TRAUMA F/X EMITT-ASL User manual

EMERGENCY MEDICAL TRAUMA TRAINER – ACTIVE
SHOOTER LOWER (EMITT-ASL)
______________________________________________________
Emergency Medical Trauma Trainer –
Active Shooter Lower (EMITT-ASL)
User Guide
Rev_Q4_2020_TSR

© Copyright 2020. TraumaFX Solutions
Rev_Q4_2020_TSR

© Copyright 2020 TraumaFX Solutions
TraumaFX®
Emergency Medical Trauma Trainer – Active
Shooter Lower (EMITT-ASL)
TraumaFX Customer Service
[email protected]
1-800-200-7465


TABLE OF CONTENTS
i
Chapter1:Introduction....................................................................1
AbouttheEmergencyMedicalTraumaTrainer–ActiveShooterLower............1
ItemChecklist.....................................................................................................2
StandardComponents................................................................................................................2
OptionalComponents................................................................................................................3
SystemOverview................................................................................................3
SpecialNotesandCautions.................................................................................4
LatexAllergyAlert.......................................................................................................................4
AfterUseCare............................................................................................................................4
WaterResistanceandCleanup...................................................................................................5
PossibleReactiontoSyntheticBloodMix..................................................................................5
SystemWeight............................................................................................................................5
SimulatedBlood.........................................................................................................................5
RadioControl..............................................................................................................................5
ThirdPartyUserManuals...........................................................................................................6
Storage........................................................................................................................................6
Compliance.................................................................................................................................6
Chapter2:EmergencyMedicalTraumaTrainer–ActiveShooter
LowerFeatures................................................................................7
Ruggedized,RealisticSyntheticSkin...................................................................7
Material......................................................................................................................................7
PackableHemostaticWound......................................................................................................7
GunshotWound.........................................................................................................................7
TibialI/OSiteonLeftLeg............................................................................................................7
Crepitus......................................................................................................................................8
CautionsandCare.......................................................................................................................8
Materials.....................................................................................................................................8
BleedingSystem.................................................................................................8
Chapter3:GettingStarted............................................................10
NotesonGeneralUseandCare........................................................................10
ChargingtheBatteries......................................................................................10
EMITT‐ASL&TSRTransmitterBatteries...................................................................................10
GeneralUseandCareofBatteries....................................................................11
InstallingandRemovingtheBatteries..............................................................12
InstallingtheEMITT‐ASLBattery..............................................................................................12
RemovingtheEMITT‐ASLBattery.............................................................................................12
InstallingandRemovingtheTSRTransmitterBattery..............................................................13
AttachinganOptionalTraumaFX®UpperUnittotheEMITT‐ASL.....................13
AttachingtoaTraumaFXUpperUnit.......................................................................................13
UsingtheEMITT‐ASLwithaLiveActor.............................................................14

TABLE OF CONTENTS
ii
SimulatedBleeding...........................................................................................15
PrimingtheHoseandBloodSystem.........................................................................................15
MixingtheTraumaFX®BloodPowder......................................................................................17
Filling/RefillingEMITT‐ASLwithBlood......................................................................................17
ApplyingBloodPaste................................................................................................................18
InsertingtheInfusibleTibialIOSkin/BonePlug................................................18
Chapter4:OperatingtheEmergencyMedicalTraumaTrainer–
ActiveShooterLower(EMITT‐ASL).................................................20
Power...............................................................................................................20
SyncandAnimatronicsCheck...........................................................................20
TourniquetApplicationandPressurePoints.....................................................21
Cleaning............................................................................................................21
CleaningtheInletBloodFilter..........................................................................22
Packing.............................................................................................................23
Chapter5:AfterUseCare.............................................................24
Chapter6:Troubleshooting&Repair............................................25
AdditionalSupport....................................................................................................................26
HowtoRepairtheEMITT‐ASLSkin...................................................................27
O‐RingProceduresandReplacement...............................................................28
MaintainingO‐Rings.................................................................................................................28
WhentoReplaceanO‐Rings....................................................................................................28
AppendixA–EMITT‐ASLTechnicalSpecs.......................................29
EMITT‐ASLLowerUnit......................................................................................29
MakitaDC18RCBatteryCharger.......................................................................29
TouchscreenRemoteControlTransmitter........................................................29
AppendixB–SafetyDataSheets....................................................31
BloodPasteSDS................................................................................................32
BloodPowder...................................................................................................35
LithiumBatterySDS..........................................................................................42

INTRODUCTION
1
Chapter 1: Introduction
About the Emergency Medical Trauma Trainer – Active
Shooter Lower
he Emergency Medical Trauma Trainer – Active Shooter Upper (EMITT-
ASL) is a ruggedized, tetherless medical training manikin that delivers
powerfully realistic simulations of lower body gunshot wounds. EMITT-
ASL employs state-of-the-art special effects materials and technologies to
deliver incredibly realistic visual and tactile stimuli with lifelike response to
treatment. EMITT-ASL features a hemostatic wound that when packed and when
pressure is applied with sufficient force for the appropriate amount of time, the
bleeding will stop. Tourniquets must be applied with realistic force to control
hemorrhaging to the right leg gunshot wound, and trainees can use field techniques
such as hand, knee and elbow pressure on arterial pressure points to occlude bleeding.
Rounding out EMITT-ASL’s already robust features is the infusible tibial I/O site on
the left leg. EMITT-ASL’s unparalleled ruggedness allows it to be carried and
dragged through inhospitable field training environments without damage, making it
ideally suited for use in Tactical Combat Casualty Care, (TCCC) and Combat
Lifesaver courses. Extraordinary realism provides desensitization to traumatic
amputation injuries allowing Medics, Corpsmen, Soldiers, and other first responders
to perform lifesaving tasks more efficiently and effectively in the field, leading to
significant improvement in the treatment of blast injuries.
The EMITT-ASL is designed for rugged use in realistic training environments. To
ensure proper operation, do not subject the EMITT-ASL to unnecessarily harsh
treatment. Care for the EMITT-ASL as you would a live patient. Also, careful
preventive maintenance and frequent after-use inspection is essential to ensure the
service life of your trainer(s). Please review Chapter 5: After Use Care which
outlines the standard preventive maintenance required under the terms of the EMITT-
ASL limited warranty.
Chapter
1
T

INTRODUCTION
2
Item Checklist
The components listed below (Figure 1) are required to set up and
operate your EMITT-ASL unit and come standard with each EMITT-
ASL trainer purchase. Optional components may or may not be
included – check your order or packing lists to determine if any
optional components were purchased.
Standard Components
EMITT-ASL Lower unit
Touch
s
creen Remot
e
Control
(
TSR
)
Transmitter Blood Filling System 1 Gallon Blood Mix
Packets (10)
1 Pint Blood Paste (Coagulated) 18v Li-ion Batteries (2)
Li-ion Battery Charger
Figure 1
Other standard components not shown



INTRODUCTION
3
 Inguinal Wound Plug
 Tibial I/O Cap
 Operating Manual – Makita Battery Charger
 Replacement O-rings (5)
 Blood stir sticks (2)
 Filter wrench (1)
 Small tube of Sil-Poxy with stick applicator
 ACC-O-rings for the Filter Cap (5pc)
 EMITT-ASL User Documentation
Optional Components
 Emergency Medical Trauma Trainer – Tactical Medical Upper (EMITT-TMU)
 Emergency Medical Trauma Trainer – Active Shooter Upper (EMITT-ASU)
 AirwayPlus Lifecast (with or without Abdominal Evisceration) (APL)
 AirwayPlus Lifecast – Pulses/Breathing (APL-PB)
 Clinical Response Upper (CRU)
 Clinical Response Upper – Resuscitate (CRU-R)
System Overview
Figure 2

INTRODUCTION
4
Figure 3
Special Notes and Cautions
Read all TraumaFX and Third-Party user instructions and manuals before
attempting to assemble, install or operate the Emergency Medical Trauma Trainer
– Active Shooter Lower (EMITT-ASL) or accessories.
Latex Allergy Alert
The tubing used in the EMITT-ASL’s bleeding system is surgical
quality and contains latex. A small portion of the tubing is exposed
externally at the base of each wound where blood enters.
Individualswithlatexallergiesorsensitivitiesshoulduseproperprecautionsbefore
operating, treating, or attempting to repair the unit.
After Use Care
EMITT-ASL is designed for rugged use in realistic training
environments. To keep EMITT-ASL working optimally, careful
preventive maintenance and frequent after-use inspection will extend
the service life of the EMITT-ASL, and is required under the terms of the limited
warranty. Please review Chapter 5: After Use Care which details the tasks to
perform at the end of every training session.

INTRODUCTION
5
Water Resistance and Cleanup
DO NOT USE PRESSURIZED WATER OR SUBMERGE EMITT-
ASLUNDERWATER. REMOVEBATTERIESBEFORECLEAN-
UP TO AVOID ELECTRIC SHOCK!
EMITT-ASL is water resistant, not waterproof. Avoid direct water contact with the
battery compartment. Wash EMITT-ASL carefully after each use with clean water
only. EMITT-ASL can be washed off with a soft wet cloth or sponge; however,
vigorous scrubbing of the legs may affect the skin surface. Simulated blood should
be washed out of clothing as soon as possible preferably within 24 hours to avoid
staining; pre-treatment of stains and vigorous cleaning will usually remove stains
caused by the simulated blood.
Possible Reaction to Synthetic Blood Mix
The chemical components that comprise TraumaFX organic dye blood
mix may cause skin and eye irritation for some users. Avoid ingestion
or inhalation. If eye contact occurs, check for and remove any contact
lenses, immediately flush eyes with water for at least 15 minutes; cold
water may be used. Get medical attention if irritation occurs. Should skin contact
occur and the skin becomes irritated, wash with soap and water. Get medical
attention if irritation persists. If blood powder is accidently inhaled, remove victim
to fresh air. If breathing difficulties occur, seek medical attention immediately. If
blood mix is ingested (powder or liquid form), DO NOT induce vomiting unless
directed to do so by a physician. Never give anything by mouth to an unconscious
person. Loosen tight clothing such as a collar, tie, belt, or waistband. Immediately
get medical attention.
System Weight
The EMITT-ASL trainer is designed to replicate the weight and
feel of a live human patient. To prevent injury, use caution and
proper procedures when lifting or carrying the manikin or cases.
Simulated Blood
Only use TraumaFX-provided simulated blood and blood mixes in the
EMITT-ASL unit. Use of other liquids or the addition of any substance,
including detergents, to the blood mix may damage internal components
and will void the manufacturer’s limited warranty.
To preserve the life of the simulated blood paste, please store in a dark, cool location.
Radio Control
The Radio Control (RC) system used to operate EMITT-ASL has an
extended range (see technical specifications) and can be used indoors
or outdoors. Note that indoor range is subject to building design and
construction materials. Test system operations whenever setting up in a new location
or moving to a different area of a building.

INTRODUCTION
6
Third Party User Manuals
The EMITT-ASL trainers use third-party commercially available
equipment. Where such equipment is provided, the associated user
manuals and any pertinent documentation are provided as well.
Storage
The EMITT-ASL unit, accessories, and fluids should be stored in a
cool, dry location.
Compliance
If EMITT-ASL is used in a manner not specified by the manufacturer,
the protection provided by the equipment may be impaired.

EMITT-ASL FEATURES
7
Chapter 2: Emergency Medical Trauma
Trainer – Active Shooter Lower Features
This section describes the highly realistic features of the EMITT-ASL that contribute
to the unique training experience the EMITT-ASL trainer provides.
Ruggedized, Realistic Synthetic Skin
The outer skin of the EMITT-ASL is designed to provide the “look-and-feel” of real
skin. The skin is very rugged, but must be maintained regularly to ensure longevity.
EMITT-ASL’s simulated skin is made of a proprietary silicone compound, and
features realistic gunshot wounds.
Material
The EMITT-ASL’s skin is made of a silicone-based compound that requires cleaning
with water only. This simulated skin covers the entire EMITT-ASL unit.
Packable Hemostatic Wound
The EMITT-ASL offers a packable hemostatic wound incorporating advanced
sensor technology, providing the trainee with immediate feedback of their efforts.
The wound at the left inguinal crease contains a packable wound with sensor that
identifies if the right amount of pressure is being applied to the wound for an adequate
amount of time. If the trainee meets both the pressure and time requirements, the
bleeding will occlude and the EMITT-ASL will live to fight another day. However,
if the pressure and time requirements are not to standard, then the EMITT-ASL will
die, as indicated on the feedback received by the Touchscreen Remote Control (TSR)
Transmitter. This is valuable measured feedback that can be shared with the trainee.
Gunshot Wound
The EMITT-ASL provides a realistic gunshot wound on the right leg that features
femoral artery hemorrhage. The right leg has an anatomically correct femoral
pressure point that will occlude bleeding via proper tourniquet application or through
pressure applied by the user.
Tibial I/O Site on Left Leg
EMITT-ASL features an infusible intraosseous (I/O) training site on the left leg with
a reusable and replaceable skin/bone plug.
Chapter
2

EMITT-ASL FEATURES
8
Crepitus
The EMITT-ASL’s upper left hip features a simulated crepitus (crackling) to cue for
a crushed pelvis.
Cautions and Care
The EMITT-ASL unit is water resistant, but not waterproof. Avoid direct water
contact with the battery compartment, bone end, and penis area. When washing
EMITT-ASL, use only water. Never use ink or marker to write on EMITT-ASL.
Doing so can cause damage to EMITT-ASL’s surface during removal.
When washing EMITT-ASL, use caution to prevent water from entering the
mechanical and electrical areas of the unit – the battery compartment should be closed
and secured before cleaning. Always use gentle pressure and avoid vigorous
scrubbing of the legs as this may affect the skin surface.
Often in live training scenarios, the EMITT-ASL’s simulated blood may come into
contact with a user’s clothes. To reduce the risk of staining, simulated blood should
be treated with detergent and be washed out of clothes within 24 hours of exposure.
Materials
The internal structure of the EMITT-ASL’s lower unit is composed of a heavy-duty
anodized aluminum yoke, surrounded by a rugged core, and layered with realistic
silicone-based skin. This construction results in a high-fidelity look and feel with
exceptional durability that allows the EMITT-ASL to be carried or dragged on many
surfaces such as outdoors or various flooring commonly found in buildings. Though
highly ruggedized, do not subject the EMITT-ASL to severely damaging conditions;
users must treat EMITT-ASL as they would care for a human patient. Failure to do
so can void the EMITT-ASL limited warranty.
The structure and joints do not require lubrication of any kind so do not attempt to
lubricate the EMITT-ASL.
Bleeding System
ALLERGY WARNING: The tubing used in the EMITT-ASL’s
bleeding system is surgical quality and contains latex. A small portion
of the tubing is exposed externally at hemorrhage points within the
wounds. Individuals with latex allergies or sensitivities should use
proper precautions before operating, treating, or attempting to repair the
unit.
EMITT-ASL provides realistic physiological response to treatment. During training
exercises, proper wound packing with applied pressure combined with the
application of tourniquets or pressure at pressure points will occlude bleeding. The

EMITT-ASL FEATURES
9
operator does not need to “judge” when enough pressure is applied and manually
discontinue the blood flow. Unless stopped by the instructor, users should continue
treatment until the bleeding is stopped through the use of proper technique, or the unit
bleeds out.
One of the EMITT-ASL’s key features is its realistic bleeding system. This system
simulates a packable hemostatic wound to the left inguinal crease area, and a gunshot
wound femoral hemorrhage. The internal reservoir (bladder) that stores blood is
made from heavy-duty polyurethane and holds approximately two (2) liters of liquid
blood mix.
The pumping system simulates pressurized, pulsed blood flow, and will exhaust the
reservoir supply (bleed-out) in approximately 4-7 minutes (depending on treatment
to occlude or slow blood flow). Once the blood bladder is filled (see Filling/Refilling
EMITT-ASL with Blood), users activate the blood pump from the command screen
and touch controls on the transmitter. This will cause blood to flow in pulsing spurts
from the gunshot wound, and the hemostatic wound at the inguinal crease wound will
quickly fill with blood. The gunshot and inguinal wound bleeding can be set so they
run at the same time, or one at a time.

GETTING STARTED
10
Chapter 3: Getting Started
Read all TraumaFX and Third-Party user instructions and
manuals before attempting to assemble, install or operate the
EMITT-ASL or accessories.
Notes on General Use and Care
The EMITT-ASL is designed for rugged use in realistic training environments. To
ensure proper operation, care for the EMITT-ASL unit as you would a human patient
by not subjecting your EMITT-ASL unit to unnecessarily harsh treatment. Also,
careful preventive maintenance and frequent after-use inspection is essential to
ensure the service life of your unit(s). Please review Chapter 5: After Use Care,
which outlines the after use care required under the terms of the EMITT-ASL limited
warranty.
Only use TraumaFX-provided TraumaFX® simulated blood and
blood mixes in your EMITT-ASL unit. Use of other liquids or the
addition of any substance, including detergents, to the blood mix may
damage internal components and will void the limited warranty.
Charging the Batteries
EMITT-ASL & TSR Transmitter Batteries
Read all instructions provided in the Operating Manual – Makita
Battery Charger and associated Transmitter Battery documentation
before using.
Each EMITT-ASL unit utilizes two (2) 18v Makita Lithium-Ion batteries for
operation. Two (2) Makita batteries are provided as standard equipment. One battery
powers the unit, and the second battery powers the TSR transmitter. Additional
batteries are available for purchase through TraumaFX by contacting your account
representative or customer support.
Only use the batteries and charger(s) provided by TraumaFX; use of different
equipment may result in damage to the batteries and/or TraumaFX equipment and
can void the limited warranty. Read the instructions for the Makita battery and
charger in the Operating Manual – Makita Battery Charger provided.
Chapter
3

GETTING STARTED
11
The EMITT-ASL and TSR Transmitter batteries are consumable items (with a one
(1) year manufacturer’s warranty). As with most batteries, Makita batteries have a
finite shelf life. After considerable use, a ‘used’ battery’s capacity will drop to a point
that it will no longer be able to hold a charge.
The EMITT-ASL contains a low voltage disconnect feature that will automatically
shut the unit off when battery voltage drops to a certain level. If the EMITT-ASL
stops operating, remove and recharge the battery or replace with a fully charged
battery.
Recharging the EMITT-ASL and TSR Transmitter Batteries
1. Plug the Makita quick charger (Figure 4)
into a standard 110V wall outlet.
2. Slide the battery onto the quick charger
until firmly in place and the indicator light
illuminates (each battery takes
approximately 30-45 minutes to charge,
and depending on the amount of usage,
provides up to 6-8 hours of training
support).
3. Remove the battery when readout indicates
charging is complete.
NOTE: A 220V Makita charger is available for International use. This is a special-
order item and available for purchase through TraumaFX by contacting customer
support or your account representative.
General Use and Care of Batteries
All batteries used in TraumaFX products were specially selected to provide optimal
operational performance. However, as with all batteries, they will last longer with
proper care and maintenance. To preserve the life of the batteries, the following best
practices are recommended:
1. Only use the batteries and charger(s) provided by TraumaFX; use of
different equipment may result in damage to the batteries and/or the
TraumaFX unit(s).
2. Remove all batteries from the EMITT-ASL or TSR Transmitter at the end
of each training session. Batteries should never be stored inside a unit
(EMITT-ASL or TSR Transmitter)
3. Recharge batteries immediately after use by placing them in the Makita
battery charger.
Figure 4

GETTING STARTED
12
4. Fully recharge all batteries before each training exercise. This is
indicated by a solid green light on the charger for each battery.
5. Store batteries indoors, away from extreme temperatures (not above
120°F or below 38°F).
6. Only charge TraumaFX-related batteries using the approved chargers
supplied with the TraumaFX system.
Installing and Removing the Batteries
Installing the EMITT-ASL Battery
1. Select one (1) 100% fully charged
Makita Lithium-Ion battery.
2. Open the battery compartment door
on the EMITT-ASL unit by twisting
the two (2) latches on the battery door
(Figure 5) counter-clockwise.
3. Insert the fully charged battery into
the battery compartment (Figure 6).
4. Push the battery into the battery
compartment until it audibly ‘clicks’
into place (Figure 6).
5. Close the battery compartment door
and secure it by twisting the two (2)
latches clockwise until tight (do not
over tighten).
Removing the EMITT-ASL Battery
1. Open the battery compartment door on
the EMITT-ASL unit by twisting the
two (2) latches on the battery door
(Figure 5) counter-clockwise.
2. Press the white, push button (Figure 7)
located on the battery to remove it
from the EMITT-ASL unit.
Figure 5
Figure 6
Figure 7

GETTING STARTED
13
Installing and Removing the TSR
Transmitter Battery
1. Install the battery by inserting the
battery into the back of the unit
(Figure 8) by sliding the battery into
the battery slot until it locks into place.
2. Remove the battery by pressing the
white, push button located on the
battery to remove the battery from the
remote control transmitter.
Attaching an Optional TraumaFX® Upper Unit to the
EMITT-ASL
The EMITT-ASL unit can attach to any TraumaFX® upper unit to help trainees learn
how to treat patients suffering from multiple traumatic injuries.
Be sure to install a fully charged battery in EMITT-ASL before connecting the upper
body unit – the connection will block access to the battery compartment. Both units
have been designed to enable rapid battery replacement during training exercises.
Attaching to a TraumaFX Upper Unit
1. Fold back the upper unit chest fascia to
expose the quick connect system (Figure 9).
Ensure bracket is installed such that it can
pivot forward.
2. Bring the Lower and Upper units together
and line up one side of the Upper quick
connect with the corresponding Lower unit
quick connect (Figure 10).
Figure 9
Figure 10
Figure 8

GETTING STARTED
14
3. Insert the cotter pins into the bracket holes
(Figure 11) on both sides of the unit.
4. Pull down chest fascia to cover the space
between the upper and lower units.
Using the EMITT-ASL with a Live Actor
For enhanced realism in training scenarios, the EMITT-ASL
unit can be used with a live actor in lieu of the optional upper
body unit. Several options exist, including the use of a
modified cot (Figure 12), a false-bottom floor (Figure 13) or
a hole dug in the earth (Figure 14).
If using a live actor, here are a few tips to enhance the
simulation:
Tips:
1. Use the actor’s shirt-tails, jacket, and some light
padding to conceal the seam where the EMITT-ASL
and the actor come together.
2. Anchor the EMITT-ASL unit with rope or straps to
the surface structure or frame to prevent the EMITT-
ASL unit from moving away from the live actor
during animatronic movement, and will allow the
actor to reposition the EMITT-ASL unit between
training sessions.
3. If possible, use a back support for the actor.
Figure 11
Figure 12
Figure 14
Figure 13

GETTING STARTED
15
Simulated Bleeding
Priming the Hose and Blood System
The EMITT-ASL blood fill hose is sent to you “pre-primed” with water and should
not require any additional priming when first received. Results are best when water
is left in the hose between uses. If cavitations (air pockets) arise, the hose can be
primed again using objects such as Allen keys or pencil erasers to push in the valve
of the quick-connect attachment at each end of the hose. To re-prime the hose, attach
one end of the blood fill hose to the quick-connect valve on the blood fill system.
Then, using a sharp object, simply push in the valve at the other end of the hose. Let
water flow through the hose until the air pocket is eliminated.
Prior to the first use or after a period of non-use, it is recommended to prime the blood
system with water (temperature range of 40° – 120°F) before filling it with artificial
blood to ensure optimum pump action. This process removes the air that may be
trapped during shipping and handling. This process can be repeated if you notice any
decrease in pumping pressure after prolonged use.
1. Fill 1-gallon bucket (with the quick connect
fitting) with clean cold or warm water
(temperature range of 40° – 120°F)
2. Connect clear hose from bucket to lower unit
via blood fitting, which can be exposed by
gently pulling the skin back at the waist.
3. Elevate bucket to allow gravity to fill the
blood reservoir in the lower unit. The
reservoir holds one liter of blood liquid. Generally, this fill process takes
between 1 and 3 minutes (the higher the fill bucket elevation, the shorter the
fill time).
4. Disconnect the hose from the unit and keep the hose clear of any grit or debris
that could impede or compromise the pump system
5. Turn the TSR transmitter ON (Figure 15).
It is important to remember to turn off the transmitter when not
in use as this will continue to drain the battery pack even if it is
not in use.
Figure 15