KOKEN LM-114H User manual

Full-Body
Pregnancy
Simulator II
LM-114H
Instruction Manual
Thank you for purchasing the full-body pregnancy simulator II.
Please read this instruction manual carefully to ensure correct use of the product,
and store it in a safe place for easy access.
KOKEN CO., LTD.
1-4-14 Koraku, Bunkyo-ku, Tokyo 112-0004 JAPAN
URL:http://www.kokenmpc.co.jp
E-mail:[email protected]
©2021 KOKEN CO.,LTD. C-1-1043-3-01-00

1
Handling and Safety Precautions
These precautions should be strictly observed in order to ensure safe,
long-term use of the product.
The following precautions should be observed particularly strictly:
1. Please handle this model with the same care that you would exercise when working with a
human body. Excessive force may damage the model.
2. Do not use oil-based inks, pencil, chalk, or paints on the model as they will soak into the material
and cannot be removed.
3. In caring for the model, do not clean the model with rubbing alcohol, thinners, benzene or other
similar organic solvents.
4. Use glycerin to lubricate the models. Be sure to apply a su󱐰cient amount of lubricant (glycerin)
to the model before use. Koken is not responsible for deterioration or damage occurring from
use of lubricants other than glycerin. Use commercially available glycerin if you run out of the
glycerin provided with the model.
5. Please do not use oily lubricant (baby oil, olive oil etc.), alcohol lubricant, and lubricant containing
organic solvent. These may cause breakage of the model.
6. Placing objects directly on top of the model or placing it on uneven surfaces may cause
deformation.
7. Store the model in a 0-50°C environment, in a place where it will not be exposed to direct
sunlight or UV rays.
※ Storing the abdominal wall piece for an extended time in a high or low temperature
environment may cause the oil component to ooze out, causing deformation or discoloration. If
possible, store at 10-50°C.
8. This model uses urethane foam for some of its parts, and may be susceptible to damage from
pests that are attracted to urethane foam (such as insects in the ant family).
When storing this model, ensure that thorough measures are taken to prevent pest damage
before storing. The company will not be involved with or held liable for pest damage that occurs
during storage.
9. This product is intended for use in standard operating environments. Do not use it in heavy
industrial settings.
10. Please read these handling precautions for each part on the following pages.

2
1. The contents of this instruction manual are subject to change without notice.
2. This instruction manual may not be reproduced in part or in its entirety without permission.
3. Please contact the manufacturer in the event that any errors or omissions are found in the contents of
this instruction manual.
4. This product should be used only as described in this instruction manual. In particular, the product
should not be used in any way that contravenes the precautions noted in the instruction manual.

3
Table of Contents
 1. Overview,FeaturesandDevelopment
 2. NameandCongurationofEachModel
 3. Full-bodyManikinHandlingPrecautions
 4. PartsoftheFull-bodyManikin
 5. UsingtheFull-bodyManikin
 6. ObstetricAbdominalPalpationModelHandlingPrecautions
 7. PartsoftheObstetricAbdominalPalpationModel
 8. UsingtheObstetricAbdominalPalpationModel
 9. CaringfortheObstetricAbdominalPalpationModel
 10. VaginalExaminationModelHandlingPrecautions
 11. PartsoftheVaginalExaminationModel
 12. UsingtheVaginalExaminationModel
 13. CaringfortheVaginalExaminationModel
 14. ObstetricAssistantModelHandlingPrecautions
 15. PartsoftheObstetricAssistantModel
 16. UsingtheObstetricAssistantModel
 17. CaringfortheObstetricAssistantModel
 18. PerinealSutureModelHandlingPrecautions
 19. PartsofthePerinealSutureModel
 20. UsingthePerinealSutureModel
 21. PuerperalUterusPalpationModelHandlingPrecautions
 22. PartsofthePuerperalUterusPalpationModel
 23. UsingthePuerperalUterusPalpationModel
 24. CaringforthePuerperalUterusPalpationModel
 25. ListofParts
 26. Specications 
 27. OptionalItems
 28. StoringtheVaginalExaminationModel,ObstetricAssistantModel,
  andPerinealSutureModel
 29. PrecautionsforUnpackingandStoring

4
1. Overview, Features and Development
Outline
・ By interchanging various parts, procedures such as external examination of a pregnant
woman, internal examination during stages of delivery, practical obstetric assistance, perineal
suture of soft birth canal lacerations, palpation of the uterus fundus during the puerperal
period, and breast care can be practiced. Trainees can practice a series of techniques based on
the L.D.R. concept (Labor, Delivery, and Recovery) using a life size full-body model.
・ Each part is made with a special material to simulate the texture of human skin.
・ Obstetric assistance can be practiced on the model in either a supine or free-style position.
Features
Obstetric Abdominal Palpation Model
・ Represents the 36th to 40th weeks of pregnancy.
・ Visual diagnosis, palpation and abdominal measurements (abdominal girth, fundal height)
according to the four types of Leopold’s Maneuvers, monitoring of fetal heartbeats, and breast
care can be practiced.
・ Changing the position and orientation of the fetus enables diagnosis in various fetal positions
and orientations, and diagnosis of stability and mobility of the fetal presenting part.
・ The fetal heartbeat can be adjusted between 80 and 180 bpm.
Vaginal Examination Model
・ Bishop scores from the late stage of pregnancy to the onset of labor (cervical dilation,
e󱐯acement, consistency and position) can be conrmed.
・ Made with a material that is more tear-resistant than the previous model, increasing its
durability.
・ Three models with varying degrees of cervical dilation are provided, together with a full
dilation model. These can be interchanged and the station can be adjusted, thereby allowing
the assessment of the progression of labor by means of a vaginal examination.
・ The full dilation model can be used to gauge orientation of the fetal head by palpation of the
positions of the sagittal sutures and posterior fontanel.
・ The vulva has a urethral orice for inserting a urinary catheter.
Obstetric Assistant Model
・ By changing between various positions, including supine, hands and knees, lateral, and
standing, the fetal model can be rotated according to each position, providing several
positions for obstetric assistant practice (Free-style delivery).
・ The obstetric model - vulva II is made with a highly elastic and durable material that
decreases resistance and reduces the amount of force needed to extract the fetus during
delivery, enabling smooth practice. (Use glycerin to lubricate.)
・ Protection of the perineum can be practiced.
・ Breech extraction can also be practiced as one type of emergency response.
• The head of the fetal model has been improved to create a more realistic shape and texture.
The neck moves exibly so that the model can be seen from the posterior fontanelle during

5
crowning. The structure and shape of the neck, corners of the mouth, and umbilical region,
where damage is most common, have been improved to reduce the risk of damage.
• The fetal head allows suction cups (soft type) to be used so that procedures such as vacuum
and forceps delivery can be practiced.
• The umbilical cord of the new placenta model has improved durability, and enables the
use of Kocher forceps and umbilical cord clip. Moreover, the model can be used to simulate
nuchal cord, and can be attached to parts that are sold separately to practice tying and
cutting the umbilical cord.
• The structure and material of the placenta has been improved, making it easier to remove
during delivery, and reducing the risk of damage.
Perineal Suture Model
・ This model enables conrmation of the perineal laceration position and level of laceration,
and practice in preparing for and performing a suture.
・ Use of forceps can also be practiced.
Puerperal Uterus Palpation Model
・ Four kinds of puerperal uterus models are provided (normal and abnormal conditions
on the first day, normal conditions on the third day and on the fifth day). These can be
interchanged for diagnosis of progress in recession of the uterus through palpation and
measurement of the abdominal area.
Breast Model
・ This model enables basic training in breast care, including breast and nipple palpation,
inspection of breast mobility, and nipple massage.
・ Flexibility and mobility of the entire breast allows palpation of the mammary glands.
Development of the full body pregnancy simulator
The full body pregnancy simulator was developed by Dr. Mieko Hirasawa, Dr. Megumi
Matsuoka, Dr. Hiroko Ando, and Dr. Keiko Suzuki from 1997 to 1998 during a two-year
program funded by a Ministry of Education, Science, Sports and Culture Grant-in-Aid for
Scientic Research.
The aim of this research was to develop a model for training in inspection, diagnosis,
and care of expectant and nursing mothers, skills of which are essential in nursing and
midwifery. Specifically, the end result would be a practical simulator that allows flexible
practice of care and inspection of a pregnant or puerperal patient to match the training
purpose, including breast inspection and care, Leopold’s Maneuvers, fetal heartbeat
monitoring, urethral catheterization, vaginal examination at the onset of labor, cleaning of
external genitalia, and obstetric assistance in free-style position.

6
2. Name and Conguration of Each Model

7
3. Full-body Manikin Handling Precautions
1. To clean smudges or marks, wipe with a moist gauze or similar material using water or a
neutral solvent diluted with water.
*Do not clean the model with rubbing alcohol, thinners, benzene or other similar solvents.
2. Dropping the model or subjecting it to strong impact could cause damage.
3. Store the model in a place where it will not be exposed to direct sunlight or UV rays.
4. Parts of the Full-body Manikin
3. Full-body Manikin Handling Precautions
1. To clean smudges or marks, wipe with a moist gauze or similar material using water or
a neutral solvent diluted with water.
*Do not clean the model with rubbing alcohol, thinners, benzene or other similar
solvents.
2. Dropping the model or subjecting it to strong impact could cause damage.
3. Store the model in a place where it will not be exposed to direct sunlight or UV rays.
4. Parts of the Full-bodyManikin
Fixing screws
Abdominal cover
Full-body manikin

8
5. Using the Full-body Manikin
5-1.Attachingtheabdominalcover
Set the abdominal cover on the full-body manikin, a󱐰x it to the hook and loop fasteners on
the leg side, and secure it in place on the abdomen side with the xing screws.
(The abdominal cover is used when practicing vaginal examination and delivery.)
- 8 -
5. Using the Full-body Mannequin
5-1. Attaching the abdominal cover
Set the abdominal cover on the full-body mannequin, affix it to the hook and loop
fasteners on the leg side, and secure it in place on the abdomen side with the fixing
screws. (The abdominal cover is used when practicing vaginal examination and
delivery.)
Secure with fixing screws
Affix to hook and loop
fasteners

9
5-2.Fixingthelegposition
As shown in the diagram below, peel back the skin of the leg and pull the leg-fixing lever
upwards to x it in position.
(Both legs can be xed into position in the same manner.)
- 9 -
5-2. Fixing the leg position
As shown in the diagram below, peel back the skin of the leg and pull the leg-fixing
lever upwards to fix it in position.
(Both legs can be fixed into position in the same manner.)
Leg-fixing lever

10
6. Obstetric Abdominal Palpation Model Handling Precautions
1. For the power supply, always use the designated AC adapter (accessory).
2. Please handle this model with the same care that you would exercise when working with a
human body. Excessive force may result in damage.
3. Dropping the model or subjecting it to a strong impact may cause damage.
4. The material of the abdominal wall piece has a distinct odor. This odor is not harmful to the
human body and does not indicate poor quality. The distinct odor fades over time. There may
also be a smell of baby powder remaining on the product, as baby powder is applied to the
models during fabrication.
5. The abdominal wall piece may become sticky due to the oil component. Always wrap the
abdominal part correctly in the protective sheet (provided as an accessory) and then place it
in the storage bag. If it becomes too sticky after use or after washing, it may be di󱐰cult to set
the skin in place. In these cases, apply baby powder (provided as an accessory) liberally to the
abdominal wall piece.
6. The skin may become sticky from the oil component in the abdominal wall piece. If this
happens, wash the skin in water to remove the oil before use. To prevent the oil from getting
onto the skin, always wrap the abdominal wall piece correctly in the protective sheet (provided
as an accessory) and then place it in the storage bag.
7. The abdominal wall piece may change its shape over a prolonged period. Check the shape
of the part about three years after purchase. If it is deformed to the extent that its function is
a󱐯ected, consider replacing it.
8. Air bubbles or impressions in the abdominal wall piece that may remain from the fabrication
process do not a󱐯ect the strength of the material, as the material used is tear-resistant.
9. Do not use oil-based inks, pencil, chalk, or paints on the model because they will soak into
the material and may cause permanent staining.
10. Do not use the model outdoors or in damp places; doing so may damage the model.
11. When lling the amnion with air, be careful not to exceed the maximum level of the amnion
indicator (indicated by a red line). Filling it with too much air may damage the model.
12. Placing objects directly on top of the models or placing them on uneven surfaces may cause
deformation.
13. Storing the model for an extended period in a high or low temperature environment or under
exposure to direct sunlight may cause the oil component in the abdominal wall piece to ooze
out, causing deformation or discoloration of the model. If possible, store the model at 10°C to
50°C, away from direct sunlight.
14. When storing the Seitz method standard adjustment base and Seitz method plus adjustment
base in the parts storage bag, always place them in the bags in which they came at the time
of purchase.

11
7. Parts of the Obstetric Abdominal Palpation Model
Abdominal wall piece
Fetus model with amnion
(with amnion indicator)
Seitz method plus
adjustment base
Seitz method standard
adjustment base
Full-body manikin
Skin II for obstetric abdominal
palpation model

12
8. Using the Obstetric Abdominal Palpation Model
8-1.AttachingtheSeitzmethodadjustmentbaseandfetusmodelwithamnion
Place the Seitz method adjustment base on the abdomen of the full-body manikin, and set
the fetus model with amnion on the abdomen.
- 12 -
8. Using the Obstetric Abdominal Palpation Model
8-1. Attaching the Seitz method adjustment base and fetus model with amnion
Place the Seitz method adjustment base on the abdomen of the full-body mannequin, and set
the fetus model with amnion on the abdomen.
Seitz method standard adjustment base Seitz method plus adjustment base
(Choose one to attach)

13
8-2.Connectingthefetusmodelwithamnion
Connect the extension cord for heartbeat generator of the heartbeat cord of the fetus model
with amnion, then connect it to the shoulder panel.
Extension cord for
heartbeat generator
Heartbeat cord

14
8-3.Explanationoftheshoulderpanelpart
*Plug the AC adapter into an outlet, and insert the other end into the connector for the
AC adapter shown above.
13
8-3.Explanationoftheshoulderpanelpart


POWER
AC adapter connector
Heartbeat cord connector
80
VOLUME HEART RATE
MIN MAX
180
Heart rate knob
Heartbeat volume knob
Enlargement of shoulder panel
The heart rate can be adjusted
between 80-180 bpm.
*PlugtheACadapterintoanoutlet,andinserttheotherendintotheconnectorfortheAC
adaptershownabove.

15
Filltheamnionwithairuntiltheblueline(indicatingthecurrentvolumeofair)
approachestheredline.
Headside
Thesidewiththenavel
istheexternalsurface.
Legside
Redline
(maximum)
8-4.AttachingtheSkinIIforobstetricabdominalpalpationmodelandAbdominalwallpiece
(1) Set the abdominal wall piece in place and ll the amnion of the fetus model with air until
the blue line on the amnion indicator approaches the red line (maximum). If the abdominal
wall piece slips out of place after lling the amnion with air, be sure to restore it to the correct
position.
*See section 8-5. “Using the amnion indicator” on page 16 that describes how to use the
amnion indicator.
*The abdominal wall piece has an external surface
and an internal surface and a superior end (towards
the head) and an inferior end (towards the legs).
Be sure that it is orientated correctly.
Filltheamnionwithairuntiltheblueline(indicatingthecurrentvolumeofair)
approachestheredline.
Headside
Thesidewiththenavel
istheexternalsurface.
Legside
Redline
(maximum)

16
(2) Place the skin on the manikin only after aligning the underside of the nipples on the skin
with the nipples on the surface of the manikin.
*For xing the skin in place, two hook and loop fasteners are located on the shoulders, six on
the sides, and two on the lower part of the abdomen.
While smoothing down the skin with the hand to eliminate wrinkles on the abdomen,
secure it with the hook and loop fasteners.
*After setting the skin in place, adjust the volume of air in the amnion while observing the
amnion indicator and tension on the abdomen before use.
[REFERENCE]
As the volume of air in the amnion becomes larger, the situation where palpation is more
di󱐰cult can be simulated. Using a smaller volume of air simulates the situation where
palpation is easier. Adjust to suit the situation.
*Attach the skin to the manikin when practicing nipple massage or breast care.
Skin
Underside of the nipple
on the skin
Nipple

17
×
○
○
8-5.Usingtheamnionindicator
(1) Set the amnion indicator stopcock in the opposite direction of the amnion indicator
(the direction shown by the red arrow in the picture).
(2) Twist the valve on the rubber bladder clockwise to close it, and then ll the rubber bladder
with air. When doing so, be careful not to twist the cu󱐯 of the amnion indicator. Placing the
amnion indicator on a table facilitates lling the rubber bladder with air.
[NOTE]
Filling the rubber bladder with air while the amnion indicator stopcock is in the incorrect
position may cause damage to the cu󱐯. Always check the stopcock position before lling the
rubber bladder with air.
Rubberbladder
side
Cu󱐯
Rubberbladder
side
Rubberbladder
side
Mainbody
side
Mainbody
side
Mainbody
side

18
Redline
(maximum) Blueline
(currentvolumeofair)
(3) Adjust the volume of air in the amnion while observing the amnion indicator. The red line
on the amnion indicator is the maximum level for lling the amnion with air. The blue line
indicates the current volume of air. To add air, pump air into the amnion using the rubber
bladder. To remove air, twist the valve on the rubber bladder counter-clockwise to loosen it.
*Filling the amnion with a volume of air that exceeds the red line (maximum) on the amnion
indicator may cause the amnion to rupture. Be sure to maintain the air volume below the red
line (maximum).
[REFERENCE]
As the volume of air in the amnion becomes larger, the situation where palpation is more
difficult can be simulated. Using a smaller volume of air simulates the situation where
palpation is easier. Adjust to suit the situation.

19
9. Caring for the Obstetric Abdominal Palpation Model
9-1.Cleaningthemainbody
(1) To clean smudges or marks o󱐯 the main body, wipe with a towel or cloth moistened with
water.
*Do not wash the main body.
9-2.Cleaningtheskin
(1) If the skin becomes dirty or sticky, wash in water with a neutral solvent. After washing,
wipe o󱐯 all the remaining water with a dry gauze or similar soft cloth, and apply baby powder
(accessory).
*Do not clean the skin with rubbing alcohol, thinners, benzene or other similar solvents.
(2) Pat the skin down with baby powder (accessory) after use and when the skin becomes
oily.
9-3.Cleaningtheabdominalwallpiece
(1) If the abdominal wall piece becomes dirty, wipe with a moist gauze or similar soft material
using water or a neutral solvent diluted with water. Then apply baby powder (accessory)
liberally to the piece.
*Do not clean the abdominal wall piece with rubbing alcohol, thinners, benzene or other
similar solvents.
9-4.CleaningthefetusmodelwithamnionandtheSeitzmethodstandardadjustmentbase
(1) To clean smudges or marks off the models, wipe with a moist gauze or similar material
using water or a neutral solvent diluted with water.
*Do not clean the models with rubbing alcohol, thinners, benzene or other similar solvents.
(2) Pat the amnion down with baby powder (accessory) after use and when the amnion
becomes oily.
(3) Remove the air from the amnion before storing the fetus model with amnion. To remove
the air, turn the amnion indicator stopcock back in the opposite direction of the amnion
indicator (the direction shown by the red arrow in the picture), and twist the valve on the
rubber bladder counter-clockwise to loosen it.
×
○
○
Rubberbladder
side
Mainbody
side