laerdal VitalsBridge Manual

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VitalsBridge for SimMan 3G
Directions for Use

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VitalsBridge Help
Directions for Use: The Directions for Use includes description, step by step instructions and
illustrations for using the VitalsBridge. Note: The illustrations may vary slightly from product.
Technical Assistance: For technical assistance, contact your local Laerdal Technical Service Center.
Web Downloads: Visit http://www.laerdal.com to download the latest Directions for Use and
Software.
Regulatory Information
Use statement: The VitalsBridge is for use in the United States and Canada only.
Federal ommunications ommission Statement: This device complies with part 15 Subpart B of the
FCC rules.
aution: Only use cables supplied with the VitalsBridge and accessories approved for use
with the VitalsBridge. Changes or modifications not expressly approved by the party
responsible for compliance could void the user's authority to operate the equipment.
Disposal/Recycling: Recycle and dispose of in accordance with all governing requirements and
regulations. The VitalsBridge contains a Li ion battery, which should be recycled.
The VitalsBridge instrumentation and its associated cables are latex free.
LATEX

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Disclaimer and Manufacturer Information
Disclaimer: Use of the VitalsBridge to train personnel should be undertaken under supervision of
suitably trained medical personnel with an understanding of clinical monitoring, patient simulation
educational principles, and recognized medical protocols. As with all simulation training devices,
there may be approximations, variations, and inaccuracies in the information being presented.
Global Warranty: See the Laerdal Global Warranty, www.laerdal.com.
Manufacturer: The VitalsBridge is made in the USA and is manufactured for Laerdal Medical AS by
Dynasthetics LLC.
3487 W. 2100 S. #300
Salt Lake City, Utah, 84119
USA

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Warnings and Caution
−Follow all cautions and warnings outlined in the SimMan 3G Directions for Use.
−The VitalsBridge is intended solely for use during patient simulation. It is not a medical device.
− Warning: Never connect the VitalsBridge to a patient.
− Warning: Never connect the VitalsBridge to a Vital Signs monitor that is connected to a
patient.
− Warning: The VitalsBridge is not waterproof. Protect the VitalsBridge in damp conditions
and keep away from liquids.
− Warning: The VitalsBridge contains a lithium ion battery, which if damaged, could cause risk
of fire or explosion.
−Compressed Gases and Regulators:
oUse only sources of compressed air or CO2 with the VitalsBridge. Adequate training and
expertise is required to work with compressed gases.
o Warning: Do not use compressed oxygen (fire hazard) or any other flammable
substance with or near the VitalsBridge.
oThe VitalsBridge is supplied with a portable CO2 regulator that uses cartridges of highly
pressurized CO2 gas. Take care when handling these cartridges as they pose a potential
risk of injury if used improperly. They should not be heated or punctured when
temperatures are above 120o F or 49o C. Do not inhale the CO2 gas.
o Warning: CO2 cartridges may become extremely cold when discharging. Protect
eyes and hands when installing and handling CO2cartridges.
o Warning: Mishandled CO2 cartridges may become a projectile.
oNote: CO2 cartridges may not be transported by air.
−Defibrillation Hazards:
oDuring defibrillation the defibrillator and VitalsBridge may present a shock hazard. All
standard safety precautions must be taken when using a defibrillator with the SimMan
3G and VitalsBridge.
oThe respiration cable connector on the manikin is designed exclusively for respiration
monitoring via ECG impedance signals.
o Warning: Defibrillation on the ECG connectors will damage the internal electronics
of the VitalsBridge and may cause personal injury.
o Warning: Never connect any cables from the VitalsBridge to the designated
defibrillator connectors on the SimMan 3G manikin.

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VitalsBridge Overview
The VitalsBridge consists of a device that allows vital signs from the SimMan 3G to be presented on a
clinical vital signs monitor. It is intended to increase the fidelity of simulation for users where they may
view, interact, and control a vital signs monitor that is used in their clinical practice. The VitalsBridge
presents opportunities for high fidelity simulations that involve critical care, training and education on
clinical monitoring, patient information systems testing, just to name a few.
The VitalsBridge is designed to function with commercially available vital signs monitors. It presents the
following vital signs on a clinical monitor: heart rate, respiration via ECG impedance, plethysmograph
waveform, SpO2, capnograph waveform, end tidal CO2, non invasive and invasive blood pressure
(arterial, central venous, pulmonary artery), and temperature. Vital signs cables are usually connected to
sensors attached to the patient. With the VitalsBridge, some of these cables attach to the patient, and
some are connected to the VitalsBridge device. Connectors for the respiration via ECG impedance and
SpO2 have been pre installed on the SimMan 3G manikin.

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The VitalsBridge converts the SimMan 3G's digitized vital signs waveforms and numbers into signals that
are compatible with a vital signs monitor. Compressed gases (air, CO2) are used for non invasive blood
pressure and capnography to generate the signal. The vital signs created by the VitalsBridge are
controlled using the SimMan 3G Instructor Application. An additional of piece software is used to
communicate vital signs between the VitalsBridge and the SimMan 3G.
VitalsBridge ables and Accessories: Each VitalsBridge is included with the following cables and
accessories:
−VitalsBridge device
−Charge only power supply (for charging the battery when VitalsBridge is off)
−In use power supply (for running the VitalsBridge)
−Mini CO2 regulator kit
−Tubing and fitting adapter kit for compressed air
−Non invasive blood pressure cable, from VitalsBridge to manikin
−Non invasive blood pressure cuff, modified for use with VitalsBridge
−Invasive blood pressure cable, from VitalsBridge to patient monitor cable (x3)
−Temperature cable, from VitalsBridge to patient monitor cable (x2)
−Respiration via ECG cable, from VitalsBridge to manikin
−SpO2 extension cable, from VitalsBridge to manikin

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Requirements
To use the VitalsBridge the following components are needed:
VitalsBridge device
VitalsBridge accessory cables: invasive blood pressure (3), temperature (2), respiration
Non invasive blood pressure cuff, modified for use with the VitalsBridge
Li ion battery charging power supply, for battery charging only
VitalsBridge power supply (15V), for use while running the VitalsBridge
VitalsBridge software installed on a computer running Windows and a network connection
Sources of compressed air and CO2 at 50 to 100 PSI. Note that a portable CO2 regulator that
accepts 12 or 16 gram cartridges of compressed CO2 is provided with the VitalsBridge; however
cartridges are not included.
A 120V A/C power source
Ethernet (LAN) or Wireless (WLAN) Communication Communication between the VitalsBridge
and the SimMan 3G is based on WLAN communication (IEEE 802.11.b/g). TheVitalsBridge can
also be connected with the manikin using an Ethernet cable (LAN, IPv4, not included).
SimMan 3G and instructor PC running the application software version 2.3 or later
A commercially available patient vital signs monitor, with relevant cables that connect between
the patient and the monitor. The monitor is not included with the VitalsBridge.

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Internal Battery Charging
Note: A separate power supply is provided for charging the battery when the VitalsBridge is not in use.
Use the power supply marked "Battery Charging Only" when charging the VitalsBridge (when not in use).
Use the power supply marked "VitalsBridge Use" when running the VitalsBridge.
harging the Internal Battery: Use the power supply marked "Battery Charging Only", and connect it to
the power port on the rear panel of the VitalsBridge. This charger will fully charge a depleted battery in
6 12 hours.
Battery Use: The battery is non replaceable. Contact technical support if battery appears to no longer
charge. Battery life will be at least 2 hours of VitalsBridge use, when fully charged. The battery indicator
on the top panel will flash when < 15% of battery life is available.
Running the VitalsBridge with wall power: The battery's charge will be maintained if the charger marked
"VitalsBridge Power Supply" is used while running the VitalsBridge.

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Installation of the VitalsBridge Software
The software may be installed on a PC that is able to establish a network connection to the SimMan 3G
manikin or to an instance of the virtual manikin. Insert the CD into the PC's DVD/CD ROM drive. If
installation is not started automatically, navigate to the DVD/CD ROM drive and double click on the file
"VitalsBridge For SimMan 3G Setup.exe". Follow the on screen installation instructions. Upon
successful installation, a VitalsBridge icon will be created on the PC's desktop.

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Configuration of the VitalsBridge WLAN and LAN communication
The VitalsBridge communicates with the SimMan 3G manikin over WLAN (Wifi) or LAN (Ethernet).
The VitalsBridge will need to be configured to connect to the WLAN using the SimMan 3G internal
router's network SSID and password. Additionally, the VitalsBridge is configured to obtain an IP address
automatically when connected to the Internal SimMan 3G router via an Ethernet switch and cable. To
alter the VitalsBridge network configuration, a network configuration utility will need to be run using an
Ethernet connection over a local area network.
VitalsBridge Network onfiguration using the SimMan 3G internal router: Using a network cable,
connect the cable from the Ethernet port located on the SimMan 3G Manikin to the Ethernet port
located on the VitalsBridge. The computer that has the VitalsBridgesoftware installed may connect
wirelessly to the SimMan 3GPower on the SimMan 3G, the computer, and wait until the Manikin’s chest
rises and falls. Then, power on the VitalsBridge hardware.
VitalsBridge Network onfiguration using an external local area network: Consult your network
administrator for assistance for configuring the VitalsBridge on an external LAN. Using an Ethernet cable,
connect the VitalsBridge to a LAN where the PC is located. Note: the local area network must have UDP
multicasting enabled.
VitalsBridge Network onfiguration over WLAN: This is not recommended.
Run the VitalsBridge network configuration utility " VitalsBridge Network Configuration", found under
the start menu in the folder Laerdal/VitalsBridge/. In the program window, choose the VitalsBridge to
configure by clicking on its label and Connect.
vb
000
008
VitalsBridge
SimMan 3G Manikin
Ethernet cable
Computer with
VitalsBridge
Software
Wifi

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If a VitalsBridge device is not shown in the window, double check all Ethernet cable connections, wait
several seconds or power off/on the VitalsBridge and restart the network configuration utility.
Once connected, the existing network settings will be read from the VitalsBridge device and shown in
the edit fields on the screen.
For WLAN, change the SSID and password fields to match the configuration of the SimMan 3G router.
For LAN, it is highly recommended that you use DHCP, however you may select between DHCP and
manual IP settings. Warning: improper changes to the Wired Network Connection settings may result
the inability to connect and configure to the VitalsBridge.
Resetting to default network configuration: To reset the VitalsBridge to default network settings, use the
power toggle switch located on the side of the VitalsBridge device to power on the VitalsBridge for 2
seconds, power off for 2 seconds. Repeat for a total of 4 power on/off cycles.

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Configuration of Cable Connections Between the VitalsBridge, the
SimMan 3G manikin, and the Patient Vital Signs Monitor
SpO2: The SpO2 sensor is located in the manikin's right index finger, and a connector is located near the
top of the arm skin, near the zipper. Connect the SpO2 extension cable between the VitalsBridge and
this connector on the arm.
Connect the SpO2 extension cable into the appropriate connector on the VitalsBridge.
SpO2 connector
(to VitalsBridge)
SpO2 connector
(to sensor in Manikin's finger
)

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Place a non disposable finger clip style SpO2 probe from the Vital Signs monitor squarely over the index
finger of the manikin’s right hand. Correct placement and position of the SpO2 probe is important:
Ensure it is not “twisted” on the finger, and leave a gap of 1 2 mm between the tip of the finger and the
top housing of the probe.
Respiration Impedance via E G: The manikin has a connector for simulation respiration via ECG
impedance, which is located near its neck (right or left side). Connect the female connector of the
Respiratory ECG to the complementary connector on the SimMan 3G manikin.
1
to
2 mm

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Firmly connect the male connector side to the VitalsBridge.
Temperature: The temperature cable is a short white cable that consists of a short RJ 11 connector on
one end, which connects to the VitalsBridge. The other end of the cable is a transducer style connector,
which connects to the temperature patient monitor cable. Two temperature cables are supplied with
the VitalsBridge. T1 simulates the temperature in the blood, and T2 simulates Tperi.
Invasive Pressure: The invasive pressure cable is a 1 ft RJ 11 cable. One end of the cable connects to the
VitalsBridge, and the other end connects to the invasive pressure patient monitor cable. Four invasive
cables are included with the VitalsBridge. ABP is arterial blood pressure, PAP is pulmonary artery
pressure, CVP is central venous pressure, and AUX is an unused auxiliary pressure connector.

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Configuration of Compressed Gases and Pneumatic Connections
ompressed Gases: For CO2 and non invasive blood pressure (NIBP) simulation, sources of compressed
air and CO2 are required. These sources must be regulated to pressures between 50 and 75 PSI. A small
CO2 regulator that uses cartridges of compressed CO2 is provided with the VitalsBridge. Alternatively,
CO2 from another external source may be available at your facility (wall, tank, etc). A 1/8" female to
female NPT coupler and tubing are provided to connect to the external source of compressed air.
Consult your facility's engineering regarding sources of compressed air (wall, tank, compressor, etc) and
for the appropriate regulators and adapters for connecting.
Using the Portable O2 Regulator: The portable CO2 regulator uses 12g or 16g cartridges of compressed
CO2. It has a luer lock fitting connection to the VitalsBridge, which may be capped when a CO2 cartridge
is in place but is disconnected from the VitalsBridge.
Installing O2 artridge: Turn the stopcock the regulator so that it is closed. If the regulator is
connected to the VitalsBridge, disconnect the luer connection from the VitalsBridge. Discharge any
remaining CO2 from the cartridge by turning the stopcock to open.
Choose the proper cup size (unthreaded 12g or 16g) for your CO2 cartridge. Ensure the cup is free of any
debris or material inside and that the cup and the threads on both the cup and regulator are not
damaged. Place the larger round end of the cartridge first into the cup, with the nipple on the top.
Ensure the cartridge is seated properly in the cup. Align the threads of the regulator with the threads on
the cup. While firmly holding the regulator in one hand and the cup in the other, quickly rotate the
regulator clockwise into the cup until it is hand tight and not leaking. Do not over tighten.
luer fitting
connects to
VitalsBridge
cap
regulator
12g CO2
cartridge cup 16g CO2
cartridge cup

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The duration of use for a cartridge varies from 30 to 60 minutes, depending on cartridge size and
simulation.
aution: Ensure CO2 has been fully released prior to removing the cup and disposing of the
cartridge. This may be done by removing the cap from the end of the regulator and waiting until no
rush of air is heard at the outlet of CO2. Wear gloves and eye protection when removing a CO2 cartridge
from the cup.
ompressed O2 connection to VitalsBridge: Hold both ends of the luer connector on the blue tubing
and the blue connector on the VitalsBridge. Rotate the tubing connector onto the connector labeled CO2
in on the VitalsBridge, but do not over tighten. When ready to simulate using CO2, open the stopcock on
the CO2 mini regulator. Re close when not simulating.

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ompressed air connection: Hold both ends of the luer connector on the yellow tubing and the yellow
connector on the VitalsBridge. Rotate the tubing connector onto the connector labeled AIR in on the
VitalsBridge, but do not over tighten. When ready to simulate, turn on the compressed air at its source.
aution: When not in use, turn off the compressed air source and disconnect the CO2 regulator and
place the cap on its outlet.
Luer fitting
connects to
VitalsBridge
1/8” NPT fitting (male or female)
connects to compressed air source
(50 – 75 PSI)

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Non-invasive blood pressure connection: There are two luer connections for non invasive blood
pressure, a green connector for measuring the pressure in the cuff (NBPin) and a red connector for
sending a pulse during measurement (NBPout). Hold both ends of the luer connector to make a firm
connection.

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The non invasive blood pressure portion of the patient monitor uses 1 or 2 tubes to inflate the cuff. For
1 tube, the fitting on the green tube (NIBPin) leads from the VitalsBridge and connects to the
appropriate fitting on one of the two black tubes on the NIBP cuff. The remaining black tube connects
to the patient monitor tube. A third white tube on the NIBP cuff connects to the fitting on the clear
tube that leads to the NIBPout connection on the VitalsBridge.
A 2 tube cuff configuration is similar to
a 1 tube configuration, but both black
tubes on the cuff connect to the patient
monitor tubes. However, there will be a
“T” fitting on one of the tubes, which
allows connection of the green marked
tube.
To Vital Signs monitor.
NBP
in
NBP
out
(To VitalsBridge)
NBP
in
NBP
out
(Blood
Pressure
Cuff)