Nasco Life/form Basic GERi LF04040U User manual

HEALTHCARE
GERi
™/ KERi ™
The Nursing Skills Manikins
INSTRUCTION MANUAL
GERi ™ – LF04040U, LF04001U, LF04030U, LF04003U, LF04005U (Light)
LF04115U, LF04116U, LF04117U, LF04118U, LF04119U (Medium)
KERi ™ – LF04021U, LF04020U, LF04022U, LF04023U, LF04026U (Light)
LF04120U, LF04121U, LF04122U, LF04123U, LF04124U (Medium)
The ideal
manikin for all
OBRA required
training.
HC18000028INM23.indd 1 11/16/18 9:23 AM

HC18000028INM23.indd 2 11/16/18 9:23 AM

3
•GERi™ has an elderly appearance with skin
wrinkles and folds
•KERi™ has a non-age-specific appearance
•Lightweight — approximately 28 lbs.
•Full-size adult manikin — measures 58"
•Overall female appearance, with simple
conversion to male with removal of wig and
attachment of male genitalia
•Visual Inspection:
•Normal and cancerous mole
•Stage 1 sacral ulcer
•Dilated and constricted pupils
•Reddened skin folds
•Patient Care Simulation:
•Bandaging and wound dressing
•Bed baths
•Clothing changes
Congratulations for choosing a GERi
™/
KERi
™Nursing Skills Manikin. This realistic, fully functional, light-
weight nursing manikin comes with a superior range of motion and allows you to simulate over 35 nursing
and medical procedures. The quality and simple design makes this manikin easy to use and care for while
teaching basic patient care techniques, so please familiarize yourself with this manual before using the
manikin for training. Five-year warranty. Actual product may vary slightly from photo. Nasco reserves the
right to change product color, materials, or function as needed.
Main Features on Every Basic, Complete, Advanced, Auscultation and Advanced Auscultation GERi™ and
KERi™ Manikin:
•Denture placement and removal — upper and
lower
•Ear canal irrigation, otic drops, and hearing aid
placement
•Eye irrigation
•Finger and toe manipulation
•Hair care washing and combing
•Intramuscular injection sites — arm, thigh, buttock
•Oral and nasal hygiene — lavage, gavage, and
suctioning
•Ostomy care — ileostomy and colostomy tissue
maintenance and appliance application, lavage,
and suctioning
•Patient positioning
•Patient transfer techniques
•Pericare
•Range of motion
•Tracheostomy care — lavage and suctioning
HC18000028INM23.indd 3 11/16/18 9:23 AM

4
Basic GERi™ LF04040U (Light), LF04115U (Medium)
Basic KERi™ LF04021U (Light), LF04120U (Medium)
LIST OF COMPONENTS PART NUMBERS
•Male and Female Genitalia M: LF04109U (Light); F: LF04110U (Light)
•Wig GERi™:LF04087U KERi™:LF04086U
•Dentures LF04085U
•Hearing Aid LF04090U
•*12 cc Syringe
•Serial number located on back of right shoulder
Complete GERi™ LF04001U (Light), LF04116U (Medium)
Complete KERi™ LF04020U (Light), LF04121U (Medium)
LIST OF COMPONENTS PART NUMBERS
•Male and Female Genitalia M: LF04075(N)U (Light); F: LF04076(N)U (Light)
•Wig GERi™:LF04087U KERi™:LF04086U
•Dentures LF04085U
•Hearing Aid LF04090U
•*12 cc Syringe
•Lubricant Spray LF03644U
•Fluid Drainage Basin SB14936U
•Stomach Reservoir Bag LF04098U
•Bladder Reservoir Bag LF04095U
•Bladder Reservoir Pressure Sleeve LF04097U
•16 FR Foley Silicone Catheter LF01127U
•*140 cc Syringe
•Enema Reservoir Bag LF04096U
•Serial number located on back of right shoulder
ADDITIONAL FEATURES
•Includes all of the main features of Basic GERi™/KERi™ with the addition of internal fluid reservoirs
•Gastrostomy procedures — lavage and gavage
•Enema administration with female genitalia
•Urinary catheterization — female and uncircumcised male genitalia
•Pap smears and douching
•Stage B prostate exam
•Nasogastric tube placement
*Note: Components without part numbers listed may be available for special order. Additional supplies
and parts not listed are located at the end of this manual and/or in each individual section.
HC18000028INM23.indd 4 11/16/18 9:23 AM

5
Advanced GERi™ LF04030U (Light), LF04117U (Medium)
Advanced KERi™ LF04022U (Light), LF04122U (Medium)
LIST OF COMPONENTS PART NUMBERS
•Male and Female Genitalia M: LF04075(N)U; F: LF04076(N)U (Light)
•Wig GERi™: LF04087U KERi™: LF04086U
•Dentures LF04085U
•Hearing Aid LF04090U
•*12 cc Syringe
•Lubricant Spray LF03644U
•Fluid Drainage Basin SB14936U
•Stomach Reservoir Bag LF04098U
•Bladder Reservoir Bag LF04095U
•Bladder Reservoir Bag Pressure Sleeve LF04097U
•16 FR Foley Silicone Catheter LF01127U
•*140 cc Syringe
•Enema Reservoir Bag LF04096U
•Right IV Training Arm LF04080U (Light), LF04125U (Medium)
•*1 Pint of Artificial Blood Powder
•*2 Fluid Supply Bags (500 ml each) with 2 clamps
•*3 cc Syringe
•*22-ga. Needle
•*Butterfly Set
•*White 2-ply Towel (2)
•Left Blood Pressure Training Arm LF04079U (Light), LF04127U (Medium)
•Electronic Control Unit LF01096U
•Sphygmomanometer LF01073U
•*6 “AA” Batteries
•Serial number located on back of right shoulder
ADDITIONAL FEATURES
•Includes all of the main features of Basic and Complete GERi™/KERi™ with the addition of right
and left IV and BP arms
•Right IV training arm has a shoulder intramuscular injection site and features replaceable skin
and veins that roll when palpated — realistic flashback confirms proper needle placement
•Left blood pressure training arm produces all five Korotkoff sounds and allows instructor to
vary systolic and diastolic levels, pulse rate, volume, and auscultatory gap
•Standard right and left arms with intramuscular injection sites are also included
*Note: Components without part numbers listed may be available for special order. Additional supplies and
parts not listed are located at the end of this manual and/or in each individual section.
HC18000028INM23.indd 5 11/16/18 9:23 AM

6
Auscultation GERi™ LF04003U (Light), LF04118U (Medium)
Auscultation KERi™ LF04023U (Light), LF04123U (Medium)
LIST OF COMPONENTS PART NUMBERS
•Male and Female Genitalia M: LF04075(N)U; F: LF04076(N)U (Light)
•Wig GERi™: LF04087U KERi™: LF04086U
•Dentures LF04085U
•Hearing Aid LF04090U
•*12 cc Syringe
•Lubricant Spray LF03644U
•Stomach Reservoir Bag LF04098U
•Fluid Drainage Basin SB14936U
•Bladder Reservoir Bag LF04095U
•Bladder Reservoir Pressure Sleeve LF04097U
•16 FR Foley Silicone Catheter LF01127U
•*140 cc Syringe
•Enema Reservoir Bag LF04096U
•SmartScope™with Single and Dual Headpieces LF01144U
•Remote Control with LCD Display LF01148U
•*2 “AA” and 2 “AAA” Batteries
•*Alcohol Pads (50)
•*8 Sheets of Green and Blue Circle Stickers
•*2 Laminated Key Cards
•Serial number located on back of right shoulder
ADDITIONAL FEATURES
•Includes all the main features of Complete GERi™/KERi™ with the addition of auscultation torso,
SmartScope™, and remote
•Six anterior heart sites with 12 heart conditions
•Five anterior, six upper posterior, four lower posterior, two mid-axillary lung sites with 12 lung
conditions
*Note: Components without part numbers listed may be available for special order. Additional supplies
and parts not listed are located at the end of this manual and/or in each individual section.
HC18000028INM23.indd 6 11/16/18 9:23 AM

7
Advanced Auscultation GERi™ LF04005U (Light), LF04119U (Medium)
Advanced Auscultation KERi™ LF04026U (Light), LF04121U (Medium)
LIST OF COMPONENTS PART NUMBERS
•Male and Female Genitalia M: LF04075(N)U; F: LF04076(N)U (Light)
•Wig GERi™: LF04087U KERi™: LF04086U
•Dentures LF04085U
•Hearing Aid LF04090U
•*12 cc Syringe
•Lubricant Spray LF03644U
•Stomach Reservoir Bag LF04098U
•Fluid Drainage Basin SB14936U
•Bladder Reservoir Bag LF04095U
•Bladder Reservoir Pressure Sleeve LF04097U
•16 FR Foley Silicone Catheter LF01127U
•*140 cc Syringe
•Enema Reservoir Bag LF04096U
•Right IV Training Arm LF04080U (Light), LF04125U (Medium)
•*1 Pint of Artificial Blood Powder
•*2 Fluid Supply Bags (500 ml each) with 2 Clamps
•*3 cc Syringe
•*22-ga. Needle
•*Butterfly Set
•*White 2-ply Towel (2)
•Left Blood Pressure Training Arm LF04079U (Light), LF04127U (Medium)
•Electronic Control Unit LF01096U
•Sphygmomanometer LF01073U
•6 “AA” Batteries SB10828U
•SmartScope™with Single and Dual Headpieces LF01144U
•Remote Control with LCD Display LF01148U
•*2 “AA” and 2 “AAA” Batteries
•*Alcohol Pads (50)
•*8 Sheets of Green and Blue Circle Stickers
•*2 Laminated Key Cards
•Serial number located on back of right shoulder
ADDITIONAL FEATURES
•Includes all the main features of Advanced and Auscultation GERi™/KERi™.
*Note: Components without part numbers listed may be available for special order. Additional supplies
and parts not listed are located at the end of this manual and/or in each individual section.n.
HC18000028INM23.indd 7 11/16/18 9:23 AM

8
SUPERIOR RANGE OF MOTION
GERi™/KERi™ manikins offer the most complete and realistic range of motion with no pinch points. This allows
for correct patient positioning. The manikin’s articulation includes:
•Trunk — rotation, hyperextension
•Shoulder — abduction, adduction, rotation, hyperextension
•Elbow — extension, flexion, pronation, supination
•Wrist — flexion, hyperextension, radial flexion, ulnar flexion
• Fingers — abduction, adduction, flexion (soft, lifelike material)
•Neck — rotation, hyperextension, lateral flexion
•Hip — abduction, adduction, rotation, hyperextension
• Knee — extension, flexion
•Ankle — eversion, inversion, dorsiflexion, plantarflexion
• Toes — abduction, adduction, flexion (soft, lifelike material)
SETUP
GERi™/KERi™ manikins are packaged with arms and legs unattached to prevent damage during shipping.
Refer to the following sections for assembly instructions.
Arms
To attach the arms, bend the elbows backward
approximately 90° to align the keyholes at the
shoulders, and then push toward the shoulder of
the manikin. Reverse this procedure to disassemble.
(See Figure 1.)
Figure 1
Legs
The legs attach to the body at the hips by bending
the legs backward approximately 150° so the feet
are near the shoulders and the keyholes are aligned.
(See Figure 2.)
Figure 2
Head
To attach the head, position the head facing back-
wards and align the keyholes. Press down and turn
head 180° so it is facing forward. Reverse the proce-
dure to disassemble.
Joints
All joints may be assembled with a flat-head screw-
driver. Hold the opposite end of the connector pin to
prevent unproductive rotation.
Figure 3
Eyes
The eyes come installed in the head. The eyes can
be removed by creasing the skin at the outside of
each eye and rolling the eye up. (See Figure 3.) We
recommend you replace the eyes in the same sock-
ets, the left pupil is dilated and the right pupil con-
stricted to keep consistent with this training manual.
Both eyes may be irrigated using water. Following
completion of the exercise, follow the above instruc-
tions for removing the eye, dry the sockets com-
pletely with a soft cloth, and replace the eyes in
their respective sockets. To keep consistent with this
manual, the left pupil is dilated and the right pupil
constricted.
HC18000028INM23.indd 8 11/16/18 9:23 AM

9
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. Denture removal
is accomplished by grasping the dentures and pull-
ing forward and then down for the upper plate and
forward then up for the lower plate. (See Figure 4.)
Figure 5
EAR CARE
Both ears may be irrigated. Nasco recommends
using water to perform ear irrigation. To drain, tilt
the head sideways and empty into the basin or
absorbent cloth. (See Figure 5 and inset.)
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 6.) The simulated hearing aid will only fit in
the right ear.
Figure 4
Figure 6
MALE CATHETERIZATION
(Available with Complete, Advanced, Auscultation, and
Advanced Auscultation GERi™/KERi™)
The male genital insert represents an uncircumcised
adult male. To prepare for catheterization exercises,
use the following procedures:
1. Ensure the simulated bladder reservoir bag and
fitting are attached to the urethra behind the
genital insert.
2. Ensure the cloth pressure sleeve is in place over
the simulated bladder reservoir bag and the
hook-and-loop fastener on the pressure sleeve is
attached to the hook-and-loop fastener on the
genital track.
3. Fill the 140 cc syringe supplied with water.
Lubricate the end of the syringe’s administration
tube and insert though the urethra at least 7"-8".
(See Figure 7.)
4. Depress the plunger of the syringe to fill the
simulated bladder reservoir bag. The bladder
reservoir will hold approximately 375 cc. Fit the
male or female genital back on the abdomen.
(See Figure 8.)
5. Lift and push the bottom of the genital insert
into the genital opening in the body. Push the
top of the genital insert down and in to secure
the system.
Figure 7
Figure 8
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. However, 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.
HC18000028INM23.indd 9 11/16/18 9:23 AM

The natural restrictions of the male urinary tract
have been designed into the male genital insert.
Proper manipulation of the penis is required to
achieve catheterization.
1. Thoroughly lubricate the 16 French Foley cath-
eter supplied with your manikin prior to insertion.
2. The mucosal fold is approximately 2" into
the urethra. Withdrawing the catheter and
stretching the penis slightly will enable the
catheter to advance past the first restriction.
3. The bulbous urethra is approximately an addi-
tional 2" past the mucosal fold. Elevating the
penis 60° will enable the catheter to advance
past the second restriction.
4. The final restriction represents the sphincter
muscle where the urethra joins the bladder.
Gently advance the catheter past this point
until you feel a “pop” as you enter the bladder.
Water will now flow through the catheter.
5. After completion of the exercise, remove the
male genital insert by reversing the assembly
instructions. Disconnect the bladder reservoir
bag with pressure sleeve from the insert piece.
Drain the reservoir thoroughly. Rinse reservoir
and the outside of the penis to remove any
residual lubricant.
Note: Special care should be taken when using a
Foley catheter. Nasco recommends use of 16 French
Foley catheters. One will be supplied with your man-
ikin, and 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 blad-
der. 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.
PROSTATE EXAMINATION
(Available with Complete, Advanced, Auscultation,
and Advanced Auscultation GERi™/KERi™)
The male genital insert also includes the capability for
digital rectal prostate palpation. (See Figure 9.)
The prostate gland represents stage B progres-
sion of prostatic cancer. A discrete hard nodule is
palpable in the upper right quadrant, simulating
a beginning state of carcinoma.
To perform a prostate examination,
1. Position the manikin following your facility’s
procedures.
2. Generously lubricate examination finger.
3. Insert lubricated finger into the rectum to
perform examination.
4. Following the procedure, remove the male
genital insert from the manikin.
5. Rinse the rectum with warm water and allow
drying.
Note: The male genital insert does not have the capac-
ity for enema administration.
FEMALE CATHETERIZATION
(Available with Complete, Advanced, Auscultation, and
Advanced Auscultation GERi™/KERi™)
To prepare for catheterization exercises:
1. Ensure the simulated bladder reservoir bag
and fitting are attached to the urethra on the
backside of the genital insert. (See Figure 10.)
2.
Ensure the cloth pressure sleeve is in place over
the bladder reservoir and the hook-and-loop
fastener on the pressure sleeve is attached to
the hook-and-loop fastener on the genital track.
3. Fill the 140 cc syringe supplied with water.
Lubricate the end of the syringe’s adminis-
tration tube and insert though the urethra at
least 7"-8".
4. Depress the plunger of the syringe to fill the
bladder bag. The bladder reservoir will hold
approximately 375 cc.
5. Gently slide the genital insert back into the
body. Lift and push the bottom of the genital
insert into the genital opening in the body.
Push the top of the genital insert down and in
to secure the system.
Simulated
Prostate
Figure 9
Figure 10
10
HC18000028INM23.indd 10 11/16/18 9:24 AM

6. Thoroughly lubricate the 16 French Foley cathe-
ter supplied with your manikin prior to insertion.
7. After completion of the exercise, remove the
female genital insert by reversing the assembly
instructions. Disconnect the bladder reservoir
with pressure sleeve from the insert piece. Drain
the reservoir thoroughly. Rinse the reservoir and
the vagina to remove any residual lubricant.
Note: Special care should be taken when using a Foley
catheter. Nasco recommends use of 16 French Foley
catheters. One will be supplied with your manikin, and
use of this size will avoid the possibility of leakage. Cuff
inflation should only be attempted when it 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.
ENEMA ADMINISTRATION
(Available with Complete, Advanced, Auscultation,
and Advanced Auscultation GERi™/KERi™)
Enema Administration can only be practiced on
the female genital insert. To prepare the manikin for
enema administrations, follow the instructions below.
1. With the female genital insert unattached
from the manikin, ensure the enema reservoir
is securely attached to the inside of the rectum.
(See Figure 11.)
2. Lift and push the bottom of the genital insert
into the genital opening in the body. Push the
top of the genital insert down and in to secure
the system.
3. Position the manikin on its left side in the Sims’
position.
4. Using a facility supplied enema kit, lubricate the
applicator liberally and gently insert through the
anus.
Note: Use water ONLY when administering an enema.
Figure 11
5. To simplify cleanup, you may choose to leave
the applicator in place while positioning the
manikin to drain, or remove applicator and
position the manikin over a drainage basin. The
enema reservoir will drain via gravity as soon as
the manikin leaves the left Sims’ position.
6. Remove the female genital insert by reversing the
assembly instructions. Rinse the anus and inter-
nal enema reservoir with warm water to remove
any residual lubricant.
DOUCHING, PAP SMEARS, AND
VAGINAL INSPECTION
(Available with Complete, Advanced, Auscultation,
and Advanced Auscultation GERi™/KERi™)
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.
To perform procedures:
1. Generously lubricate instrument of insertion.
2. Use water only for douching exercises.
3. Use the smallest possible speculum for Pap
smear and visual inspection exercises.
4. Avoid exerting too much pressure on the vaginal
walls.
5. Following completion of the exercises, remove
the female genital insert by reversing the
assembly instructions.
6. Rinse the vagina with warm water to remove
any residual lubricant. Allow to dry before
reassembling into the manikin.
GASTROSTOMY CARE LAVAGE AND GAVAGE
(Available with Complete, Advanced, Auscultation,
and Advanced Auscultation GERi™/KERi™)
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 12.)
Gastrostomy
Site
Figure 12
11
HC18000028INM23.indd 11 11/16/18 9:24 AM

1. Inside the upper torso is a reservoir bag with
a maximum capacity of 500 cc, which is
attached to the underside of the gastrostomy
opening with a two part coupler. The bag is
removed by pushing in on the L-shaped but-
ton and pulling it straight away. (See Figure 13
and inset.)
Note: In some models, the waist pin will need to be
removed for easier access.
2. To attach, simply 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.
With extensive use, these two coupler parts may no
longer snap. The L-shaped button will then have to
be manually pulled all the way out after connecting
the two parts. Test the connection by gently pulling
on the coupler body to ensure it is locked.
The gastrostomy feature is designed for use with
a 16 French Feeding Tube. It is recommended
that the tip of the feeding tube is well lubricated
before inserting.
1. Ensure the reservoir is straight and flat before
attempting to simulate feeding with water.
Note: Water only should be used to perform feeding
procedures.
2. Lubricate the end of the feeding tube and
gently insert through the flanged hole.
3. Upon completion of the exercise, remove the
reservoir, drain the liquid from the reservoir
bag, and rinse the bag.
4. Ensure the bag is clean and dry prior to storing
it back inside the torso. Wipe any residual lubri-
cant from the exterior gastrostomy site with
warm water and a soft cloth prior to storing the
manikin.
Removal of the internal stoma reservoirs can be
achieved by:
1. Removing the genitalia and reaching through
the genital cavity. The reservoir bags are
attached to the underside of the stomas.
2. To remove, pull the reservoir fittings down and
disconnect from the stomas. Then pull the
reservoir bags from the hook-and-loop attach-
ments. (See Figures 15 and 16.)
Figure 14
Figure 13
Figure 15 Figure 16
12
3. Rinse with water to clean. Reverse the procedure
to reattach the internal stoma reservoirs. Ensure
reservoirs are clean and dry prior to reattaching
for storage.
TRACHEOSTOMY CARE
(Available on all GERi™/KERi™ models)
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 can hold approximately
20 cc of water. Suctioning, dressing changes, tra-
cheostomy tube placement, and cuff inflation may
be practiced on the manikin. Ensure proper lubri-
cation is completed prior to inserting tubes into the
stoma site. The tracheostomy canal is not connect-
ed to the oronasal system, and access is provided
only through the stoma site.
OSTOMY CARE
(Exterior Ostomy Care available on all
GERi™/KERi™models)
Colostomy and ileostomy care can be practiced on all
GERi™/KERi™ models, including stoma dilation, clean-
ing, and ostomy bag changing procedures. Irrigation
can be practiced on Complete, Advanced, Auscultation,
and Advanced Auscultation. 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. (See Figure 14.)
HC18000028INM23.indd 12 11/16/18 9:24 AM

7. Following completion of the procedures, com-
pletely 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.
INTRAMUSCULAR INJECTIONS
(Available on all GERi™/KERi™ models)
Intramuscular injections may be performed in inserts
at the left hip, right thigh, at both deltoids of the
standard arms, and left deltoid of the injectable train-
ing arm (available with Advanced and Advanced
Auscultation GERi™/KERi™). Inject AIR ONLY as the
inserts cannot be drained in the standard arms, injec-
tion training arm, and thigh.
To remove the inserts on standard arms and thigh:
1. Compress them sideways and pull out.
2. Reverse procedure to replace.
Avoid using alcohol or similar substances to prep the
injection site. Use distilled water to simulate this
procedure.
Figure 17
Pinch Clamp
Outlet Tubing
Inlet Tubing
Pinch
Clamp
12"
Life/form®
Blood
Venous System
Anterior
Posterior
Needle
Adapter
Posterior Anterior
Figure 18
13
INTERNAL AND EXTERNAL STRUCTURE
The outer skin is easily peeled off, revealing the “core”
and veins. The skin and veins can be readily replaced
when needed. Using smaller gauge needles will pro-
long the life of the original skin and veins. Replace-
ment parts are available and listed at the end of this
manual. The internal vascular structure begins at the
shoulder and continues under the arm, crosses the
antecubital fossa forearm, makes a loop in the back
of the hand, and then returns to the underarm. This
venous system is constructed of special, natural dry
rubber, with the lumen being the approximate size of
an adult human vein. (See Figure 18.)
INJECTABLE TRAINING ARM
(Available on Advanced and Advanced Auscultation GERi™/KERi™ or as a modular or add-on to all other models)
CAUTION: PRODUCT CONTAINS DRY NATURAL RUBBER!
5. To remove the stomach, rotate the head back-
ward 180° to align the keyholes in the neck.
6. Gently pull up head to expose three tubes with
the stomach reservoir bag connected at the
end. (See Figure 17.)
Note: The stomach reservoir bag will only come
through the neck opening if less than 250 cc of water
is contained in the stomach.
This vascular structure has inlet and outlet tubing at
the shoulder. It is via these tubes that synthetic blood
is infiltrated, thus allowing practice in techniques of
blood drawing and starting intravenous infusions.
ORAL AND NASAL LAVAGE, GAVAGE,
AND SUCTIONING
(Available with Complete, Advanced, Auscultation,
and Advanced Auscultation GERi™/KERi™)
Access to the stomach is provided through the
mouth and both nostrils. The internal stomach res-
ervoir bag has a 375 cc capacity. Only water should
be used in tube feeding exercises.
1. Lubricate feeding tubes generously prior to
inserting through mouth, nose, or nostrils.
2. Ensure the upper torso of the manikin is slight-
ly elevated to prevent water backflow into the
head of the manikin.
3. Introduce water only using standard facility
procedures and materials.
4. Following the procedure, empty the stomach.
Water may be removed by suctioning or remov-
ing the stomach reservoir bag and disconnect-
ing it and draining it into a sink or basin.
Note:
Ensure the manikin’s torso remains elevated
when the stomach reservoir bag contains water to con-
tinue to prevent backflow into the head of the manikin.
HC18000028INM23.indd 13 11/16/18 9:24 AM

SETUP
A. Filling the Venous System and Preparing
the Arm for Blood Draws
1. Prepare the synthetic blood by filling the pint
bottle containing the synthetic blood concen-
trate with distilled water.
2. Be sure the clamp on the IV tubing is closed,
and pour the synthetic blood into one of the
provided fluid supply bags. This will be IV Bag
A. Fill to 500 cc maximum.
3. Hang IV Bag A no more than 18" (45.72 cm)
above the level of the arm.
4. Attach the tubing on IV Bag A to one of the
shoulder tubes. Since this is a single tube loop
system it does not matter which tube you use.
This will now be the inlet tube.
5. Use the second shoulder tube for draining;
this will be the outlet tube. With the outlet
shoulder tube in the basin (included), a sink,
or attached to the second IV Bag or IV Bag
B, make sure the clamp on the drain tube is
open. If using IV Bag B, ensure the clamp on
IV Bag B is also open. “Flush” the vascular sys-
tem with synthetic blood by slowly opening
the clamp on IV Bag A. Allow the system to
flush with synthetic blood until the air bubbles
are no longer seen passing through the outlet
shoulder tubing into the basin, sink, or IV Bag B.
(See Figure 19.)
6. Close the clamp on the outlet shoulder tube
and, if using IV Bag B to close off the blood
outlet, the system is now filled and pressurized.
Be sure to leave the clamp on IV Bag A open.
The arm is ready to practice drawing blood.
Synthetic blood can be drawn anywhere along the
pathway of the vein.
B. Preparing the Arm for Intravenous Infusions
1. Start with an “empty” unpressurized arm.
Close the clamp at the end of IV Bag A and
then fill with distilled water, 500 cc maximum.
Hang IV Bag A not more than 18" (45.72 cm)
above the arm.
2. Ensure one of the tubes leading from the shoul-
der of the Injectable Training Arm is fitted with a
clamp. Attach fitting end of IV Bag A to the shoul-
der tubing with the clamp. Attach the fitting end
of IV Bag B to the remaining shoulder tube.
3. With IV Bag B laying on the surface and IV Bag
A hanging, open the clamps on both bags
and the arm tube. Allow fluid to flow through
the Injectable Training Arm until air bubbles
are no longer seen flowing into IV Bag B. Close
the clamp on IV Bag B, the system is now pres-
surized. (See Figure 20.)
4. Insert IV needle (butterfly) in vein. “Flashback”
will indicate proper insertion.
5. Close the clamp on IV Bag A and the clamp
on the arm tube. Disconnect IV Bag A from the
shoulder tubing. You may now use IV Bag A as
the infusion supply.
6. Cleanse the IV site with distilled water and
insert IV needle or butterfly.
7. Connect IV Bag A with the latex connector to the
IV needle or butterfly tubing. (See Figure 21.)
8. To start the IV flow, open the clamps on both
IV Bags A and B.
Figure 19
Figure 20
Figure 21
Latex Connector
A
A
B
14
HC18000028INM23.indd 14 11/16/18 9:24 AM

Proof of proper procedure will be evidenced by the
flow of fluid from IV Bag A. Control flow rate with
the clamp on IV Bag A. A third IV Bag (not supplied)
can be used for the infusion of fluid. This will enable
bags A and B to remain attached to the arm.
If a more realistic experience is desired, with “blood
flashback” instead of water when inserting the but-
terfly into the lumen of the vein, use the following
procedure, C.
C. Recommended Procedure for Simultaneous
IV Infusions and Drawing Blood
1. Follow the procedure for setting up your IV
Arm to draw blood, Procedure A, and using IV
Bag B as the drain bag.
2. Once the arm is pressurized and full of blood,
open the clamps on IV Bags A and B.
3. Obtain a third IV Bag (not supplied), IV Bag
C, and ensure the clamp is closed and fill with
distilled water. Hang IV Bag C according to
your desired flow rate.
4. Cleanse the IV site with distilled water and insert
IV needle or butterfly. A realistic blood flash-
back will be evidenced with proper insertion.
5. Connect IV Bag C to the IV needle or butterfly
with the latex connector and open the clamp
to IV Bag C. (See Figure 22.)
6. IV Bag B, when full, may be easily switched
with A.
USER HELP GUIDE FOR THE INJECTABLE
TRAINING ARM
1. Follow procedures and ensure clamps are
open on appropriate fluid supply/IV bags and/
or shoulder tubes.
2. Look over your equipment prior to use. IV
tubes will kink at the clamp site with repeated
use. Routinely move clamps up or down the
tube to reduce the probability of kinks. When
kink occurs, slide the clamp to a new position
and, with fingers, massage tubing at pinched
site to restore lumen. Replacement fluid bags
are available. Removing clamps prior to stor-
age is recommended.
3. Check to ensure hanging bags are hung to
the appropriate height. Hanging the supply
bags slightly higher for bags not producing
enough pressure can create just enough grav-
itational force on the fluid to facilitate flow.
4. If a venous system clog is suspected, try using
a large 50 cc syringe to force distilled water
through the tubing.
5. Check the venous system tubing for kinks. First,
lubricate the outside of the arm skin generously
with Ivory®liquid dishwashing detergent. Peel
the skin back to the knuckles, being careful NOT
to remove the skin from the fingers. Examine all
the tubing for possible kinks. Replace the skin
and infiltrate the system again.
CARE AND MAINTENANCE
After each use of the Injectable Training Arm,
follow these procedures:
1. Disconnect IV bags, remove infusion needles,
and flush the venous system using distilled
water and 12 cc syringe.
2. Simulated blood can be returned to its bottle
and reused.
3. Rinse IV bag containing simulated blood with
distilled water, flushing through tubing into a
sink or basin.
4. Remove pinch clamps from IV bags and inject-
able training arm shoulder tubing.
5. Wash the outside of the injectable training
arm with mild liquid detergent, such as Ivory®
dishwashing soap. Stubborn stains may be
washed with Nasco cleaner. Dispense Nasco
cleaner on clean, soft, dry cloth and gently
wipe soiled area.
6. Remove excess water from the venous system
by raising the hand, lowering the shoulder,
and draining it into a sink or basin.
7. Allow the arm to dry completely before storing.
To prevent causing harm to the Injectable Training
Arm, use the following recommendations:
1. Use distilled water rather than alcohol,
Betadine®, or other skin preparing substances
to simulate preparing the puncture site.
2. Small diameter needles, 20-gauge to
25-gauge, should be used to extend the life of
the skin and veins.
3. Synthetic blood will stain the soft skin of the
injectable training arm, clothes, most soft
surfaces, and some hard surfaces. Please use
caution.
4. Ink and newsprint will cause an indelible stain
to the injectable training arm. DO NOT place
the injectable training arm on printed surfaces
or plastic.
5. Follow Care and Maintenance instructions
carefully.
Figure 22
15
HC18000028INM23.indd 15 11/16/18 9:24 AM

6. DO NOT clean the simulator with solvents or
corrosive materials as they will damage it.
7. DO NOT use for subcutaneous injection.
Nasco’s Intradermal Injection Simulator
(LF01008U) is specifically designed for intra-
dermal injection training and practice.
SUPPLIES/REPLACEMENT PARTS FOR
INJECTABLE TRAINING ARM
LF04081U Skin and Vein Replacement Kit (Light),
LF04126U (Medium)
LF00845U Life/form®Blood, 1 Quart
LF00846U Life/form®Blood, 1 Gallon
LF01099U Vein Tubing Sealant Kit
LF09919U Nasco Cleaner
LF01130U IV Fluid Supply Bag Set: 500 ml Supply
Bag, Tubing, Clamp and Connector
LF00996U Vinyl Adhesive, 2 tubes (1 oz. each)
LF01117U Butterfly Set (Pkg. of 12)
6. 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 sur-
face.
Figure 23
Figure 24 Power Button
16
BLOOD PRESSURE SIMULATOR ARM
(Available on Advanced and Advanced Auscultation GERi™/KERi™ or as an update or add-on to all other model s)
CAUTION: PRODUCT CONTAINS DRY NATURAL RUBBER!
The Left Blood Pressure Simulator Arm has digitally recorded blood pressure sounds that can be varied by
pulse rate and volume. The different Korotkoff phases can be identified and an optional auscultatory gap
can be selected. A palpable radial pulse is present in the wrist.
GENERAL INSTRUCTION FOR USE
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.
2. Locate the “Open” compartment on the back
of the panel where the batteries are to be
installed.
CAUTIONS
1. This synthetic blood is specially formulated to
be compatible with the self-sealing veins and
plastics used in manufacturing the injectable
training arm.
2. NEVER use synthetic blood for intramuscular
injection.
3. DO NOT use dull or burred needles, these will
cause leaks in the system. Burred needles will
cause permanent damage.
4. DO NOT allow synthetic blood to dry on the
simulator — it may stain the skin.
5. Use only 500 cc of infusion fluid. Larger
amounts will increase the pressure of the
venous system, resulting in leaks.
5. Install 6 “AA” batteries as indicated by the ori-
entation diagram embossed in the bottom of
the bracket.
Note: It is recommended that alkaline batteries be
used for increased battery life.
2. Press the power button on the top right of the
unit. (See Figure 24.)
3. 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.
3. Place your thumb or
index finger on the
“Open” compartment
and push up.
(See Figure 23.)
4. This will open the bat-
tery compartment. The
compartment is marked
as to the positions of the
batteries “+” or “-”.
HC18000028INM23.indd 16 11/16/18 9:24 AM

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 25.)
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 26.)
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
Under the display window are three buttons: Menu,
Gap, and Calibrate. (See Figure 27.)
Setting Systolic and Diastolic Pressure
1. Press the Menu Key once.
2. The “Set SYSTOLIC” pressure menu will
display in the Electronic Control Unit window.
(See Figure 28.)
3. Use the up or down arrow keys, located to the
right of the menu button, to adjust the systolic
pressure.
4. Press the Menu key a second time.
5. The “Set DIASTOLIC” pressure menu will
display in the Electronic Control Unit window.
(See Figure 29.)
6. Use the up or down arrow keys located to the
right of the menu button to adjust the diastolic
pressure.
The systolic and diastolic pressures can be set any-
where from 0-300 mmHg.
Setting the Heart Rate
1. Press the Menu Key a third time.
2. The “Set HEARTRATE” menu will display in the
Electronic Control Unit window. (See Figure 30.)
3. Use the up or down keys located to the right
of the menu button to adjust the heart rate. The
heart rate can be set from 0-300 beats per minute.
Figure 25
Figure 26
Figure 27
Figure 28
Figure 29
Figure 30
17
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.
HC18000028INM23.indd 17 11/16/18 9:24 AM

Setting the Palpable Pulse
The palpable pulse is found at the radial location.
(See Figure 31.)
Palpations can be felt upon start-up of the unit or
after blood pressure and heart rate settings have
been made. The palpable pulse is delicate and
should be palpated lightly. Pressing too hard will
damage the pulse feature.
1. Press the Menu key a fourth time.
2. The “Set PALPATION” menu will display in the
Electronic Control Unit window.
3. “Pulse ON” is defaulted.
Use the down arrow key to the right of the menu key
to set palpation to “pulseless.”
NOTE: The palpation can be set to either on or
pulseless. When the pulseless setting is used, the
diastolic and systolic pressures will automatically be
set to 0.
4. Use the up arrow key to the right of the menu
key to set palpation as “Pulse ON.”
(See Figure 32.)
Note: During an actual blood pressure reading, the
palpable pulse will automatically turn off when the
cuff is inflated and surpasses the systolic set point.
It will turn on when the cuff is deflated 20 mmHg
below the diastolic set point. This function allows
students to clearly hear Korotkoff sounds.
Setting the Auscultatory Gap
This function is included to simulate the gap that is
sometimes present between phases 1 and 2 in which no
audible sound is noted.
1. Locate the GAP Key to the right of the MENU Key.
2. Press the GAP Key to set the function on (Y=Yes) or
off (N=No).
3. When the key is pressed, a message will briefly
appear that the auscultatory gap is enabled or
disabled.
4. The Main display will show AGap:Y (or ON)
(See Figure 33.) or AGap:N (or OFF).
Setting the Volume
The arrow keys also control the volume of the sounds
present in the arm.
1. From the main menu, press the up arrow key to
increase the volume.
2. Press the down arrow key to decrease the volume.
The volume levels can be adjusted from level 1 (the low-
est volume) to level 7 (the highest volume).
Performing a Blood Pressure
1. Verify the pressure line tubing from the sphyg-
momanometer and the audio line from the
arm are properly connected to the electronic
control unit. (See above connection instructions)
2.
Apply the sphygmomanometer cuff and gauge
to the arm according to facility procedures.
3. Place the stethoscope to the arm according to
facility procedures.
4. Set the systolic and diastolic pressure to the
desired levels.
5. Select the auscultatory gap.
6. Select the heart rate to the desired setting.
Note: The electronic control unit will default to the
last levels previously set. It is important to go through
all menus and program the electronic control unit
with each training session as desired. A standard
stethoscope will work with the blood pressure simula-
tor, one is not provided.
Pulse Location
Figure 31
Figure 32
Figure 33
18
HC18000028INM23.indd 18 11/16/18 9:25 AM

Low Battery Indicator
When the battery supply diminishes to a level near
the point the unit will no longer function properly,
a “low batt” message will display on the systolic
pressure menu when the systolic pressure reaches
above 20 mmHg. At this point, the batteries should
be replaced as soon as possible to ensure proper
operation of the unit. Refer to the section “Installing
the Batteries” for more information.
Calibration Procedures
1. Follow the setup procedures.
2. Apply the cuff to the simulated arm.
3. Set the electronic control unit systolic pressure
to 150 mmHg and set the diastolic pressure to
70 mmHg.
4. Proceed with performing the blood pressure
and note the differences between the gauge
and what was set on the electronic control unit.
5. Set the systolic correction by pressing and
holding the CALIBRATE key to the right of the
GAP key. (See Figure 34.)
6. Using the arrow keys, set the correction. For
example, if the blood pressure reading for systol-
ic pressure was 148 mmHg, the systolic correc-
tion would be +2 and the up arrow key would be
pressed until +2 would display in the window.
7. Press the MENU key from the Systolic
Correction window to change to the Diastolic
Correction window. (See Figure 35.)
Preparing Your Sphygmomanometer for
Use with Blood Pressure Simulator
In the event the supplied sphygmomanometer
would cease to operate, any standard sphygmo-
manometer can be adapted for use with the blood
pressure simulator. It is recommended that a child-
size cuff continue to be used.
1. Disconnect the sphygmomanometer from the
pressure line connected to the electronic con-
trol unit. The pressure line can be left connect-
ed to the electronic control unit.
2. Remove the T-fitting included with the assem-
bled sphygmomanometer.
3. Obtain a new sphygmomanometer.
4. Using a scissors, carefully cut the tube of
the sphygmomanometer about 2" from the
gauge. (See Figure 36.)
5. Take the T-fitting and insert the horizontal ends
between the two ends of the cut tubing of the
new sphygmomanometer. (See Figure 37.)
Figure 34
Figure 35
Figure 36
Figure 37
19
8. Using the arrow keys, set the correction. For
example, if the blood pressure reading for
diastolic pressure was 72 mmHg, the diastolic
correction would be -2 and the down arrow
would be pressed until -2 would display in the
window.
9. Press the MENU key. The “CALIBRATION
COMPLETE” message will appear and the
main menu window will be displayed.
HC18000028INM23.indd 19 11/16/18 9:25 AM

SUPPLIES/REPLACEMENT PARTS FOR
BLOOD PRESSURE SIMULATOR
LF01189U Speaker System
LF01096U Electronic Control Unit with
Sphygmomanometer
LF01125U Electronic Control Unit Only
LF01073U Child Size Cuff and Gauge with Pressure
Line Tubing
SB10828U “AA” Batteries, 2 pack
4. Press the red power button on the remote
control. This turns on the remote control and
sends a signal to activate the SmartScope™.
5. After the unit is activated, the LCD display on
the remote control will be in the “status” mode,
displaying the current menu settings for the
heart and lung conditions.
Note: Powering on one remote control will activate
and control all SmartScopes™and manikins simul-
taneously within a 100-foot range. Multiple remotes
operating within this range will cause complications
and signal confusion.
GENERAL INSTRUCTIONS FOR USE
Selecting New Heart and Lung Conditions
1. Activate remote control and SmartScope™
using instructions above.
2. Press either the heart or lung button. This will
put the display into menu mode.
3. Select a condition by using the number but-
tons or the scroll button to view the conditions
in sequence.
4. When the desired condition is viewed on the
LCD display, press the enter button to activate.
5. Heart and lung sounds are heard simultane-
ously. Check the main screen to ensure the
desired sounds are being heard. For example,
when hearing normal heart sounds and nor-
mal lung sounds, the LCD display will read:
HS= (01) LS= (01).
20
THE AUSCULTATION SIMULATOR AND SMARTSCOPE™ WITH WIRELESS REMOTE CONTROL
The auscultation feature duplicates heart and lung conditions selected by the instructor via wireless remote
control with LCD Display. Palpation is required to correctly identify the auscultation locations.
Heart
Sounds are detected at 6 anterior locations
with 12 heart conditions:
01 Normal 07 S3 Gallop
02 Aortic Regurgitation 08 S4 Gallop
03 Pulmonary Stenosis 09 Systolic Click
04 Mitral Stenosis 10 Atrial Septal Defect
05 Holosystolic 11 PDA
06 Mid-systolic 12 VSD
Lungs
Sounds are detected at 5 anterior, 6 upper
posterior, 4 lower posterior, and 2 mid-axillary
locations. With 16 lung conditions:
01 Normal Lungs 09 Cavernous
02 Normal Vesicular 10 Bronchovesicular
03 Wheezes 11 Bronchial
04 Mono Wheeze 12 Pulmonary Edema
05 Fine Crackle 13 Infant
06 Coarse Crackle 14 Friction Rub
07 Rhonchi Crackle 15 Egophony
08 Stridor 16 Pectoriloquy
Setup
1. Locate your SmartScope™and Remote
Control with LCD display.
2. Locate included “AA” and “AAA” batteries.
3. Install 2 “AA” batteries into SmartScope™and
2 “AAA” batteries into the remote control. The
compartments are marked as to the positions
of the batteries “+” or “-”.
6. Assemble the free end of the pressure line
tubing, still connected to the electronic control
unit, to the free end of the T-fitting.
(See Figure 38.)
7. Connect the newly modified sphygmoma-
nometer to the child-size cuff.
8. Follow the calibration instructions to calibrate
with the electronic control unit and blood
pressure simulator.
Figure 38
HC18000028INM23.indd 20 11/16/18 9:25 AM