Nasco Healthcare TERi LF04302EX User manual

TERi™
Patient Care Trainer LF04300
Patient Skills Trainer LF04301
Patient Simulator LF04302
Patient Simulator, Export LF04302EX
INSTRUCTION MANUAL
5 Year Warranty

2
Table of Contents
About the Simulator ..........................................3
List of Components ...........................................7
Arms / Joints / Legs / Eyes / Oral Hygiene . . . . . . . . . . . . . . . . . . . . . . . 8
Ear Care / Bath & Washing / Tracheostomy Care.................9
Lavage / Gavage / Suctioning / Nasogastric / Carotid Pulse......10
Lavage / Gavage / Suctioning / Nasogastric ....................11
Intubatable Head ............................................12
Ostomy Care.................................................13
Gastrostomy Care Lavage and Gavage .........................14
Male Catheterization .........................................15
Foreskin Application / Prostate Examination...................16
Female Catheterization.......................................17
Enema Administration .......................................18
Female Cervical Exam ........................................18
Suprapubic and Urinary Catheterization.......................19
Blood Pressure Arm ..........................................20
IV and Injection Arm .........................................25
Injectable Arm...............................................26
Auscultation .................................................30
Anterior Heart Sites ..........................................32
Anterior / Posterior Lung Sites ................................33
Pressure Injury Wounds ......................................34
Edema ......................................................34
CPR Measuring ..............................................35
Consumables ................................................36
Care and Maintenance .......................................38

3
About the Simulator
Nasco Healthcare TERi™Androgynous Geriatric
Trainer is a comprehensive male/female elderly
patient care trainer for medical simulation. Evolving
from our GERi™/KERi™full-body manikins, it has a
more realistic look and feel accurately representing
the human anatomy. Weight is distributed to
represent a real patient for lifting and carrying.
Each version is affordable and durable with
upgradable items.
• Geriatric Patient Care Trainer – General patient
care, daily living assistance simulation platform.
• Geriatric Patient Skills Trainer – Physical skills
practice simulation platform with injection/IV,
catheterization, cardiovascular and respiratory
support.
• Geriatric Patient Simulator – Comprehensive and
complete simulation platform including patient
monitoring capability.

4
• Superior Range of Motion
• Enhanced Full Body Aesthetics
• Articulating Jaw
• Lightweight: 50 lbs.
• Interchangeable Pupils: normal, constricted, dilated
• Male & Female Options (wig included)
• Soft Male (circumcised and uncircumcised features) and
Female Genitalia
• Normal and Cancerous Moles
• Stage 1 Sacral Ulcer
• Reddened Skin Folds
• Bandaging and Wound Dressing (Recommended bandages:
Silicone Adhesive Bandages)
• Patient Positioning (fully articulated)
• Clothing Changes
• Bed Baths
• Eye Irrigation & Optic Drops
• Dental Care (including placement and removal)
• Ear Canal Irrigation
• Hearing Aid Included (interchangeable between right and left ears)
• Hair Care
• Pericare
• Ostomy Care (ileostomy and colostomy care)
• Urinary Catheter Care (external care only; supporting bladders
not included)
• Stomas (colostomy and ileostomy)
• Standard Arms with Injection Sites (IM injection only)
• Injection Sites (thigh, right side buttocks supporting IM and
sub-cutaneous injections)
• Support for Oxygen Administration
LF4300: TERi™Geriatric Patient Care Trainer
About the Simulator
• Superior Range of Motion
• Enhanced Full Body Aesthetics
• Articulating Jaw
• Lightweight: 50 lbs.
• Interchangeable Pupils: normal, constricted, dilated
• Male & Female Options (wig included)
• Soft Male (circumcised and uncircumcised features) and
Female Genitalia
LF4301: TERi™Geriatric Patient Skills Trainer
• Normal and Cancerous Moles
• Stage 1 Sacral Ulcer
• Reddened Skin Folds
• Bandaging and Wound Dressing (Recommended bandages:
Silicone Adhesive Bandages)
• Patient Positioning (fully articulated)
• Clothing Changes
• Bed Baths
• Eye Irrigation & Optic Drops
• Dental Care (including placement and removal)
• Ear Canal Irrigation
• Hearing Aid Included (interchangeable between right and left ears)
• Hair Care
• Pericare
• Ostomy Care (ileostomy and colostomy care)
• Urinary Catheter Care (external care only; supporting bladders
not included)
• Stomas (colostomy and ileostomy)
• Support for Oxygen Administration
• Left Blood Pressure Arm with Radial Pulse
• Injection Sites (arms, thigh, right side buttocks supporting IM
and sub-cutaneous injections)
• Gastrostomy Procedures (lavage, gavage, tube placement)
• Nasogastric Tube Procedures (lavage, gavage, tube placement,
feeding, suctioning)
• Respiratory Support:
• Tracheostomy Care, Airway/Trach Suctioning (lavage, suctioning)
• Urinary Catheterization
• Suprapubic Catheterization
• Enema Administration (female)
• Pap Smears (female)
• Pelvic Examination (female) – 3 cervix presentations
(healthy/normal, pre-cancerous, cancerous)
• Prostate Examination (male) – 5 prostate presentations
(1 normal/healthy, 4 cancerous in varied sizes)
• Right IV Arm
• Foot Wound Care
• CPR with Quality Performance Metrics (compressions and
ventilation rate & depth; audible and visual feedback)
• Carotid Pulse (manual)
• Intubation
• Ventilation

5
• Superior Range of Motion
• Enhanced Full Body Aesthetics
• Articulating Jaw
• Lightweight: 50 lbs.
• Interchangeable Pupils: normal, constricted, dilated
• Male & Female Options (wig included)
• Soft Male (circumcised and uncircumcised features) and
• Female Genitalia
• Normal and Cancerous Moles
• Stage 1 Sacral Ulcer
• Reddened Skin Folds
• Bandaging and Wound Dressing (Recommended bandages:
Silicone Adhesive Bandages)
• Patient Positioning (fully articulated)
• Clothing Changes
• Bed Baths
• Eye Irrigation & Optic Drops
• Dental Care (including placement and removal)
• Ear Canal Irrigation
• Hearing Aid Included (interchangeable between right and left ears)
• Hair Care
• Pericare
• Ostomy Care (ileostomy and colostomy care)
• Urinary Catheter Care (external care only; supporting bladders
not included)
• Stomas (colostomy and ileostomy)
• Support for Oxygen Administration
• Left Blood Pressure Arm with Radial Pulse
• Injection Sites (arms, thigh, right side buttocks supporting IM
and sub-cutaneous injections)
• Gastrostomy Procedures (lavage, gavage, tube placement)
• Nasogastric Tube Procedures (lavage, gavage, tube placement,
feeding, suctioning)
• Respiratory Support:
• Tracheostomy Care, Airway/Trach Suctioning (lavage,
suctioning)
• Urinary Catheterization
• Suprapubic Catheterization
• Enema Administration (female)
• Pap Smears (female)
LF4302: TERi™Geriatric Patient Simulator
(includes monitors)
LF4302EX: TERi™Geriatric Patient Simulator Export
(excludes monitors)
• Pelvic Examination (female) – 3 cervix presentations
(healthy/normal, pre-cancerous, cancerous)
• Prostate Examination (male) – 5 prostate presentations
(1 normal/healthy, 4 cancerous in varied sizes)
• Right IV Arm
• Foot Wound Care
• CPR with Quality Performance Metrics (compressions and
ventilation rate & depth; audible and visual feedback)
• Carotid Pulse (manual)
• Intubation
• Ventilation
• Auscultation (heart and lung sounds)
• Patient Vital Signs and Monitored Signals Simulation Suite
(LF04302EX does not include monitors/tablets)

6
Feature Set Capability Geriatric Patient
Care Trainer Geriatric Patient Skills Trainer Geriatric Patient
Simulator
General
Superior range of motion ✓✓✓
Enhanced full body aesthetics ✓✓✓
Lightweight: 50 lbs. ✓✓✓
Pupils ✓✓✓
Male and female ✓✓✓
Soft male and female genitalia ✓✓✓
Skin Care
Normal and cancerous moles ✓✓✓
Stage 1 sacral ulcer ✓✓✓
Reddened skin folds ✓✓✓
Bandaging and wound dressing ✓✓✓
Movement Assistance,
Fall Prevention and Care Patient positioning ✓✓✓
Bathing Clothing changes ✓✓✓
Bed baths ✓✓✓
Grooming &
Daily Living
Assistance
Eye irrigation and optic drops ✓✓✓
Dental care ✓✓✓
Ear canal irrigation ✓✓✓
Hearing aid ✓✓✓
Hair care ✓✓✓
Nursing Care
Pericare ✓✓✓
Ostomy care ✓✓✓
Urinary catheter care ✓✓✓
Stomas ✓✓✓
Standard arms with injection sites ✓✓✓
Support for oxygen administration ✓✓✓
Left blood pressure arm (with radial pulse) Option*✓ ✓
Advanced Skills
Injections sites Option*✓ ✓
Gastrostomy procedures ✓ ✓
Nasogastric tube procedures ✓ ✓
Respiratory support: tracheostomy care, airway/trach suctioning ✓ ✓
Urinary catheterization ✓ ✓
Enema administration (female) ✓ ✓
Pap smears (female) ✓ ✓
Pelvic examination (female) ✓ ✓
Prostate examination (male) ✓ ✓
Right IV arm trainer Option*✓ ✓
IV arm circulation pump Option*Option*Option*
Foot wound care ✓ ✓
ACLS/BLS
CPR with quality performance metrics ✓ ✓
Carotid pulse ✓ ✓
Articulating jaw ✓✓✓
Intubation ✓ ✓
Ventilation ✓ ✓
Advanced Nursing ACLS/BLS Auscultation (heart and lung sounds) ✓
Monitoring&Therapeutics Patient vital signs and monitored signals Option1Option2,3 ✓3

7
TERi™Geriatric Patient Care Trainer LF4300
• Male Genitalia Foreskins, Pack of 3 (LF000843 G)
• Pupils, Constricted, Set of 2 (LF04317 B)
• Pupils, Dilated, Set of 2 (LF04317 C)
• Male Genitalia (LF04318)
• Female Genitalia (LF04319)
• Hearing Aid (LF04325)
• Wig (LF04326)
• Dentures, Upper & Lower (LF04327)
• Hospital Gown (LF04333)
TERi™Geriatric Patient Simulator LF4302 (includes
monitors)
TERi™Geriatric Patient Simulator Export LF4302EX
(excludes monitors)
• Male Genitalia Foreskins, Pack of 3 (LF000843 G)
• Pupils, Constricted, Set of 2 (LF04317 B)
• Pupils, Dilated, Set of 2 (LF04317 C)
• Male Genitalia (LF04318)
• Female Genitalia (LF04319)
• Hearing Aid (LF04325)
• Wig (LF04326)
• Dentures, Upper & Lower (LF04327)
• Hospital Gown (LF04333)
• Simulated Blood, Pint
• Blood Pressure Cuff with Sphygmomanometer
(LF01073)
• Electronic Blood Pressure Control Unit with
Batteries (LF01096)
• Fluid Supply Bag, 500 ml, with Pinch Clamp
(LF01130)
• Cervix Kit, Set of 7 (LF01230 C)
• Pump Spray Lubricant (LF03644)
• Foot Wounds, Pressure Injury Stages 1-4 (LF04310)
• Foot Wound Sleeve (LF04310 A)
• Deep Tissue Wound (LF04328)
• Enema Bag (LF04316)
• Edema, Set of 5, Stages 1-4 & Non-Pitting
(LF04329)
• Prostate Kit, Set of 5 (LF04332)
• External Bladder Bag, Urinary & Suprapubic
(LF04334)
• Simulated Urine, Quart (PN01037)
• Carotid Pulse Bulb (100-2028)
• Syringe, 20 cc
• Auscultation SmartScope™ with Batteries
(LF01144)
• Auscultation Remote with Batteries (LF01148)
• Patient Vital Signs and Monitored Signals
Simulation Suite (LF04302EX does not include
monitors/tablets)
List of Components
TERi™Geriatric Patient Skills Trainer LF4301
• Male Genitalia Foreskins, Pack of 3 (LF000843 G)
• Pupils, Constricted, Set of 2 (LF04317 B)
• Pupils, Dilated, Set of 2 (LF04317 C)
• Male Genitalia (LF04318)
• Female Genitalia (LF04319)
• Hearing Aid (LF04325)
• Wig (LF04326)
• Dentures, Upper & Lower (LF04327)
• Hospital Gown (LF04333)
• Simulated Blood, Pint
• Blood Pressure Cuff with Sphygmomanometer
(LF01073)
• Electronic Blood Pressure Control Unit with
Batteries (LF01096)
• Fluid Supply Bag, 500 ml, with Pinch Clamp
(LF01130)
• Cervix Kit, Set of 7 (LF01230 C)
• Pump Spray Lubricant (LF03644)
• Foot Wounds, Pressure Injury Stages 1-4 (LF04310)
• Foot Wound Sleeve (LF04310 A)
• Deep Tissue Wound (LF04328)
• Enema Bag (LF04316)
• Edema, Set of 5, Stages 1-4 & Non-Pitting (LF04329)
• Prostate Kit, Set of 5 (LF04332)
• External Bladder Bag, Urinary & Suprapubic
(LF04334)
• Simulated Urine, Quart (PN01037)
• Carotid Pulse Bulb (100-2028)
• Syringe, 20 cc
TERi™comes packaged with the normal pupils,
dentures, female genitalia, lungs, stomach, and
other internal reservoir bags installed (features
included with LF04301, LF04302, and LF04302EX).

8
Eyes
All versions of TERi™
come with 3 sets of
brown eyes. 1 set of
normal pupil brown eyes,
1 set of constricted pupil
brown eyes and 1 set of
dilated pupil brown eyes.
The normal eyes come
installed in the head. The eyes can be changed to
dilated or constricted by creasing the skin at the
outside of each eye and rolling the eye up. (See
Figure 3.) Both eyes may be irrigated using water.
Eye sockets will hold no more than a few drops
of liquid at a time. Following completion of the
exercise, follow the above instructions for removing
the eye, dry the sockets completely with
a soft cloth, and replace the eyes.
Oral Hygiene
Tooth brushing should be simulated without water
or any cleaning agents to avoid leaking into the
head of the manikin and to simplify cleanup. Teeth
cannot be flossed. Denture removal is accomplished
by grasping the dentures and pulling forward and
then down for the upper plate and forward then up
for the lower plate. (See Figure 4). Dental adhesive
may be used.
Note: To clean adhesive,
use mild soap, warm
water, and a soft cloth.
Allow to dry completely
before storing.
Arms / Joints
TERi™is packaged
with arms and female
genitalia attached and
legs unattached to
prevent damage during
shipping. Refer to the
following sections for
assembly instructions
(See Figure 1).
Note: All Versions of TERi™come packaged with
the normal eyes, dentures, and female genitalia
installed. Geriatric Patient Skills Trainer and
Simulator (LF04301, LF04302, LF04302EX) come
with lungs, stomach, and other internal reservoir
bags installed.
Set Up
Arms / Joints / Legs / Eyes / Oral Hygiene
Fig 2. Fig 4.
Fig 3.
Fig 1.
Fig 1.
Leg Assembly
The legs attach to
the body at the
hips by rotating
the legs backward
approximately 150°
so the feet are near
the shoulders and the
keyholes are aligned.
(See Figure 2).

9
Set Up
Ear Care / Bath & Washing / Tracheostomy Care
Ear Care
Both ears may be
irrigated. Using water to
perform ear irrigation is
recommended. The ear
canal will hold up to
1 mL of water.
To drain, tilt the head
sideways and empty into
the basin or absorbent
cloth. (See Figure 5 & 6).
Cotton swabs may be used
gently in the ear as you
would with a real patient.
The manikin includes a
simulated hearing aid for
placement practice. (See
Figure 7). The hearing
aid is interchangeable
between both ears.
Bed Baths and
Hair Washing
To simplify cleanup, dry
bed baths and shampoos
are recommended to
eliminate the chance of
water entering the inside
of the manikin. A soft
cloth and water can be used for bathing exercises,
and a mild shampoo and cool water can be used
for hair washing. Avoid scrubbing any painted areas
of the manikin. To dry the wig, blot with a soft
towel and air dry. Do not brush the hair when wet,
and never use a hair dryer or blow dryer on the wig.
Tracheostomy Care
Suctioning, dressing changes, tracheostomy tube
placement, and cuff inflation may be practiced
on the simulator. The tracheostomy canal is not
removable from the body. Any water administered
to this site must be suctioned out after completion
of the exercise. The tracheostomy canal (See Figure
8) can hold approximately 20 cc of water.
Ensure proper lubrication prior to inserting tubes
into the stoma site by using the Pump Spray
Lubricant included. The tracheostomy canal
is not connected to the oronasal system, and
access is provided only through the stoma site.
Recommended tracheostomy tube size is 6.0 mm.
Note: Does not support
ventalation of lungs
through tracheostomy.
Supports lavage and
saline treatment. Features
included with LF04301,
LF04302, and LF04302EX.
Fig 5.
Fig 6.
Fig 7.
Fig 8.

10
Oral and Nasal Lavage,
Gavage, and Suctioning
Access to the stomach
is provided through the
mouth and both nostrils.
The internal stomach
reservoir bag has a 200 cc
capacity. The head
should be connected to
the stomach reservoir bag green) and NOT the
intubation air bladder bag yellow). (See Figure 9).
Lubricate feeding tubes generously prior to
inserting through mouth, nose, or nostrils by using
the Pump Spray Lubricant included. Only water
should be used in tube feeding exercises. Ensure
the upper torso of the manikin is slightly elevated
to prevent water backflow into the head of the
manikin. Introduce water only using standard
facility procedures and materials.
Following the procedure,
empty the stomach.
Water may be removed
by suctioning or removing
the stomach reservoir
bag by disconnecting 2
velcro straps and white
diconnect and then
draining it into a sink or
basin. (See Figure 10).
Note: Ensure the manikin’s torso remains elevated
when the stomach reservoir bag contains water to
continue to prevent backflow into the head of the
manikin. Features included with LF04301, LF04302,
and LF04302EX.
Fig 9.
Set Up
Lavage / Gavage / Suctioning / Nasogastric / Carotid Pulse
Fig 11.
Fig 13.
Fig 12.
To remove the Stomach
Reservoir Bag:
1. Remove the head by
disconnecting the
snaps on the head
skin, around the neck,
and pulling the head
straight back with the
head facing forward.
(See Figure 11).
2. Gently pull up head to
expose four tubes with
the stomach reservoir
bag connected at the
end. (See Figure 12).
3. Unfasten the strap
that holds the
Stomach Reservoir Bag and esophagus tube
together and depress button on the quick
disconnect feature of the bag. (See Figure 13).
Following completion of the procedures,
completely drain the stomach reservoir and allow
drying prior to reattaching and storing inside the
manikin. Wipe any residual lubricant with warm
water and a soft cloth.
Carotid Pulse
Attach pump bulb to Carotid tube exiting the rear
neck. (See Figure 14). Pump bulb to simulate pulse
at the pulse points of the Carotid (See Figure 15).
Pulse points are present on both sides.
Fig 14. Fig 15.
Fig 10.
Disconnect
Velcro
Velcro

11
Nasogastric
This section pertains to TERi™Geriatric Patient
Skills Trainer (LF04301) and TERi™ Geriatric Patient
Simulator (LF04302, LF04302EX). The simulator can
be connected for nasogastric suctioning or airway
intubation with stomach rise. The airway includes
a sinus passage to the back of the throat through
the nostrils. The esophagus leads to a stomach
reservoir bag located in the lower end of the torso.
This stomach reservoir bag is accessible by the user
for maintenance. Air insertion will cause a visual
stomach rise only when the head is connected to
the airway intubation stomach reservoir. Supported
procedures include nasal trumpet and nasogastric
tube insertion. Lavage and gavage are also
supported.
1. Ensure the nasogastric
tubing is connected
to the nasogastric
stomach reservoir via
the (green, yellow)
coded tubes. Ensure
tubing is well attached
and adhere the tubes
with the hook and
loop. Insert the tubes
back into the torso
of the manikin and
replace the head on
the torso. (See Figure 16).
2. Lubricate nasogastric
devices and supplies
being used with the
Pump Spray Lubricant
provided (See Figure
17). NG tubes should
be well lubricated and
force should not be
used when placing
the tube through the
sinus canal.
Fig 16.
Set Up
Lavage / Gavage / Suctioning / Nasogastric
3. Fluids should be
drained and the
reservoir bags emptied
after every use.
Accessing Lung
Bag and Stomach
Bag for Cleaning or
Replacement
1. To remove lung bags
disconnect four
snaps on the neck
skin and pull neck
skin away from two
rivets in front of
neck. Roll the skin
down from the neck
to change the lung
bags (See Figure 18).
2. To remove the
stomach reservoir.
Remove legs. Roll
the skin up from the
pelvis (See Figures
19 and 20). Ensure
the bag is clean and
dry prior to storing it
back inside the torso.
3. Wipe any residual lubricant from the site with
warm water and a soft cloth prior to storing the
manikin.
Note: Use Nasco Healthcare’s Pump Spray Lubricant
to lubricate airway devices before use.
Fig 19.
Fig 20.
Fig 17.
Fig 18.

12
Set Up
Intubatable Head
Intubatable Head
There are individual inflatable lung bags for both
left and right lungs and a separate stomach
bag. Each bag will cause visual chest rise in the
correct anatomical location to indicate effective
and ineffective intubation styles. Jaw thrust is
supported. A manual pulse bulb is included to
simulate a carotid pulse. Features included with
LF04301, LF04302, and LF04302EX.
The unit is not designed for use with mouth-to-
mouth techniques and may contaminate the mouth
and airway. Airway devices are recommended and
the supported devices are listed.
Before using the simulator
for airway management,
lubricate both the
simulator and supplies
being used with the
Pump Spray Lubricant
provided. (See Figures 21
& 22).
Extreme care should be
exercised when using a
laryngoscope blade. As
with a real human, (See
Figure 23), damage can be
caused if improper forces
and techniques are used.
It is not recommended to
intubate with dentures
installed. Damaged
caused by improper use
will void the warranty
Note: There is no cricoid.
Fig 21.
Fig 22.
Fig 23.
NG Tube, Nasal
Size 16FR Preferred
Note: Use Nasco Healthcare’s Pump Spray Lubricant
to lubricate airway devices before use.
Laryngoscope Blades
Miller Blades: Size 3
Macintosh Blades: Size 4
BVM – Bag Valve Mask
Adult Size
Oropharyngeal Airway
110 Preferred
100 Smallest acceptable
Endotracheal Tube
7.0mm Preferred
6.5mm Supported
7.5mm Supported
Combitube
37FR Preferred
41FR Supported
LMA Supreme and iGel
Size 3 Supported
Size 4 Preferred
Size 5 Supported
Nasal Trumpet
Size 6 (24FR) Preferred
Size 7 (28FR) Supported
King Airway
Size 3 Supported
Size 4 Preferred
Size 5 Supported
NG Tube, Nasal
Size 16FR Preferred
NG Tube, Oral
Size 16 Preferred
Size 14 Supported
Size 18 Supported
Trachesotomy
Intubation
Uncuffed 6.0mm Preferred
7.0mm Preferred
Cuffed 6.0mm Preferred
7.0mm Preferred

13
Set Up
Ostomy Care
Ostomy Care
Colostomy and ileostomy care can be practiced on all
TERI™models, including stoma dilation, cleaning, and
ostomy bag changing procedures. Irrigation can be
practiced. Irrigation tubes should be well lubricated
prior to insertion. After completion of the exercises,
the stomas can be rinsed with warm water to remove
any residual lubricant. The stoma reservoirs have
a 20 cc fluid capacity.
Removal of the internal stoma reservoirs
(See Figure 24) :
1. Remove the genitalia and reach through the
genital cavity. It is recommended to suction the
fluid from the bag prior to removal to prevent
spillage when removing for cleaning.
2. The reservoir bags are attached to the underside
of the stomas. To remove push in on the L-shaped
button pull the reservoir fittings down and
disconnect from the stomas.
3. Pull the reservoir bags from the hook-and-loop
attachments. (See Figures 25 and 26). Rinse with
water to clean.
4. Reverse the procedure to reattach the internal
stoma reservoirs. Ensure reservoirs are clean and
dry prior to reattaching for storage.
Fig 24.
Fig 25.
Fig 26.

14
A flanged hole simulating
an abdominal incision
for the insertion of a
feeding tube is included
on the upper torso for
performing lavage and
gavage. (See Figure 27).
Inside the upper torso
is a reservoir bag with a
maximum capacity of 200 cc, which is attached to
the underside of the gastrostomy opening with a
two-part coupler. Access the bag by:
1. Reaching through the genital opening in the
pelvis, on the left side of the torso.
2. Remove the bag by
pushing in on the
L-shaped button and
pulling it straight away.
(See Figure 28 and
inset).
Note: In some models,
the waist pin will need
to be removed for easier
access. Not easy to remove
the waist connection, it
no longer a pin but two
individual attachment points
Set Up
Gastrostomy Care Lavage and Gavage
Gastrostomy Care Lavage and Gavage
Fig 27.
Fig 28.
To attach the bag:
1. Push the coupler body (with bag attached)
onto the coupler insert (part with the black
O-ring) that is protruding from the underside of
the gastrostomy inside the upper torso of the
manikin. You will hear a slight snap when the
connection is complete.
2. Test the connection by gently pulling on the
coupler body to ensure it is locked.
Note: The gastrostomy feature is designed for
use with a 16 French Gastrostomy Tube. It is
recommended that the tip of the feeding tube is
well lubricated before inserting.
3. Ensure the reservoir is straight and flat before
attempting to simulate feeding with water.
Note: Water only should be used to perform
feeding procedures.
4. Lubricate the end of the feeding tube and gently
insert through the flanged hole.
5. Upon completion of the exercise, remove
genitals, remove the reservoir, drain the liquid
from the reservoir bag, and rinse the bag.
6. Ensure the bag is clean and dry prior to storing it
back inside the torso. Wipe any residual lubricant
with warm water and a soft cloth prior to storing
the manikin.

15
Male Catheterization
& Prostate Examination
Features included with
LF04301, LF04302, and
LF04302EX.
The male genital
insert can represent
an uncircumcised or
circumcised adult male,
with the addition of
the included foreskin. To change genitals in the
simulator, simply press to fit into the open genital
area of the pelvis. (See Figure 29).
The urinary catheterization reservoir is
interchangeable between male and female genitals.
Female Genitals come installed with the simulator.
Note: To apply the foreskin, apply the included pump
spray lubricant to the glans and slide the foreskin in
place.To prepare for catheterization exercises:
. The urinary resevoir is installed on the back side,
make sure the urinary
resevoir is firmly in
place. (See Figure 30).
2. Close the clamp on
the Fluid Supply Bag
(See Figure 31) and
fill with water or
included simulated
urine. Recommended
amount of fluid to fill
the Fluid Supply Bag
is between 100 and
250 mL.
3. Hang the filled Fluid
Supply Bag. Attach the
tubing quick connect
on end of Fluid Supply
Bag to the quick
connect on the left
lower side of the simulator’s torso.Open Clamp
on fluid supply bag (See Figure 32).
Set Up
Male Catheterization
Fig 33.
Fig 32.Fig 29.
Note: The Fluid Supply
Stand is not included.
Use distilled water or
follow instructions on
the Simulated Urine.
4. Lubricate the
catheter being used
with the Pump Spray
Lubricant provided
(See Figure 33). The
catheter should be
well lubricated and
force should not be
used when placing
the tube.
Note: Special care
should be taken when
using a Foley catheter.
Nasco recommends
use of 16 French Foley
catheters. Use of this size will avoid the possibility
of leakage. Cuff inflation should only be attempted
when the catheter is in the proper position inside
the bladder. The cuff must also be completely
deflated before the catheter is removed. The catheter
should not be left inserted in the simulator for an
extended period of time. Improper use of a Foley
catheter may result in damage to the simulator and
void the warranty.
5. After completion of the exercise, close the clamp
on the Fluid Supply Bag tubing and remove the
male genital insert by reversing the assembly
instructions. Disconnect the urinary catheter
reservoir tubing via the quick disconnect, remove
the reservoir from the male genitalia insert, and
drain the reservoir thoroughly (See Figure 30).
6. Rinse the reservoir and the outside of the male
genitalia to remove any residual lubricant.
Fluids should be drained and the reservoir emptied
after every use. Ensure the reservoir is clean and dry
prior to storing.
Fig 31.
Fig 30.

16
Prostate Examination
There are five prostates
included with your
simulator.
1normal size,
2normal size with
hard nodule,
3enlarged on one side,
4enlarged across the
midway with hard
nodule, and
5enlarged with hard
irregular surface
(See Figure 36).
Insert chosen prostate via
the backside of the male
genitalia in the bottom
cavity (See Figure 37).
Use included Pump Spray Lubricant to practice
prostate examination. Following the procedure,
rinse the rectum with warm water and allow to dry
prior to storing.
Note: The male genital insert does not have the
capacity for enema administration. Must use female
genital insert for enema administration practice.
Set Up
Foreskin Application / Prostate Examination
Foreskin Application
Place the foreskin over the gland by lubricating the
gland with baby powder and placing the foreskin
over the gland. The placement of the foreskin can
be placed higher or lower depending on how much
skin needed. (See Figures 34 and 35).
Fig 37.
Fig 34 Fig 35.
Fig 36.
1
2
5
3
4

17
4. Lubricate the catheter
being used with the
Pump Spray Lubricant
provided (See Figure 42).
The catheter should
be well lubricated and
force should not be
used when placing
the tube.
Note: Special care should be taken when using
a Foley catheter. Nasco recommends use of 16
French Foley catheters. use of this size will avoid
the possibility of leakage. Cuff inflation should only
be attempted when the catheter is in the proper
position inside the bladder. The cuff must also be
completely deflated before the catheter is removed.
The catheter should not be left inserted in the
simulator for an extended period of time. Improper
use of a Foley catheter may result in damage to the
simulator and void the warranty.
5. After completion of the exercise, close the clamp
on the Fluid Supply Bag tubing and remove the
female genital insert by reversing the assembly
instructions. Disconnect the urinary catheter
reservoir tubing via the quick disconnect, remove
the reservoir from the female genitalia insert,
and drain the reservoir thoroughly.
6. Rinse the reservoir and the outside of the female
genitalia to remove any residual lubricant.
Fluids should be drained and the reservoir emptied
after every use. Ensure the reservoir is clean and dry
prior to storing.
Female Catheterization,
Enema Insertion &
Cervical Examination
Features included with
LF04301, LF04302, and
LF04302EX.
To change genitals in the
simulator, simply press to
fit into the open genital
area of the pelvis. (See Figure 38).
The urinary catheterization reservoir is
interchangeable between male and female genitals.
Female Genitals come installed with the simulator.
To prepare for catheterization exercises:
. The urinary resevoir
is installed on the
back side, make sure
the urinary resevoir is
firmly in place. (See
Figure 39).
2.. Close the clamp on
the Fluid Supply Bag
(See Figure 40) and
fill with water or
included simulated
urine. Recommended
amount of fluid to fill
the Fluid Supply Bag is
between 100 and 250
ML.
3. Hang the filled Fluid
Supply Bag. Attach
the tubing quick
connect on end of
Fluid Supply Bag to the
quick connect on the
left lower side of the
simulator’s torso. Open
clamp on fluid supply
bag (See Figure 41).
Note: The Fluid Supply
Stand is not included.
Use distilled water or
follow instructions on the Simulated Urine.
Set Up
Female Catheterization
Fig 42.
Fig 41.
Fig 38.
Fig 40.
Fig 39.

18
Enema Administration
Features included with LF04301, LF04302, and
LF04302EX.
Enema Administration can only be practiced on the
female genital insert.
To prepare the simulator for enema administration:
1. Remove the female genital insert the simulator,
and ensure the enema reservoir is inserted into
the inside of the rectum (See Figure 43).
2. Press the female genital insert into the pelvis
of the simulator. Position the simulator. Using
a facility supplied enema kit, lubricate the
applicator liberally with the included Pump
Spray Lubricant and gently insert through the
anus.
3. After completion of the exercise, remove the
female genital insert by reversing the assembly
instructions.
4. Remove the enema from the female genitalia
insert and drain the reservoir thoroughly. Rinse
the reservoir and the outside of the female
rectum to remove any residual lubricant.
5. Drain the reservoir and dry thoroughly after
every use. Ensure the reservoir is clean and dry
prior to storing.
Note: Use water ONLY when administering an
enema. The enema reservoir holds up to 200cc of
fluid.
Fig 43.
Set Up
Enema Administration
Female Cervical Examination
Features included with LF04301, LF04302, and
LF04302EX.
The female genital insert allows for douching. Only
water should be used as a douching agent. Pap
smear procedures and visual inspection of the
vagina and cervix may also be demonstrated. Seven
cervical conditions are included: 1normal,
2early pregnancy, 3polyp, 4early cancer,
5late cancer, 6inflammation, and 7dysplasia
(See Figure 44).
To prepare the simulator for cervical examination:
1. Insert the chosen cervix via the backside of the
female genitalia in the center cavity (See Figure 45).
2. To perform procedures, generously lubricate
the instrument of insertion using the included
Pump Spray Lubricant and use the smallest
possible speculum for Pap smear and visual
inspection exercises. Avoid exerting too much
pressure on the vaginal walls.
Following completion of the exercises:
1. Remove the female genital insert by reversing
the assembly instructions.
2. Rinse the vagina with warm water to remove any
residual lubricant.
3. Allow to dry before reassembling into the
simulator.
Set Up
Female Cervical Exam
Fig 45.Fig 44.
< Catheter
< Rectal
< Cervix
1
2
5
6
7
3
4

19
Suprapubic Catheterization
Features included with LF04301, LF04302, and
LF04302EX.
To prepare the simulator for suprapubic
catheterization:
1. Attach the suprapubic stoma/bladder reservoir
to the twist lock quick connect located in the
abdomen of the simulator (See Figure 46).
2. Lubricate the suprapubic stoma/bladder reservoir
using the included Pump Spray Lubricant.
3. Insert the suprapubic stoma/bladder reservoir
through the pelvis and into the abdomen (See
Figure 47). See Inset for exterior view.
Note: The suprapubic bladder will come installed in
the simulator. Insert the male or female genitalia.
4. Close the clamp on the Fluid Supply Bag (See
Figure 48) and fill with water or included simulated
urine. Recommended amount of fluid to fill the
Fluid Supply Bag is between 100 and 250 ML.
5. Hang the filled Fluid Supply Bag.
6. Attach the tubing quick connect on the end of
Fluid Supply Bag to the quick connect on the left
lower side of the simulator’s torso. (See Figure 49).
Set Up
Female Cervical Exam
Note: Use distilled water or follow instructions on
the Simulated Urine.
7. Lubricate the catheter being used with the
Pump Spray Lubricant provided. The catheter
should be well lubricated and force should not
be used when placing the tube.
After completion of the exercise:
1. Close the clamp on the fluid supply bag tubing
and remove the suprapubic insert by reversing
the assembly instructions.
2. Disconnect the fluid supply bag via the quick
disconnect on the left side of the simulator.
3. Drain the bag and tubing thoroughly.
4. Rinse the reservoir and the suprapubic stoma to
remove any residual lubricant.
Fluids should be drained and the reservoir emptied
after every use. Ensure the reservoir is clean and dry
prior to storing.
Set Up
Suprapubic and Urinary Catheterization
Urinary Catheterization and Suprapubic Valve
Maintenance
To keep the urinary catheterization features of
this simulator operating eciently, maintenance
is required at the beginning of catheterization
training for both the urinary catherization and
suprapubic reservoirs, with the included silicone
lubricant.
Before training:
1. Remove the urinary or suprapubic reservoir from
the torso or genitalia.
2. Apply a generous
amount of silicone
lubricant onto the
end of a cotten
swab. Deposit grease
between the valve
membranes. (See
Figure 50).
Fig 46. Fig 47.
Fig 48. Fig 50.
Fig 49.

20
2. Attach this end of the
pressure line to the
female luer fitting
assembled at the top of
the electronic control
unit marked CUFF. (See
Figure 53).
3. Locate the cable that
extends from the blood
pressure simulator
arm and plug into the
top of the Electronic
Control Unit using the
jack labeled ARM. (See
Figure 54).
At this point, the blood
pressure simulator is ready
for use. The unit has been
factory calibrated for use
with accessories included. No further calibration
adjustments are necessary at this time. If the unit is
to be used with a sphygmomanometer other than
the one supplied, or when recalibration is necessary,
see the section titled Calibration Procedures.
Electronic Control Unit
Function
1. Press the power
button on the top
right of the unit. (See
Figure 55). Observe the
display and verify that
a readable display is
present.
Note: The control box has a battery saving feature
that will turn the unit off after approximately 8-10
minutes if no keys are used within that period of time.
2. Under the display window are three buttons:
Menu, Gap, and Calibrate.
Blood Pressure Arm
Features included with LF04301,
LF04302, and LF04302EX.
Installing the Batteries
1. Take the Blood Pressure
Electronic Control Unit out
of the box and turn it over,
placing it face down onto
a padded work surface. Locate the “Open”
compartment on the back of the panel
where the batteries are to be installed. Place
your thumb or index finger on the “Open”
compartment and push up. (See Figure 51).
2. Install 6 “AA” batteries as indicated by the
orientation diagram embossed in the bottom
of the bracket. After the batteries have been
properly installed, reassemble the Electronic
Control Unit by reversing the disassembly
procedures.
Turning the Electronic Control Unit On
1. Place the unit face up
on the padded work
surface.
2. Press the power button
on the top right of the
unit. (See Figure 52).
3. Observe the display
and verify that a
readable display is
present.
Connecting the Arm, Electronic Control Unit, and
Sphygmomanometer
1. Locate the end of the pressure line attached to
the sphygmomanometer that is assembled with
a male luer fitting.
Set Up
Blood Pressure Arm
Fig 53.
Fig 54.
Fig 55.
Fig 52.
Power
Button
Fig 51.