator intervention at any time, not script-based - graphical user interface with mouse and pop-up windows library of mathematical physiological models controlling: heart function / hemodynamcs pulmonary function / ventilation fluids / glucose / temperature drug kinetics / dynamics manipulates the mannequin's physiological responses starting with the patient profile selected by the operator and then modified in real time as the trainee interacts with the mannequin and administers drugs starts with a default patient with a normal physiological profile, provides a library of patients with various diseases (e g appendicitis, severe asthma) and allows the operator to edit or create new patient profiles by altering an extensive list of physiological variables (e.g. patient age, weight, base heart rate, baroreceptor gain, lung tidal volume, pulmonary shunt fraction to name just a few) provides a library of events pre-designed but which can be modified (e.g. anaphylaxis, bronchospasm, myocardial ischemia) case scenarios can be run from the beginning (before anything has happened) or can be started in the middle of cases which have been done previously (like bookmarks, called "snap restore") manual input of gases and anesthetic agents is possible if real agents are not used manual input of drug choice and dosage also possible - over 70 drug choices available manual input of intravenous fluid management real-time patient lab data (e.g. arterial blood gases, electrolytes, hemoglobin) Simulated Monitor Data Output ECG waveform standard 3 or 5 leads connected to electrically conductive studs on the mannequin's chest arrhythmias and ST-T changes are possible, either by physio model or by operator control; defibrillation can be simulated as well non-invasive BP air pressure line from the interface cart is spliced into the tubing for the BP cuff and upon sensing the start of a BP determination, the computer will send line pressure impulses to simulate the arterial pressure impulses under the BP cuff bladder invasive BP - monitor-specific (e.g. Datex AS/3) cables go directly from the interface cart to the appropriate sockets on the monitor, allowing the computer to output electrical signals to simulate arterial, central venous, pulmonary artery, pulmonary capillary wedge, right ventricular and right atrial pressure waveforms to the vital signs monitor cardiac output - cardiac output is calculated continuously by the math models and can be signaled to the vital signs monitor, including a waveform pulse oximetry a cable from the interface cart supplies the signal to the monitor and provides the blood oxygen saturation data; the finger probe is simply a simulation prop gas analysis as mentioned above, CO2 is injected into the lungs of the mannequin, the resulting capnogram upon ventilating the lungs is quantitatively appropriate but the waveform may be less than accurate when viewed on standard OR gas analysers. The mannequin does not absorb or excrete gases or anesthetic agents as a human would; therefore, end-tidal concentrations rise faster than expected. ventilatory parameters - tidal volumes are generated accurately and will therefore be measured appropriately during spontaneous breathing elevated airway pressures during mechanical ventilation can be generated on demand by mechanically restricting lung movement Other Equipment / Room Setup modern anesthetic gas machine (Aestiva 3000 - supplied by Datex-Ohmeda) - unaltered in any way, complete with isoflurane, sevoflurane and desflurane vaponzers anesthesia vital signs monitor (S/5 - supplied by Datex-Ohmeda) intensive care unit vital signs monitor (supplied by Agilent - Hewlett-Packard) defibrillator with simulated discharge Audio- Visual Equipment video cameras ceiling-mounted to record scenarios video-mixing equipment to superimpose the data from the vital signs monitor on to the video images as they are recorded wireless intercom system for operator to communicate with actors while scenario is in progress conference room to view video for debriefing discussion Next - Typical Simulator Applications