Cardionics PAT User manual

OPERATOR’S MANUAL
PAT, the Pediatric Auscultation Trainer
Cardionics
910 Bay Star Blvd.
Webster, Texas 77598 USA
Telephone: [phone]
Fax: [phone]
E-Mail: [email protected]
PAT Pediatric Auscultation Trainer, Cardionics, E-Scope, CardioSim, SimulScope and
Heartmanare registered trademarks of Cardionics, Webster, Texas 77598 USA.
file:Op-PAT 0148850.doc
Copyright Cardionics 2012
All Rights Reserved

SAFETY PRECAUTIONS
Please read this information before using the SAM II, the Student Auscultation Manikin. It
applies to the basic System as well as any optional equipment that may be used with the
System.
In this manual, WARNINGS describes precautions necessary to prevent injury or loss of
life. CAUTIONS describe those precautions, procedures, techniques, etc. which are
considered essential to emphasize.
WARNING
SHOCK HAZARD: A shock hazard may exist if this System is not properly grounded. The
System is designed to operate with a 3-wire AC power system containing a separate ground
wire. The ground wire must not be removed or defeated.
WARNING
SHOCK HAZARD: Do not remove protective covers on any components of the SAM II manikin.
Hazardous voltages may be present. Cabinet panels for this System and all components must
be in place while the System is in use. All the internal adjustments, replacements and
initializations should be made by a qualified technician.
WARNING
CLEANING AND CARE: As a general safety precaution, the System should be turned off and
the AC power disconnected before performing any cleaning procedures. Use Windex to clean
SAM.
CAUTION
CONNECTORS: Do not immerse any of the connectors used in the System in any fluid.
TRADEMARKS
SAM Student Auscultation Manikin, Cardionics, CardioSim, SimulScope, E-Scope and
Heartman registered trademarks of Cardionics. Ausculette, StethView and Pocket-monitor are
trademarks of Cardionics.
REPRODUCTION OF SOUNDS
All sounds, both simulated and real, and veterinary sounds are copyrighted by Cardionics and
may not be reproduced for any reason except by written authorization of Cardionics, Webster,
Texas 77598 USA.

TABLE OF CONTENTS
1.0 Product Description…….………………………………………………………….……..4
2.0 PAT Set Up……………………………………………………………………………………2
3.0 Using PAT ………………………………………………………………………………..…..3
Volume level adjustments………………………………………………………………….3
Select and Play a Sound…………………………………………………………………...4
Select and View a Lesson………………………………………………………………….4
Lectures………….……………………………………………………..…………………….5
Create a Lecture….……………………………………………………………………...5
Delete a lecture entry….………………………...………………………………………6
Play a lecture…………….……………………………………………………………….6
Give a lecture as a test…….…………………………………………………………….6
Edit a lecture……………….……………………………………………………………..7
Password Setup………….….……………………………………………………………7
Add an instructor……….………………………………………………………………10
Student Assessment Program….……………………………………………………….....11
4.0 Group Listening
with Classroom Infrared Emitter…………………………………………………………13
with SimulScope Bedside Auscultation System….…………………………………….13
with Auditorium Infrared Sound System…………….…………………………………..14
with Low Frequency Speaker…………………….………………………………………14
5.0 Appendix A - Sounds List………………………………….…………………………………...18
6.0 Appendix B - Troubleshooting………………………….………………………………………21
7.0 Appendix C - Limited Warranty…………………………….…………………………………. 22
List of Figures:
Figure 1… PAT System……………………………………………………………………………….1
Figure 2 PAT Control Panel……………………………………………………………………..…2
Figure 3 Sound Select Page……………………………………………………………………….3
Figure 4 Sound Menu Page………………………………………………………………………..5
Figure 5 Lecture Page………………………………………………………………………………6
Figure 6 Test Mode Set Up …….…………………………………………..…………………..….7
Figure 8 Student Assessment………………………………………………………………………8
Figure 9 Test Mode Set Up…………………………………………………………………………8
Figure 10 Change Administrator Name and Password……..………………………………….…9
Figure 11. Test Mode Set Up……………………………………….………………………………10
Figure 12 Log Out .…………………………………………………………………………………10
Figure 13 Instructor List Assignment..……………………………………………………………..11
Figure 14 Adding a New Instructor…………………………………………………………………11
Figure 15 Giving a Test………………………..……….……………………………………………11
Figure 16 Enabling Test Mode ….………………………...………………………………………. 12
Figure 17 Assigning a Test Number….…………………………………………………………….12
Figure 18 Test Assignment List……………………………………………………………………..13
Figure 19 Location of Anatomical Sites for Heart Sounds…………..……………………….... 15
Figure 20 Heart Sound Locations…….……………………………………………………………16
Figure 21 Breath Sound Locations…………………………………………………………………16
Figure 22 Bowel Sound Locations………………………………………………………………….17

4
1.0 Product description
PAT, the Pediatric Auscultation Trainer, is an interactive manikin for teaching students the art of
auscultation.
PAT consists of a half-body male manikin, Laptop computer.
Figure 1 –PAT System
PAT has four listening sites for heart sounds, eight listening sites for breath sounds, two
listening sites for bowel sounds, and one site for bruit sounds. There are 69 heart sounds, 17
breath sounds and 4 bowel sounds. Additional sounds may be added from time to time.
The heart sound sites are the aortic, tricuspid, pulmonic and mitral areas on the chest and
breath sound sites are anterior (left upper and lower; right upper and lower) and posterior (left
upper and lower; right upper and lower). The bowel sound sites are the upper right and left
quadrants. The bruit site is located in the left side neck.
Sounds may be heard with (1) a normal stethoscope, (2) the E-Scope Electronic Stethoscope,
(3) the SimulScope Bedside Auscultation System for group listening, (3) the Classroom Infrared
Emitter for group listening, (4) the CardioSim VII Digital Heart Sound Teaching System for group
listening and display (5) the Cardionics Auditorium Infrared Sound System, (6) Cardionics
Auditorium Infrared Sound System for large group listening or (7) a low frequency speaker.
When listening to breath sounds, there are eight locations -right and left upper anterior chest,
right and left lower anterior chest, right and left upper posterior and right and left lower posterior
lobes.
For group listening, the SimulScope Bedside Auscultation System (Cat. No. 718-7003) or the
Classroom Infrared Emitter (Cat. No. 718-0015) is recommended. Each listener will need a
HeartmanInfrared Headphone (Cat. No. 718-7040). For group listening and display of the
phonocardiogram, the CardioSim Digital Heart Sound Teaching System (Cat. No. 718-2600) is
recommended.

5
2.0 Setting Up PAT
There are two cables and one power supply for the PAT set up. There are two USB cables that
connect to the laptop computer on the left side of PAT as shown below in Figure 2.
Power USB Headphone or Power
Supply Cable Speaker Light
Figure 2 Control Panel for PAT
Set up
Connect the two USB cables to the PAT Control Panel as shown above in Figure 2. Connect
the Power Supply to the DC In as shown above.

6
3.0 Using PAT
The laptop computer displays two pages. A Sound Select page and a Lecture Sequence
page.
Begin by selecting the sound for study by clicking on the Select Sounds button as shown in
Figure 3 below. You will then see the Sounds Directory (Figure 4 below). All sounds have
been placed in Groups.
Volume Play Trace Freeze
Adjust or Create Size Phonocardiogram Trace
Lecture
Figure 3 Sound Select Page
Select Select
Basic Lesson
Auscultation for Sound
Lesson Under Study
1. Volume Adjust.Each sound has preset volumes. The instructor may wish to change
these volumes to illustrate certain events. Volume adjustment at different anatomical
location is done by moving one or more of the slide bars to the left for sound reduction
and right for sound increase. The volume on each listening area of SAM II can be
altered to fit the particular situation.
2. Volume Save.Once set, these volume levels can be saved by clicking on the SAVE
button immediately below the slide bars.
3. Recall. At any time, the factory settings can be recalled, by simply clicking on the
RECALL button next to the SAVE button.
4. Reset –The Reset button allow the user to return to his/her previously saved volumes.
Select
Sound
Sound
Select
Sound for
Comparison
Play A Sound
Save Changed
Volume Levels

7
5. Select Sound 1–by clicking on this button, the user will be taken to the Sound Select
Menu (Figure 4). A second sound may be selected for comparison purposes by clicking
on Select Sound 2.
6. Play a Sound –by clicking on this button, the sound shown in the Select Sound area
will be played. Initially, there will be no phonocardiogram shown, but sound can be
heard using a stethoscope. By clicking on one of the circled areas, the
phonocardiogram will appear.
7. Compare a Sound –When selecting a sound, it is often helpful to select a second
sounds for comparison purposes. By clicking on this button, the user will be taken to the
Sound Select Menu for the selection of a sound for comparison purposes. A second
sound may be selected for comparison purposes by clicking on Select Sound 2.
8. Select a Lesson for sound under study. Every sound has a lesson. By clicking on this
button, a Lesson will appear on the screen. Each lesson has a description of the sound,
a schematic of the chest showing where best to listen, four phonocardiograms at the
appropriate anatomical location, questions and answers.
9. Select Basic Heart Sound Lesson. In case the student wishes to refer back to the
basics, this lesson can be viewed. It appears on every sound.
10. Phonocardiogram. A phonocardiogram is a graphic depiction of the heart or breath
sounds. When heart and breath sounds are being played simultaneously, the heart
sounds will appear in Yellow and breath sounds in Blue.
11. Freeze Trace. This allows the trace to be frozen for study. However, the sounds can
still be heard.
12. Trace Size. This button allows the amplitude of the trace to be increased for better
viewing.

8
3.1 Sound Selection. Click on the Sound Selection button as shown in Figure 3 and the
below menu will be seen.
Sounds Directory
Group
Description
Pediatric Heart
Normal Heart Sounds, 60 bpm
Sounds and Variants
Normal Heart Sounds, 75 bpm
Paradoxical Split of S2
Pediatric Systolic Murmurs
Aortic Stenosis Mild 75 bpm
Atrial Septal Defect 90 bpm
Pediatric Diastolic Murmurs
Aortic Regurgitation Mild, 75
bpm
Pediatric Breath Sounds
Normal Vesicular Breath
Sounds, 24 bpm
Figure 4 Sound Select Page
(see Appendix A for the complete Sounds Directory)
If you wish to select a second sound for comparison purposes, from the Main Page, click on
Select Sound 2 directly under the first selection. You can now toggle back and forth between
sounds as desired.
Once the Sound has been selected, click on Play 1 or Play 2.Initially, you will not see a
phonocardiogram on the screen, but the sounds can be heard with a stethoscope on PAT.
To visualize a sound while hearing it, click on one of the circled locations. Listening can be
done with an ordinary stethoscope, a speaker, headphones or the SimulScope Bedside
Auscultation System as shown in Figure 1.
3.2 Volume Levels. Each heart sound has been adjusted at the factory so that the sound does
not migrate to another area. There are times, however, when the instructor may want the
sounds to migrate such as having severe aortic stenosis migrate into the neck. In these cases,
the instructor may alter the preset volume using the slide bars shown in Figure 3. By clicking on
the SAVE button, these the audio volumes will be saved. To RECALL the factory settings,
simply click on the RECALL button. Then use the RESET button to go back to the previously
saved settings.
3.3 Lectures. Instructors can preprogram their lectures. Each Instructor may have multiple
lectures each with a different name. To set up a lecture, from the Main Page (Figure 3),
click on “Lecture Sequence” at the top of the page. This action brings up the lecture page
(Figure 5) below.
3.3.1 Click on Create.This brings up the Create Lecture page (Figure 5). Fill in the
name of the instructor and the Scenario or Lecture name. Then double click on the each
sound number. The Sounds Menu will be seen. Double click on your selection. Wait a
moment for the sound fill in in the sequence selected. When finished selecting the
sounds, click on the word Done. It is not necessary to set up a password for playing or
Play a
Sound

9
editing a lecture, but you can prevent unauthorized editing. Please see below section
3.3.4 for instructions.
If you wish to give a lecture as a test, assign a Test Number to the Lecture. See section
3.3.4 below. A Test Number must be assigned to any lecture that you wish to give it as
a test. To assign a test number, click on the Name of the Instructor, then click on Test
Number. See page 12, Figure 17 below.
3.3.2 Delete a Lecture Entry. To delete a lecture entry, right click the mouse or select
“Delete” from the selection omn the left side of the below dialog box..
3.3.3 Playing a lecture. To begin using your lecture, click on Start at the top
of the below page (Figure 5).
Figure 5 Lecture Page

10
Figure 6 –Create Lecture Page
3.3.4 Editing a Lecture. A lecture can be edited without a password. However, if the
instructor wishes to secure his or her lecture from editing by another person, it can be done
easily.
To secure your lecture, click on “Enter Test Set Up” as shown on Figure 8 below. If you wish to
prevent your lecture from being edited by another party, click on NO in the dialog box shown
below in Figure 7. If, at a later time, you wish to edit your lecture, open the below dialog box
again and click on YES.
Figure 7
Test Mode Set up.
3.4 Setting Up Passwords for Student Assessment. Setting up a test is much the same as
setting up a lecture. This section deals with password set up. In Section 3.5, instructions for
using the Student Assessment program are set forth. Step 1 is to select an Administrator. For
password set up and administration, each institution should assign an administrator to

11
coordinate the tests, lectures and passwords. This feature allows any instructor to give different
tests to different students, if desired. The Administrator can set up each lecture, monitor
passwords and tests. If there is only one instructor, he/she will be the Administrator.
Figure 8 –Setting up a Student Assessment Test
Step 1. Click on Lecture Sequence OR “Enter Test Set up”. The below screen (Figure 9) will
then be seen.
Step 2. Setting up the Administrator’s password is a one-time routine. In the below dialog box,
under NAME, enter PAT123 and press Enter. Use capital letters as it is case sensitive. In the
dialog box labelled “Password”, enter GOPAT and press Enter. Use capital letters as the
password routine is case sensitive. Both the name and password can be changed as shown
below in section 3.4.2.
Figure 9 Test Mode Setup
Step 3. We recommend that you change the Name and Administrative Password so you will be
able to manage the Student Assessment function easily. To change the above Name and
Password, click on “Change Admin Name/Password” (see Figure 9 above). When you click on
the above tab, the below dialog box will be seen.

12
Figure 10 –Change Administrator Name
and Password dialog box
Fill in the name of the person who is to be the password administrator. Select a password. You
will be asked to enter the password twice. The computer will then tell you that the password
has been sucessfully entered.
Step 4. After entering the new Name and Password, press Enter and the following dialog box
will be seen with the new Name. To complete the password set up, click on the “log out” tab at
the bottom of Figure 11.
Figure 11 Test Mode Set up

13
3.4.1 Adding Password for Additional Instructors
To add additional instructor passwords, click on “Change User Accounts” below.
Figure 12 Test Mode Set Up
The Select Account Page will then appear as shown below in Figure 13. The first instructor in
this example is John Smith. He is the first instructor signed in. To add a second or subsequent
instructor, enter the next number here. In this case, we will enter the number 2 for instructor
Mary Jones.
Figure 13 –Lecture/Test Assignments
In Figure 13 above, we will select Mary Jones as the second instructor by entering the number 2
and press Enter. The below dialog box will appear for entering Mary Jones name and
password. The computer will ask you to enter the password twice and will then tell you that the
password has been successfully entered. Mary Jones’ name will now appear below John Smith
in the Instructor list (Figure 13).

14
Figure 14. Adding a new Instructor
This completes the section on Password set up. To review, a password is required to use the
Student Assessment Program or to edit a lecture. To give a lecture does not require a
password.
3.5 Giving a Test using the Student Assessment Program.
Step 1. From either the Sound Select Page (Figure 15 below) or the Lecture Sequence Page,
click on Enter Test Set Up.
Figure 15 Sound Select Page

15
Step 2. Assuming that you have already set up a password (see section 3.4), enter your
Name first. Then click on “Enable Test Mode. Next, decide if you want to display a
phonocardiogram on your test. Make your selection here. Then Log Out by clicking here.
Figure 16 Test Mode
Set Up Page
Step 3. A Test Number must be assigned to any lecture that you wish to give as a test. To
assign a test number, click on the Name of the Instructor, then click on Test Number.If the
instructor has multiple lectures, a test number can be assigned to each.
Figure 17 Assigning a Test Number
Step 4. Select Lecture Sequence (Figure 15 above). Then Select Instructor, Select Test
number and click on Start (Figure 17).
Step 5 After completion of the test, be sure to log out.
If you wish to review the test assignments, click on “View Summary of Test Assignments.” See
Figure 18. The following dialog box of test assignments will be seen.

16
Figure 18 Test Assignment List
You may quit the test at any time by clicking on the “Quit Test” button.
IMPORTANT. When the test is complete, you will still be in the Test Mode. So you MUST go to
the Test Setup, enter your Name and log out. Click on Test Set up, and then click on Log Out.
4.0 Group Listening
To teach with PAT in a classroom or auditorium, the Classroom Infrared Emitter (Cat. No. 718-
0015), the SimulScope Bedside Auscultation System (Cat. No. 718-7003), the Auditorium
Infrared Sound System (Cat. No.718-4006) or the CardioSim Digital Heart Sound Teaching
System is recommended. With the SimulScope or Classroom Infrared Emitter, each listener
must wear a HeartmanInfrared Headphone (Cat. No. 718-7040). A low frequency speaker
system may also be used; however, speakers of any kind do not reproduce heart sounds well.
Speakers can be connected by inserting the appropriate cable into the Headphone Output Jack
(Figure 2).
4.1 Group Listening with the Classroom Infrared Emitter
Connect the output of the supplied E-Scope Electronic Stethoscope to the input of the
Classroom Infrared Emitter using the supplied cable. The output is on the side of SAM (see
Figure 2). The instructor and each student must wear a HeartmanInfrared Headphone. Place
the E-Scope on SAM in the appropriate anatomical location. The sounds will be heard by the
instructor and students simultaneously. Also,
4.2 Group Listening with the SimulScope
The SimulScope System is designed for group listening in a classroom or at the bedside. The
typical System is supplied with six HeartmanInfrared Headphones. More can be added, if
desired, up to a maximum of about 25.
The SimulScope is a small, portable, battery-operated (and/or line-operated), wireless infrared
transmitter that picks up heart, lung and bowel sounds and transmits them via infrared energy to
the wireless Heartmanheadphone worn by each listener. The headphone senses the infrared
signal and converts it into an audible sound. Each headphone has its own volume control.
After PAT has been set up (see section 2.0), place the stethoscope of the SimulScope on the
manikin at the appropriate anatomical site. Each listener wearing a HeartmanInfrared
Headphone hears the sounds. Adjust the volume of the SimulScope to maximum
volume, then adjust the volume control knob on the HeartMan Headphone to a comfortable
listening level.

17
4.3 Large Group Listening with the Auditorium Infrared Sound System
The Auditorium Infrared Sound System is designed for large group listening. The Auditorium
Infrared Sound System operates in much the same manner as the SimulScope. To use with the
infrared sound system,
1. Connect the E-Scope Electronic Stethoscope to the
Power Supply Module of the Auditorium Infrared Sound System.
Follow the Operator’s manual for the Infrared Sound System.
2. Place the E-Scope on the manikin in the appropriate manner and
begin listening. Listeners will use the HeartmanInfrared Headphone.
4.4 Group Listening with a Low Frequency Speaker
Connect the Cardionics Low Frequency Speaker, (cat. no. 718-9011) to the
Headphone/Speaker Output on the right side of SAM (Figure 2).

18
Figure 19–Location of listening sites for heart sounds.
Aortic
Aortic
Pulmonic
Tricuspid
Mitral

19
Figure 20 Heart, and Bruit Locations
on PAT
Figure 21 Breath Sound Locations
Anterior and Posterior Lobes
Pulmonic
Tricuspid
Mitral
Bruit
Aortic
Upper Lung
Lower Lung

20
Figure 22 Bowel Sound Locations
Bowel Sounds
Upper right
quadrant
Bowel Sounds
Upper left
quadrant