Meti HPS User manual

®

i
License/Copyright
Medical Education Technologies, Inc.®
Human Patient Simulator®(HPS®) Software and Users Guide©
FOR DEMONSTRATION, LICENSE PURCHASE AND USE
ATTENTION: USE OF THE SOFTWARE IS SUBJECT TO THE METI SOFTWARE LI-
CENSE TERMS SET FORTH BELOW. BY INSTALLING, COPYING, DOWNLOAD-
ING OR OTHERWISE USING THE SOFTWARE, YOU AGREE TO BE BOUND BY THE
TERMS OF THIS LICENSE AGREEMENT. YOU SHALL INFORM ALL USERS OF THE
SOFTWARE OF THE TERMS AND CONDITIONS OF THIS AGREEMENT.
METI SOFTWARE LICENSE TERMS
Medical Education Technologies, Inc. (METI) is licensed to provide the Software, which
is an integral part of its series of Simulation Systems. The Software is licensed for use
on a designated single computer system provided with the purchase of a simulator.
Software consists of the graphical user interface, physiological models, scenario pro-
cess, data acquisition and control software and patient scenarios.
The following terms govern your use of the enclosed Software unless you have a sepa-
rate written agreement with METI.
Designated Equipment
HPS
License Grant
(a) Restricted License
METI grants you, the user, a non-exclusive license to use one copy of the Software un-
der the terms and conditions stated herein. You agree that all beta releases, upgrades,
enhancements, maintenance releases, patches, bug-fixes or other modification to the
Software provided to you shall be governed by the terms and conditions, including the
limited warranty, exclusive remedies and limitation of liability provisions, contained in
this agreement. In addition, you agree that any Software Development Kits, Application
Programming Interfaces, communication protocols or other information necessary in
the development of third party applications provided to you by METI shall be governed
by the terms and conditions contained in this agreement. The license granted herein
shall be perpetual provided you comply with the terms hereof.
Except to the extent that such prohibition is not permitted by law, you may not reverse
compile, reverse assemble or otherwise reverse engineer any portion of the software or
create derivative works based upon the METI software, without prior written consent
from METI.

ii
License/Copyright HPS®
(b) Evaluation Licenses
METI may provide demonstration versions of the Software at no charge to you, for
evaluation purposes only. This evaluation Software is licensed to you with all the rights
set out in the above, but with a limited license terms, operability and/or functionality.
You agree and acknowledge that METI provides evaluation Software solely for demon-
stration purposes and not for long-term use. On your accepted order and payment of
the applicable fee, METI will provide a key or other mechanism to you for conversion of
an evaluation-limited license to a non-evaluation full restricted license.
Ownership
The Software is owned and copyrighted by METI and/or its licensors. Your license con-
fers no title or ownership in the Software and is not a sale of any rights in the Software.
METI’s licensors may protect their rights in the event of any violation of these License
Terms.
Trademarks
This Software Agreement does not grant you any rights in connection with any trade-
marks or service marks of METI.
Copyright
All title and copyrights in and to the Software, the accompanying printed materials and
any copies of the Software are owned by METI and/or its licensors. All title and intellec-
tual property rights in and to the content that may be accessed through use of the Soft-
ware is the property of the respective content owner and may be protected by applica-
ble copyright or other intellectual property laws and treaties. This agreement grants you
no rights to use such content. If this Software contains documentation that is provided
only in electronic form, you may print one copy of such electronic documentation.
Copies and Adaptations
You may only make copies or adaptations of the Software for archival purposes or when
copying or adaptation is an essential step in the authorized use of the Software. You
must reproduce all copyright notices in the original Software on all copies or adapta-
tions. You may not copy the Software onto any newsgroup websites or similar system.
Source code, if provided, is so the licensee may combine or modify the Software. Such
modified or combined programs, or any derivative programs, or parts thereof, are the
property of METI and are subject to this licensing agreement. Any other use, including
the distribution, sale or licensing of this software, the manuals or program listing, or any
portion thereof, shall not be made without written approval by METI.

iii
License/Copyright
Transfer
Your license will automatically terminate upon any transfer of the Software. Upon trans-
fer, you must deliver the Software, including any copies and related documentation, to
the transferee. The transferee must accept these License Terms as a condition to the
transfer.
Termination
This agreement shall be in effect until terminated or, in the case of evaluation software,
until your license to use evaluation Software expires as designated by METI. You may
terminate this agreement at any time by destroying all copies of the Software and cor-
responding documentation. This agreement will terminate immediately without notice
from METI if you fail to comply with any provision of this agreement. Upon termination,
you must destroy all copies of the Software in your possession or control.
Export Requirements
You may not export or re-export the Software or any copy or adaptation in violation of
any applicable laws or regulations.
U.S. Government Restricted Rights
If the licensee of this Software is an instrumentality of the U.S. Government, then the
rights conveyed with respect to the listed software are those minimum rights identified
in FAR 52.227-14 and/or DFARS 252.227-7013.
LIMITED SOFTWARE WARRANTY AND DISCLAIMERS
METI supplies Software on its own behalf or as a licensed distributor of third party pro-
prietary owners.
(a) METI owned Software
METI warrants to you that, in the case of any Software it has identified as its own
property, the Software will substantially conform to the applicable METI specifications
in effect at the date of installation and for a period that is consistent with the warranty
offered or extended with the purchase of a simulation system. METI’s sole obligation
under this warranty is limited to responding to your calls and to using all reasonable
endeavors to correct reported problems by supplying you with a corrected version of
the Software.
DISCLAIMER: TO THE EXTENT ALLOWED BY LOCAL LAW, METI DOES NOT WAR-
RANT THAT OPERATION OF ITS SOFTWARE WILL BE UNINTERRUPTED OR ERROR
FREE, OR THAT ANY DEFECTS IN THE SOFTWARE ARE CORRECTABLE OR WILL BE
CORRECTED; OR THAT FUNCTIONS CONTAINED IN ITS SOFTWARE WILL OPER-
ATE IN THE COMBINATIONS WHICH MAY BE SELECTED FOR USE BY YOU TO MEET
YOUR REQUIREMENTS. METI’S WARRANTY OBLIGATIONS WILL BE VOID IF ITS
SOFTWARE IS MODIFIED WITHOUT THE PRIOR WRITTEN CONSENT OF METI.

iv
License/Copyright HPS®
(b) Third Party Proprietary Software
All third party proprietary Software is supplied with the benefit of warranties, if any, of-
fered by the third party owners and reproduced by METI. TO THE FULLEST EXTENT
PERMITTED BY LAW, METI DOES NOT ITSELF WARRANT THIRD PARTY PROPRI-
ETARY SOFTWARE IN ANY WAY, INCLUDING BUT NOT LIMITED TO ITS PERFOR-
MANCE, RELIABILITY OR FUNCTIONALITY, AND METI DOES NOT ACCEPT ANY
RESPONSIBILITY FOR PERFORMANCE OF WARRANTY TERMS BY THIRD PARTY
SOFTWARE OWNERS.
EXCEPT FOR THE EXPRESS WARRANTIES STATED ABOVE, METI DISCLAIMS AND
EXCLUDES ALL OTHER WARRANTIES WHETHER EXPRESS OR IMPLIED IN LAW
OR OTHERWISE TO THE FULLEST EXTENT PERMITTED BY LAW, AND THE ABOVE
WARRANTIES ARE IN LIEU OF ALL OBLIGATIONS AND LIABILITIES ON THE PART OF
METI FOR DAMAGES ARISING OUT OF OR IN CONNECTION WITH THE SOFTWARE,
OR YOUR USE OF THE SOFTWARE, INCLUDING WITHOUT LIMITATION ANY WAR-
RANTY OF MERCHANTABILITY, SATISFACTORY QUALITY OR FITNESS FOR A PAR-
TICULAR PURPOSE.
LIMITATION OF LIABILITY: EXCEPT TO THE EXTENT PROHIBITED BY LOCAL LAW, IN
NO EVENT WILL METI OR ITS AFFILIATES OR SUPPLIERS BE LIABLE FOR DIRECT,
SPECIAL INCIDENTAL, CONSEQUENTIAL OR OTHER DAMAGES (INCLUDING LOST
PROFIT, LOST DATA, OR DOWNTIME COSTS), ARISING OUT OF THE USE, INABILITY
TO USE, OR THE RESULTS OF THE USE OF THE SOFTWARE, WHETHER BASED ON
WARRANTY, CONTRACT, TORT, OR OTHER LEGAL THEORY, AND WHETHER OR NOT
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
NOTE: EXCEPT TO THE EXTENT ALLOWED BY LOCAL LAW, THESE WARRANTY
TERMS DO NOT EXCLUDE, RESTRICT OR MODIFY, AND ARE IN ADDITION TO, THE
MANDATORY STATUTORY RIGHTS APPLICABLE TO THE LICENSE OF THE SOFT-
WARE TO YOU.
If you have any questions about your rights and responsibilities under this Software
license, please contact Medical Education Technologies, Inc. 102 Cattlemen Road,
Sarasota, FL 34232 (USA).

vii
Specifications
HPS Specifications
Size
Mannequin 5ft, 11inches (180cm)
Instructor Workstation
18.5” H x 19.1” W x 7.4” D
(46.9cm x 48.5cm x 18.9cm)
Lab Rack
51”H x 22”W x 31”D
(130cm x 60cm x 78cm)
Weight
Mannequin/Simulator 75lbs (34kg)
Lab Rack 350lbs (159kg)
Instructor Workstation 20lbs (9.1kg)
Environmental Requirements
Ambient Temperature Range
Operation 40°F to 104°F (4°C to 40°C)
Storage 40°F to 122°F (4°C to 50°C)
Maximum Altitude
Instructor Workstation
Maximum operating altitude: 10,000 ft
Maximum storage altitude: 10,000 ft
Maximum shipping altitude: 10,000 ft

viii
Specifications HPS®
Power
Rack & Mannequin
AC Input: AC 100 – 120VAC, 50/60Hz
Consumption: Approx. 400W
(NOTE: The METI transformer kit is supplied for 220VAC users.)
Instructor Workstation
AC Input: AC 100 – 240VAC, 50/60Hz
Electrotherapy
Defibrillation Monophasic

ix
Cautions/Warnings
Cautions/Warnings
Please read and understand these cautions and warnings before you begin using the
HPS system.
USE OF THIS EQUIPMENT IN AN UNSPECIFIED MANNER
MAY IMPAIR DESIGNED PROTECTION.
Your safety is in your hands. Be sure to follow the instructions on the proper
setup, breakdown and use of the HPS system.
SHOCK HAZARD
Electrical Safety
This product must be connected to an electrical outlet that is properly grounded•
Precautions should be taken so that grounding or polarization is not defeated.
Do not place defibrillator paddles on or adjacent to the ECG patient electrodes or•
the PACE patient electrodes. Contact between defibrillator paddles and the ECG/
PACE electrodes may cause injury to the user and damage to the equipment.
The METI HPS is tested to work with the Physio Control Model LifePak 11•
monophasic defibrillator. The use of other defibrillators should be certified by METI
prior to use.
Do not attempt to disassemble the HPS Lab Rack or Portable Rack or service any•
of the electrical components.
Operate the system from a power source with the following rating: 115VAC, 50/60•
hertz (cycles per second) (e.g., North America, Japan).
For International users, it is necessary to use the provided electrical•
transformer to convert 220 AC to 110 AC.
Do not spill fluids of any kind in or on any piece of HPS/PediaSIM equipment.•
General Use Warnings
Electrical System and HPS Rack
Do not drop, step on, or stack anything on the HPS rack.•
Do not clean the HPS Lab Rack front panel with chemical solvents. Use water and a•
light soap solution only.

x
Cautions/Warnings HPS®
Mannequin
Do not disassemble factory-assembled parts of the mannequin.•
Apply water to the mannequin only in accordance with the supported clinical•
procedures identified in this User Guide.
Make sure the mannequin is set up on a stable, sturdy work surface to avoid•
collapsing and causing injury to users.
Do not introduce foreign substances into the airway, with the exception of small•
amounts of approved silicone-based lubricant.
The HPS should be operated in ambient temperatures below 104˚ Fahrenheit (40˚•
Celsius). Prolonged operation (more than 2 hrs) in ambient temperatures greater
than 104˚ Fahrenheit (40˚ Celsius) results in anomalous behavior and out of-spec
performance.
Only perform invasive procedures supported by the system as described in•
applicable sections of the User Guide.
Do not pick the mannequin up by the limbs — support head and leverage weight•
with torso.
It is essential to power off the entire HPS system before switching the mannequin•
from the adult patient mannequin to the pediatric patient mannequin for users with
this option.
Latex is contained within the HPS Mannequin in the vein assembly of the right arm•
(i.e., IV arm). Should you need to replace any portion of the vein assembly please
take the necessary precautions.
Gases
Follow the standard United States Department of Transportation, or applicable•
national agency’s warnings and regulations for handling and using compressed
gases.
Use caution when engaging the air and medical gas valves.•
Latex Warning
METI simulators incorporate latex into their design. When performing certain
maintenance procedures, the latex can become exposed. Users with latex sensitivity
should take necessary precautions when handling the simulator while performing those
procedures.
Volatile Anesthetic Agents
Exposure to volatile anesthetic agents is dangerous. It is essential to follow the instructions provided in
this document and any local protocols for handling and disposal.
Using volatile anesthetic agents requires the use of a fume hood and personal protective equipment
(PPE) such as eyewear and gloves.

xi
Table of Contents
Table of Contents
License/Copyright ������������������������������������������������������������������������������������������i
Declaration of Conformity ������������������������������������������������������������������������������ v
Specifications ��������������������������������������������������������������������������������������������� vii
Cautions/Warnings ��������������������������������������������������������������������������������������ix
Introduction �����������������������������������������������������������������������������������������������1�1
METI HPS .................................................................................................. 1.1
Contained in this User Guide .................................................................... 1.2
Equipment Overview ................................................................................. 1.4
Human Patient Simulator - HPS Standard Components Inventory .. 1.4
Human Patient Simulator - HPS Optional Components Inventory ... 1.4
Health Science HPS Standard Components Inventory .................... 1.5
Health Science HPS Optional Components Inventory ...................... 1.5
HPS Equipment ......................................................................................... 1.6
HPS Mannequin ................................................................................ 1.6
Umbilical Assembly .................................................................................1.6
HPS Lab Rack ................................................................................... 1.7
Front Panel .............................................................................................1.8
The Back of the Rack ............................................................................1.10
Instructor Workstation ..................................................................... 1.12
Wireless Remote Control ................................................................ 1.12
Waveform Display Application and Flat Panel Monitor ................... 1.12
Drug Recognition System ............................................................... 1.12

xii
Table of Contents HPS®
OxSim .............................................................................................. 1.13
Monitor Interface ............................................................................. 1.13
Wireless Microphone and Receiver ................................................. 1.13
Replacement Kit .............................................................................. 1.14
IV Arm Kit ..............................................................................................1.14
Trauma Features Kit ..............................................................................1.14
Airway Kit ..............................................................................................1.14
Genitourinary (GU) Kit ...........................................................................1.14
METI Transformer Kit ......................................................................1.15
Diagnostic Peritoneal Lavage .......................................................... 1.15
Anesthesia Delivery System ............................................................ 1.15
Anesthesia Gas Accessory Kit ........................................................ 1.15
Gas Accessory Kit ........................................................................... 1.15
Trauma Disaster Casualty KitTM (TDCKTM) .......................................... 1.16
Moulage Kit ..................................................................................... 1.16
METI Tool Kit ................................................................................... 1.17
PediaSIM®Plug and Play Mannequin .............................................. 1.17
METIVision®..................................................................................... 1.18
METI FX ........................................................................................... 1.19
Hands-Free Training Cables ............................................................ 1.20
HPS Learning Modules and Training Courses ................................ 1.21
HPS Learning Modules .........................................................................1.21
HPS Training Courses ...........................................................................1.22
HPS Setup ��������������������������������������������������������������������������������������������������2�1
Before Beginning Setup ............................................................................ 2.2
Step 1: Place the Simulator in the Work Area ........................................... 2.3

xiii
Table of Contents
Step 2: Connect the Umbilical Assembly .................................................. 2.4
Step 3: Connect the Gases ....................................................................... 2.6
Step 4: Power on the Instructor Workstation ............................................ 2.7
Step 5: Connect the OxSim (Optional) ...................................................... 2.8
Step 6: Connect Clinical Monitors (Optional) .......................................... 2.10
Step 7: Connect the Waveform Display Monitor to the Instructor
Workstation (Optional) ............................................................................. 2.11
Step 8: Configure the Waveform Display for External
Sound (Optional) ...................................................................................... 2.12
Step 9: Ensure All Gas Supplies Are Turned off ...................................... 2.12
Step 10: Turn on Patient Monitors ...........................................................2.12
Step 11: Power on the HPS Lab Rack .................................................... 2.13
Step 12: Power on and Log Into the Instructor Workstation ................... 2.14
Step 13: Launch the HPS6TM Software ..................................................... 2.15
Step 14: Activate the Gas Supplies ......................................................... 2.16
Step 15: Open a Patient in the HPS6 Software ....................................... 2.17
Step 16: Connect to the Mannequin ....................................................... 2.18
HPS Software Features �������������������������������������������������������������������������������3�1
Starting the Application ............................................................................. 3.1
Patient Start Up ......................................................................................... 3.2
Opening a Patient File ....................................................................... 3.3
Locating Patient Files ........................................................................ 3.4
Creating a New Patient ..................................................................... 3.4
Using the Patient Menu ............................................................................. 3.5
Opening a Recent Patient File ........................................................... 3.5
Utilizing Shortcut Keys ...................................................................... 3.6
The Patient Window .................................................................................. 3.6

xiv
Table of Contents HPS®
Using the Patient Toolbar Icons ........................................................3.7
Save .................................................................................................. 3.7
Stop ................................................................................................... 3.7
Logs .................................................................................................. 3.8
The Event Log ........................................................................................3.9
The Physiologic Data Log ....................................................................3.10
The Drug Log .......................................................................................3.11
The Logs Folder .............................................................................. 3.12
Detach Tab ...................................................................................... 3.12
Recorder .......................................................................................... 3.13
Patient Time .................................................................................... 3.14
Connection Icons ............................................................................ 3.15
Viewing the Heads Up Display (HUD) ...................................................... 3.16
The Ischemic Index ......................................................................... 3.18
Working with Tabs ........................................................................... 3.19
Numeric and Discrete Parameters .................................................. 3.20
Parameter Settings ......................................................................... 3.20
Saving Data ............................................................................................. 3.23
Saving Patient Files ......................................................................... 3.23
Saving to a CD ....................................................................................3.24
Saving to a USB Memory Device .........................................................3.25
Printing Files ............................................................................................ 3.26
Tabs ......................................................................................................... 3.27
The Simulation Tab .......................................................................... 3.27
The Scenario Tab ............................................................................ 3.28

xv
Table of Contents
Playing Scenarios ............................................................................ 3.29
Opening a Scenario .............................................................................3.29
Understanding the Scenario Script ......................................................3.31
Navigating Between States ............................................................. 3.33
Closing Scenarios ........................................................................... 3.34
Working with Multiple Scenarios ..................................................... 3.34
Switching Scenarios ............................................................................3.34
Repeating Scenarios ............................................................................3.34
Editing Scenarios ............................................................................ 3.35
Modifying Existing Scenarios .......................................................... 3.36
Developing New Scenarios ............................................................. 3.38
Adding, Editing and Deleting States ............................................... 3.39
Adding, Editing and Deleting Events ............................................... 3.42
“Set” Events .........................................................................................3.43
“Bolus” Events .....................................................................................3.46
“Call” Events ........................................................................................3.48
“Go To” Events .....................................................................................3.49
“Infusion” Events ..................................................................................3.51
“Multiply” Events ..................................................................................3.53
Adding, Editing and Deleting Transitions ......................................... 3.55
Defibrillation Transitions .......................................................................3.59
Editing Transitions ................................................................................3.60
Deleting Transitions ..............................................................................3.60
Changing the Location of Events and Transitions ................................3.60
Copying Events and Transitions ...........................................................3.61

xvi
Table of Contents HPS®
Saving Scenarios ............................................................................ 3.62
Using the Event Recorder ................................................................ 3.64
Managing Events in the Event Recorder ..............................................3.66
Copying Recorded Events to a Scenario ........................................ 3.67
The Condition Tab ........................................................................... 3.68
The Drugs Tab ................................................................................. 3.69
The Fluids Tab ................................................................................. 3.70
The Cardiovascular Tab ................................................................... 3.71
The Respiratory Tab ........................................................................ 3.72
Using HPS ........................................................................................................ 4.1
Patient Profiles ........................................................................................... 4.2
20-year-old with Spontaneous Pneumothorax ................................. 4.4
20-year-old with Tension Pneumothorax .......................................... 4.4
26-year-old with 7 min Fresh Water Submersion .............................. 4.5
27-year-old MVC victim with ARDS .................................................. 4.5
30-year-old with Acute Asthma Attack ............................................. 4.5
50-year-old with Alcoholic Cardiomyopathy ..................................... 4.6
50-year-old with GI Bleeding ............................................................ 4.8
55-year-old with Acute Cholecystitis ................................................ 4.8
61-year-old with Internal Bleeding .................................................... 4.9
62-year-old with Acute Atrial Fibrillation ......................................... 4.10
67-year-old with CHF & Pulmonary Edema .................................... 4.11
72-year-old with Septic Shock ........................................................ 4.12
Dr. Iven Fast .................................................................................... 4.14
Mr. Outta Joint ................................................................................. 4.16

xvii
Table of Contents
Mr. Reen L. Stone ............................................................................ 4.18
Mrs. Una Goodeye .......................................................................... 4.20
Orthostatic Granny .......................................................................... 4.21
Soldier ............................................................................................. 4.22
Soldier with Gun Shot Wound ......................................................... 4.22
Soldier with Land Mine Injury .......................................................... 4.23
Soldier with Snake Bite Injury ......................................................... 4.23
Standard Child ................................................................................ 4.24
Standard Granny ............................................................................. 4.24
Standard Man .................................................................................. 4.25
Standard Man Narcotized ............................................................... 4.26
Standard Man Relaxed ................................................................... 4.27
Stannette ......................................................................................... 4.28
Stannette Preeclampsia .................................................................. 4.29
Truck Driver ..................................................................................... 4.30
Truck Driver Pre-clamp ................................................................... 4.32
Truck Driver Pre-unclamp ............................................................... 4.34
Developing a New Patient ....................................................................... 4.36
Adding a Photograph ...................................................................... 4.37
Completing the Patient History ....................................................... 4.37
Changing the Patient’s Physiology .................................................. 4.37
Altering an Existing Patient ...................................................................... 4.38
Editing the Patient History ............................................................... 4.38
Changing the Patient’s Physiology .................................................. 4.38
Auditory and Ocular Physiological Signs ................................................ 4.39

xviii
Table of Contents HPS®
Reactive Eyes .................................................................................. 4.39
Wireless Voice Capability ................................................................ 4.41
Metabolic Features .................................................................................. 4.42
Bowel Sounds ................................................................................. 4.42
Airway ...................................................................................................... 4.43
Realistic Upper Airway .................................................................... 4.44
Variable Upper/Lower Airway Resistance ....................................... 4.45
Airway Occluder ...................................................................................4.45
Laryngospasm .....................................................................................4.46
Tongue Edema (Swelling) .....................................................................4.47
Bronchial Occlusion .............................................................................4.48
PEEP ....................................................................................................4.49
Cricothyrotomy ................................................................................ 4.50
Replacing the Cricothyrotomy Tape .....................................................4.50
Resealing the Membrane after a Puncture ..........................................4.50
Breakaway Teeth ............................................................................. 4.50
Pulmonary ................................................................................................ 4.51
Breath Sounds ................................................................................ 4.52
Lung Parameters ............................................................................. 4.53
Respiratory Control Parameters ...................................................... 4.54
Cardiovascular ......................................................................................... 4.55
Pulses .............................................................................................. 4.56
Heart Sounds .................................................................................. 4.57
5-Lead ECG .................................................................................... 4.58
Myocardial Ischemia ....................................................................... 4.59