Nasco Lifeform lf01121u User manual

Advanced Injection Arm

LF01121U & LF01126U

Instruction Manual

Advanced Injection Arm

LF01121U & LF01126U

Instruction Manual

Products by Nasco Products by Nasco

Instruction ManualInstruction Manual

CAUTION: PRODUCT CONTAINS DRY

NATURAL RUBBER!

CAUTION: PRODUCT CONTAINS DRY

NATURAL RUBBER!

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About the Simulator

The Life/form® Advanced Injection Arm Simulator duplicates the human

condition as closely as modern plastics technology allows. This unit is

the simulation of the entire human arm from the shoulder to fingertips.

Externally, the skin texture is realistic to touch, and the fingertips have

fingerprints.

Although this arm will provide you with long trouble-free usage, the skin

and veins can be easily removed and replaced when needed, providing lit-

erally, a brand new arm. The life of the replaceable skin and veins will be

prolonged by utilizing smaller needle sizes (such as 20- to 25-gauge).

However, if instruction with larger needle sizes is required, this can be

done; the skin and veins will merely need to be replaced sooner. The

Skin and Vein Kits are available through Nasco (see list of supplies).

List of Components

A. Advanced Injection Arm Simulator (LF01121U – White

or LF01126U – Black

B. 3 cc Syringe with Needle

C. 12 cc Syringe with Needle

D. 22-gauge Needle

E. 2 Fluid Supply Bags

F. Infusion Butterfly

G. Pinch Clamp

H. 2 Small Towels

I. Infusion Needle

J. Intradermal Sealant (2 oz.)

K. 2 Pint Bottle with Blood Powder

L. Latex Adapter

About the Simulator

The Life/form® Advanced Injection Arm Simulator duplicates the human

condition as closely as modern plastics technology allows. This unit is

the simulation of the entire human arm from the shoulder to fingertips.

Externally, the skin texture is realistic to touch, and the fingertips have

fingerprints.

Although this arm will provide you with long trouble-free usage, the skin

and veins can be easily removed and replaced when needed, providing lit-

erally, a brand new arm. The life of the replaceable skin and veins will be

prolonged by utilizing smaller needle sizes (such as 20- to 25-gauge).

However, if instruction with larger needle sizes is required, this can be

done; the skin and veins will merely need to be replaced sooner. The

Skin and Vein Kits are available through Nasco (see list of supplies).

List of Components

A. Advanced Injection Arm Simulator (LF01121U – White

or LF01126U – Black

B. 3 cc Syringe with Needle

C. 12 cc Syringe with Needle

D. 22-gauge Needle

E. 2 Fluid Supply Bags

F. Infusion Butterfly

G. Pinch Clamp

H. 2 Small Towels

I. Infusion Needle

J. Intradermal Sealant (2 oz.)

K. 2 Pint Bottle with Blood Powder

L. Latex Adapter

D. D.

E. E.

F. F.

A. A.

B. B.

C. C.

I. I.

H. H.

G. G.

J. J.

K. K.

L. L.

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Internal Structure

(See figure 1.) Image shows the arm without the skin.

Internally the vascular structure (dry natural rubber tubing) includes the

basilic, median, accessory cephalic, and metacarpal veins. This venous

system is constructed of special self-healing dry natural rubber tubing,

with the lumen being the approximate size of a human vein. This vascu-

lar structure has inlet tubing and outlet tubing at the shoulder, and it is

via these tubes that the venous system is filled. Thus, the techniques of

blood drawing and starting intravenous infusions may be practiced on

the Advanced Injection Arm.

Internal Structure

(See figure 1.) Image shows the arm without the skin.

Internally the vascular structure (dry natural rubber tubing) includes the

basilic, median, accessory cephalic, and metacarpal veins. This venous

system is constructed of special self-healing dry natural rubber tubing,

with the lumen being the approximate size of a human vein. This vascu-

lar structure has inlet tubing and outlet tubing at the shoulder, and it is

via these tubes that the venous system is filled. Thus, the techniques of

blood drawing and starting intravenous infusions may be practiced on

the Advanced Injection Arm.

Figure 1 Figure 1

Venous Channels Beneath the Skin Venous Channels Beneath the Skin

8 Fluid Lines 8 Fluid Lines

Subcutaneous and

intramuscular

injection site

Subcutaneous and

intramuscular

injection site

Intradermal injection sites (3) Intradermal injection sites (3)

Life/form®Realism Life/form®Realism

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General Instructions for Use

A. Pressurizing the Veins with Synthetic Blood:

1. Add 1 pint of distilled water to the pint bottle with blood powder;

shake it to mix.

2. Be sure the clamp on the fluid supply bag A tubing is closed, fill it

with the blood and hang the bag no more than 18" above the level

of the arm. (See Figure 2 and Inset.) (Fluid Supply Stand shown

sold separately.)

3. Attach the fitting end of the fluid supply bag A tubing to one of the

shoulder tubes. (Make sure the arm is palm down at this point.)

(See Figure 3.)

Note: Connecting the fluid supply bag to the shoulder tube may

require a small amount of water soluble lubricant, heating the

shoulder tube end in the palm of a warm hand, or dipping the

shoulder tube end into warm water.

General Instructions for Use

A. Pressurizing the Veins with Synthetic Blood:

1. Add 1 pint of distilled water to the pint bottle with blood powder;

shake it to mix.

2. Be sure the clamp on the fluid supply bag A tubing is closed, fill it

with the blood and hang the bag no more than 18" above the level

of the arm. (See Figure 2 and Inset.) (Fluid Supply Stand shown

sold separately.)

3. Attach the fitting end of the fluid supply bag A tubing to one of the

shoulder tubes. (Make sure the arm is palm down at this point.)

(See Figure 3.)

Note: Connecting the fluid supply bag to the shoulder tube may

require a small amount of water soluble lubricant, heating the

shoulder tube end in the palm of a warm hand, or dipping the

shoulder tube end into warm water.

A. A.

B. B.

Figure 2 Figure 2

Figure 3 Figure 3

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4. With the other shoulder tube attached to the second (empty) fluid

supply bag B, (see Figure 4) gradually “flush” the vascular system

with synthetic blood by slowly opening the clamp on fluid supply

bag A. (See Figure 5.) (The pinch clamp on fluid supply bag B

should be open.) Allow same “blood” to pass through the system

until the air bubbles have been eliminated.

5. Close the clamp on bag A and then turn the arm over so it is palm

up. Slowly open the clamp on bag A to allow some blood to pass

through and to remove any remaining air that is trapped in the

system. (See Figure 6.)

Note: It may be necessary to swap the positions of the fluid supply

bags A and B during the filling process in order to prevent bubbles in

the tubing. If bag A runs out of blood before the arm is fully prepped,

simply remove it from its hanging position and replace it with (full)

bag B.

6. Once the system is filled, close the clamp on (resting) fluid supply

bag B and leave (hanging) fluid supply bag A clamp open. The arm

is now fully pressurized and can be used palm up or down.

4. With the other shoulder tube attached to the second (empty) fluid

supply bag B, (see Figure 4) gradually “flush” the vascular system

with synthetic blood by slowly opening the clamp on fluid supply

bag A. (See Figure 5.) (The pinch clamp on fluid supply bag B

should be open.) Allow same “blood” to pass through the system

until the air bubbles have been eliminated.

5. Close the clamp on bag A and then turn the arm over so it is palm

up. Slowly open the clamp on bag A to allow some blood to pass

through and to remove any remaining air that is trapped in the

system. (See Figure 6.)

Note: It may be necessary to swap the positions of the fluid supply

bags A and B during the filling process in order to prevent bubbles in

the tubing. If bag A runs out of blood before the arm is fully prepped,

simply remove it from its hanging position and replace it with (full)

bag B.

6. Once the system is filled, close the clamp on (resting) fluid supply

bag B and leave (hanging) fluid supply bag A clamp open. The arm

is now fully pressurized and can be used palm up or down.

Figure 4 Figure 4

Figure 5 Figure 5Figure 6 Figure 6

5 5

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B. IV Injection and Withdrawal

1. Start with a fully pressurized

arm. See procedure A under

General Instructions for Use.

2. Close the clamp on Fluid

Supply Bag B.

3. Open the clamp on Fluid

Supply Bag A.

The arm is now ready to perform injections or withdrawals along any

of the 8 fluid lines present in the arm. Nasco recommends the use of

small diameter needles for these procedures; 20 to 25 gauge. Use

only distilled water to prep the injection sites and as an injection. A

realistic flashback will occur when the vein has been properly punc-

tured. (See Figure 7)

C. Intravenous

Infusions

1. Begin with a fully

pressurized arm.

See procedure A

under General

Instructions for

Use.

2. Select the appro-

priate intravenous

infusion needles

or butterfly

included. Nasco

recommends

small gauge

needles 20-25

gauge.

3. Make sure the

arm is palm down

and the clamps on Bags A and B are closed.

4. Simulate cleansing the injection site with distilled water.

5. Insert the IV needle or butterfly into a vein. Flashback will indicate

proper insertion.

6. Attach the needle or butterfly to the tubing from the infusion solution

(not supplied) or fluid supply bag C (sold separately) with the latex

adapter if needed. (See Figure 8 and inset.)

7. Open the clamps on fluid supply bag B.

B. IV Injection and Withdrawal

1. Start with a fully pressurized

arm. See procedure A under

General Instructions for Use.

2. Close the clamp on Fluid

Supply Bag B.

3. Open the clamp on Fluid

Supply Bag A.

The arm is now ready to perform injections or withdrawals along any

of the 8 fluid lines present in the arm. Nasco recommends the use of

small diameter needles for these procedures; 20 to 25 gauge. Use

only distilled water to prep the injection sites and as an injection. A

realistic flashback will occur when the vein has been properly punc-

tured. (See Figure 7)

C. Intravenous

Infusions

1. Begin with a fully

pressurized arm.

See procedure A

under General

Instructions for

Use.

2. Select the appro-

priate intravenous

infusion needles

or butterfly

included. Nasco

recommends

small gauge

needles 20-25

gauge.

3. Make sure the

arm is palm down

and the clamps on Bags A and B are closed.

4. Simulate cleansing the injection site with distilled water.

5. Insert the IV needle or butterfly into a vein. Flashback will indicate

proper insertion.

6. Attach the needle or butterfly to the tubing from the infusion solution

(not supplied) or fluid supply bag C (sold separately) with the latex

adapter if needed. (See Figure 8 and inset.)

7. Open the clamps on fluid supply bag B.

Figure 7 Figure 7

Figure 8 Figure 8

A. A.

C. C.

B. B.

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8. Open the clamp on the infusion solution or fluid supply bag C.

Proof of proper procedure will be evidenced by the flow of fluid

from the infusion solution or fluid supply bag C. (See Figure 9.)

Note: This procedure may dilute your simulated blood solution.

D. Intramuscular Injections

The procedure for administer-

ing intramuscular injections

can be practiced in the area of

the deltoid. (See Figure10.)

Prep the site with distilled

water only. Injections can be

done utilizing the appropriate

needle and syringe. 1⁄2cc of

distilled water may be injected,

however, we recommend utiliz-

ing air as injectant since the dis-

tilled water cannot be drained,

but must evaporate from

the arm. Synthetic blood must

NEVER be used for injections.

E. Intradermal/Intracuetaneous

Injections

Use a 3 cc syringe with a

25-gauge needle for this

procedure.

Internal Structure

The arm features three loca-

tions. All are located on the

outer aspect of the upper arm.

(See Figure 11.) If fluid is properly injected, a characteristic skin welt

will form. The welt is removed by with drawing the fluid after practice.

We recommend you use distilled water as an injection fluid.

8. Open the clamp on the infusion solution or fluid supply bag C.

Proof of proper procedure will be evidenced by the flow of fluid

from the infusion solution or fluid supply bag C. (See Figure 9.)

Note: This procedure may dilute your simulated blood solution.

D. Intramuscular Injections

The procedure for administer-

ing intramuscular injections

can be practiced in the area of

the deltoid. (See Figure10.)

Prep the site with distilled

water only. Injections can be

done utilizing the appropriate

needle and syringe. 1⁄2cc of

distilled water may be injected,

however, we recommend utiliz-

ing air as injectant since the dis-

tilled water cannot be drained,

but must evaporate from

the arm. Synthetic blood must

NEVER be used for injections.

E. Intradermal/Intracuetaneous

Injections

Use a 3 cc syringe with a

25-gauge needle for this

procedure.

Internal Structure

The arm features three loca-

tions. All are located on the

outer aspect of the upper arm.

(See Figure 11.) If fluid is properly injected, a characteristic skin welt

will form. The welt is removed by with drawing the fluid after practice.

We recommend you use distilled water as an injection fluid.

Figure 9 Figure 9

Figure 10 Figure 10

7 7

Figure 11 Figure 11

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Care of the Intradermal Sites

Puncturing the skin with needles forms small slits or cuts witch will even-

tually lead to deterioration. Should leakage occur, perform the following

steps:

1. Using the supplied Intradermal Sealant (component J) and supplied

22-guage syringe, remove the needle end of the syringe by twisting

at the luer lock.

2. With the needle removed, insert the open end of the syringe into

the intradermal sealant. (See Figure 12.)

3. Pull back on the plunger to load the syringe with the sealant.

4. Replace the needle on the syringe twisting at the luer lock. (See

Figure 13.)

5. Insert the syringe into the Intradermal Site in the same manner you

would to perform procedures.

6. Inject the Intradermal Sealant into a blister dot. (See Figure 14.)

Note: This will require more pressure applied on the syringe

than the typical procedure to form a blister dot.

7. Remove the syringe leaving the sealant inside the Intradermal Site.

8. Rub any excess or leaked intradermal sealant on the skin surface

to seal surface holes. (See Figure 15.)

9. Allow to set overnight.

10. Withdraw remaining intradermal sealant and the intradermal site

is ready for practice.

Care of the Intradermal Sites

Puncturing the skin with needles forms small slits or cuts witch will even-

tually lead to deterioration. Should leakage occur, perform the following

steps:

1. Using the supplied Intradermal Sealant (component J) and supplied

22-guage syringe, remove the needle end of the syringe by twisting

at the luer lock.

2. With the needle removed, insert the open end of the syringe into

the intradermal sealant. (See Figure 12.)

3. Pull back on the plunger to load the syringe with the sealant.

4. Replace the needle on the syringe twisting at the luer lock. (See

Figure 13.)

5. Insert the syringe into the Intradermal Site in the same manner you

would to perform procedures.

6. Inject the Intradermal Sealant into a blister dot. (See Figure 14.)

Note: This will require more pressure applied on the syringe

than the typical procedure to form a blister dot.

7. Remove the syringe leaving the sealant inside the Intradermal Site.

8. Rub any excess or leaked intradermal sealant on the skin surface

to seal surface holes. (See Figure 15.)

9. Allow to set overnight.

10. Withdraw remaining intradermal sealant and the intradermal site

is ready for practice.

Figure 12 Figure 12

Figure 13 Figure 13

Figure 14 Figure 14

Figure 15 Figure 15

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Care and Maintenance

The Advanced Injection Arm should be completely drained of fluid and

dry before storing. Simulated blood can be reused.

A. Draining and Rinsing the Simulator

1. Disconnect the fluid supply bags and drain simulated blood into

the supplied pint bottles.

2. Fill one bag with water and reconnect to a shoulder tube.

3. Reconnect the other rinsed fluid supply bag to the open shoulder

tube.

4. Open both clamps and allow the system to flush.

5. Repeat with clean water until the water runs clear from the arm.

6. Drain the fluid supply bags and leave the caps open to allow

the inside to air dry as much as possible.

7. Excess water may be removed from the arm by raising the

hand, lowering the shoulder, and draining it into a sink or basin.

8. Remove the clamps from the fluid supply bag tubing as they

can cause permanent kinks and restrict fluid flow.

B. Cleaning the Simulator

1. Wash the outside of the arm with mild liquid detergent and water.

2. Stubborn stains may be removed using Nasco Cleaner

(LF09919U, sold separately). Simply dispense the Nasco

Cleaner to the stained area and wipe clean with a soft cloth

or paper towel.

C. Maintaining the Simulator

1. Nasco Vein Tubing Sealant Kit (LF01099U) will extend the useful

life of the tubing.

Note: Nasco Vein Tubing Sealant cannot be shipped outside of

the United States..

2. Vyna Bond, purchased separately (See Supplies and Replace-

ment Parts) can be applied to the skin to repair puncture sites.

Cautions

1. This synthetic blood is specially formulated to be compatible with

the self-sealing veins and plastics used in manufacturing the arm.

2. NEVER use synthetic blood for intramuscular injection.

3. DO NOT use dull or burred needles, as these will cause leaks in

the system. Burred needles will cause permanent damage. Use

smaller needles (20- to 25-gauge).

4. DO NOT allow “blood” to dry on simulator — it may stain the skin.

5. Use only 500 cc of infusion fluid, as a larger amount will also

increase the pressure of the venous system, resulting in leaks.

6. DO NOT clean the simulator with solvents or corrosive material as

they will damage it.

7. Newsprint, similar printed paper, or plastic will permanently stain

the simulator if prolonged contact occurs.

Care and Maintenance

The Advanced Injection Arm should be completely drained of fluid and

dry before storing. Simulated blood can be reused.

A. Draining and Rinsing the Simulator

1. Disconnect the fluid supply bags and drain simulated blood into

the supplied pint bottles.

2. Fill one bag with water and reconnect to a shoulder tube.

3. Reconnect the other rinsed fluid supply bag to the open shoulder

tube.

4. Open both clamps and allow the system to flush.

5. Repeat with clean water until the water runs clear from the arm.

6. Drain the fluid supply bags and leave the caps open to allow

the inside to air dry as much as possible.

7. Excess water may be removed from the arm by raising the

hand, lowering the shoulder, and draining it into a sink or basin.

8. Remove the clamps from the fluid supply bag tubing as they

can cause permanent kinks and restrict fluid flow.

B. Cleaning the Simulator

1. Wash the outside of the arm with mild liquid detergent and water.

2. Stubborn stains may be removed using Nasco Cleaner

(LF09919U, sold separately). Simply dispense the Nasco

Cleaner to the stained area and wipe clean with a soft cloth

or paper towel.

C. Maintaining the Simulator

1. Nasco Vein Tubing Sealant Kit (LF01099U) will extend the useful

life of the tubing.

Note: Nasco Vein Tubing Sealant cannot be shipped outside of

the United States..

2. Vyna Bond, purchased separately (See Supplies and Replace-

ment Parts) can be applied to the skin to repair puncture sites.

Cautions

1. This synthetic blood is specially formulated to be compatible with

the self-sealing veins and plastics used in manufacturing the arm.

2. NEVER use synthetic blood for intramuscular injection.

3. DO NOT use dull or burred needles, as these will cause leaks in

the system. Burred needles will cause permanent damage. Use

smaller needles (20- to 25-gauge).

4. DO NOT allow “blood” to dry on simulator — it may stain the skin.

5. Use only 500 cc of infusion fluid, as a larger amount will also

increase the pressure of the venous system, resulting in leaks.

6. DO NOT clean the simulator with solvents or corrosive material as

they will damage it.

7. Newsprint, similar printed paper, or plastic will permanently stain

the simulator if prolonged contact occurs.

9 9

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Troubleshooting

PROBLEM: Cannot get blood to flow or flashback.

If you are unable to get blood flow through your IV Arm, there is most

likely a restriction somewhere within the system. Restrictions can be

caused by air bubbles, kinks (either in the veins or supply and drain

tubing), or dried blood within the system.

1. Check for kinks in the tubing of the fluid supply bags: If a

clamp has been located in one spot of the tube for a long period

of time, the tube can become kinked, restricting flow even when

the clamp is open. Massage the tube where the clamps have

been to open the tubing again. Change positions of clamps often

to keep this from reoccurring.

2. Fluid supply bag height: Is the supply bag hung at the appro-

priate height according to the instruction manual? Hanging the

supply bags slightly higher for the arms that are not producing

enough pressure can create just enough gravity on the fluid to

facilitate flow.

3. Vein connection: Are the veins/tubes connected to the manifold

correctly? Check correct positions in the instruction manual for

LF01122U Advanced IV Arm Skin and Vein Replacement Kit.

Contact Nasco for a FREE instructional video.

4. Check for air bubbles: Make sure you purge the arm of air

bubbles. Gradually “flush” the system with synthetic blood by

slowly opening the supply clamp. Allow some blood to pass

through the system until the air bubbles have been eliminated

in the drain bag. Close the clamp on the supply bag and then

turn the arm over so it is palm up. Slowly open the clamp to

allow some blood to pass through and to remove any remaining

air that is trapped in the system.

5. Dried blood left in veins from previous uses: If these are veins

that have been used before, you could try running a couple of

bags of clear warm water through them. There may be some

sediment from previous uses lodged within the veins/tubing.

6. Check vein tubing for kinks: Following a skin/vein replacement,

it is possible that a vein rolled out of the track or there may also

be a slight kink in the tubing. This is most likely in the underside

of the fingers. Flexing the fingers will sometimes work out the

kink. Try massaging the area of the arm (thumb and fingers) to

relocate the vein back within the track of the arm core. Also,

make sure you haven’t pulled the skin on too tight, causing a

restriction. Skins should be loose fitting, especially around the

thumb and finger areas. Apply lubrication to help move the

veins back into place.