Instruction Manual
Model No.l1257-159
Cardiology patient Simulator “K Plus”
Training System
Japanese Patent No. 2990602
US Patent No. 6,641.165B1
US Patent No. 6,527.559B2
Cardiology Patient Simulator"K"
Lung Sound Auscultation Trainer
Features
This device is a simulator for medical education, which is designed to facilitate total hands-on training in bedside diagnostic skills for cardiac patients and auscultation skills for pulmonary disorder.The Simulator “K” training system includes 2 manikins for simulation trainings.
Cardiology Patient Simulator “K”: Training in heart sound auscultation can be performed around auscultation sites accurately located on the manikin using actual clinical instruments.Other findings, jugular vain waves, artery pulses, cardiac impulses are also simulated in synchronization, allowing training in observation and palpation.
Lung Sound Auscultation Trainer LSAT:A single-purpose simulator for lung sound auscultation training
The simulator is designed for training in medical diagnosis education.
Do not use for other purposes.
Please read the instructions carefully before using.
Cardiology Patient Simulator "K " Plus Training System
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Simulator"K" Plus Training SystemA thorogh medical examination training system for the human chest.High quality auscultation training with plenty of important cases through an actual stethoscope, along with comprehension ofthe relationship between sounds and sites on the chest.Monitor display which shows synchronized chart, explanation of cases and other operation aids that enrich training. The external speaker system allows a shared, group learning experience.
Cardiology Patient Simulator “K”: Synchronized physical findings for comprehensive bedside diagnosis trainingHeart sound & murmur auscultationObservation of jugular veinsPalpation of arteries:8 sitesPalpation of cardiac impulses (RV and LV) 13 cases each.Normal respiratory sounds and observation of abdominal movement (HR:60/min)Monitoring electrocardiogram (ECG), jugular venous pulse (JVP) and carotid arterial pulse (CAP) and apexcardiogram (ACG)
Lung Sound Auscultation Trainer LSAT:Outstanding sound quality:Cases were recorded from actual patientsAccurate location and spread of lung soundsThe torso rotates on the base allowing examination of both front and back as in a real clinical procedure. Efficient selection of the 35 cases based on classification standards of the American Thoracic Society. Useful explanation windows - including illustrations, chest radiographs and CT images
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DOsPlease operate the system under the designated circumstances
Power input: AC 220V-240V 50Hz, 60Hz/ Max220WTemperature range: 10 degrees C – 40 degrees C Relative humidity; less than 85 per cent (no condensation)
Safe disposition To allow safe operation, please locate the units with sufficient space around the switches on each part of the system.
Inappropriate disposition may cause serious accident.Follow the instruction on labels
“Warning label” indicates there is a danger of an electric shock when the part is opened up.Never open any lids, caps or covers with warning labels.There will be no compensation considered by the manufacturer for any damage or loss alleged to have been caused by the simulator, if the labeled part(s) have been opened inappropriately.
Handle with careThe models consists of special compositions of soft resin. Please handle them with the utmost care at all times.
Storage Store the training set at room temperature, away from heat, moisture and direct sunlight.
DON’Ts Do not discharge water while the unit is set above a power receptacle.
There is a sewer valve for a tank at the bottom of the control box unit.To avoid short circuit, do not discharge water from the tank while the unit is set above a power receptacle.
Never wipe the models and pads with thinner or organic solvent.Don’t mark on the models with pen or leave any printed materials in contact with their surface. Ink marks on the models are not removable.
DOs and DON’Ts
Before installationProduct outline and Features / DO's and DON'Ts---------------------------------------------------1,2Parts and Functions/ Set Includes----------------------------------------------------------------------3Installation-----------------------------------------------------------------------------------------------4,5System start-up----------------------------------------------------------------------------------------- 6OperationSimulator K-----------------------------------------------------------------------------------------------7-11LSAT-------------------------------------------------------------------------------------------------------12,13System configurations----------------------------------------------------------------------------------14,15System closing down------------------------------------------------------------------------------------16
Index
"K" plus SImulatorK
1.Control box ----------------------------------------1 1 2.Cardiology Model unit --------------------------- 1 1 3.LSAT Model unit-----------------------------------1 1 4.Audio cable (long cable)--------------------------2 1 1 5.Control cable (short cable)------------------------1 1 6. Power supply cable (excludes cable for PC/monitors)-- 4 3 2 7.Air tubes-------------------------------------------- 4 4 8.PC (OS.Windows2000Pro)----------------------- 1 1 1 9.TFT monitor --------------------------------------- 1 1 110.Audio distributor---------------------------------- (1) (1) 11.Power amplifier ------------------------------------ 1 1 112.Speaker-----------------------------------------------2 2 213.Speaker cable----------------------------------------2 2 214.Text book"Bedside Physical Examination"----- 4 4 15.Rib sheet ---------------------------------------------1 1 16.T shirt-------------------------------------------------1 117. Pulse tube(replacement part)--------------------- 5 518. Instruction manual -------------------------------- 1 1 1
LSAT
1
1. Control box
2.Cardiology model unit
3.LSAT model unit
4. Audio cable (long cable)
5.Control cable (short cable)
6.Air tubes
7.Power supply cable
8.PC (OS.Windows2000Pro) a 12chD/A PCI board (installed) a power supply cable / a mouse a 109 keyboard / Windows2000Pro.
9.TFT monitor a power supply cable/ manual (Japanese)/ monitor cable(10. Audio distributor)
11. Power amplifier
12.Speaker
13.Speaker cable
NO STETHOSCOPE IS
INCLUDED.
2
3
5
8
9
11
12
The table is not included.
Name of the Parts
Set includes
3
13
7
4
6
7
17
16
8) Connect the control box and the Cardiology model unit with 4 air tubes, matching the indications (CAP,JAV,ACG,R, ) above the sockets. Be careful not to mix up the lines. * The tubes can be detached safely by pushing the socket ring as illustrated below.
1) Raise the mouse table from the side of the controle box and latch it firmly. 2) Attach the PC table to the side of the control box and fix it using the wing nuts.
Installation :A1-A12
3) Place the PC, TFT monitor and amplifier on the control box.
A-1A-2
AUDIO INPUT AIR TUBE SOCKETS(4) POWER SUPPLY
Cardiology model unit
4) Plug the main power supply cable into the socket on the back-bottom of the control box.
5) Connect the keyboard and the mouse to the computer.6) Connect the TFT monitor to the computer.7) Connect the PC and the control box using the control cable.
A-4A-7
A-8
Control box Model unit Detach
4
A-3
Connection of Simulator "K" Plus training system
5
9) Connect the power amplifier to the computer.10) Connect model unit(s)to the power amplifier with the audio cable(s).
Cardiology model unitControl
BoxAir tubes
Main power supply cable
PC
Control cable
Amplifier Audio cable
SpeakersMonitor
PS
PS
PS
OUTLET
Audio cable
LSAT model unit
Simulator K
LSAT
11) Plug the power supply cables of the model units, the PC, the TFT monitor and the power amplifier into the outlets on the backwall of the control box.
12) Plug the main power supply cable from the control box and the LSAT model unit into outlets.
PS
Audio cable
PS: Power supply cableWhen the LSAT system is installed separately, the power supply codes are pluged directly into outlet.
When the system is installed without using external speaker system, connect the PC and model(s) directly with audio cable. In that case, to connect both models simultaneously an audio distributor is required.
System set-up B1-B5
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Before the session, Please set-up the system following the procedure below.
1) Turn on the power switch on the front wall of the control box.
2)Turn on the monitor.
3) Turn on the PC.
4)Turn on the power switch on the model unit bases with the LSAT torso in "FRONT" position.
5)Turn on the amplifier.
When you finish a session, please refer to the system close-down instruction.
C1. Opening of the simulator "K"system
Going through procedure B1-B5, Microsoft Windows 2000Pro is started up.Open the simlator "K" system by double-clicking at the icon.It takes a little while for the air compressor to get the pressure ready. (This process can be skipped by clicking "Start" button. )
Operation: Simulator "K": C1-C5
C2. Chosing cases
Choose the mode using the "Mode" button and select up to four cases from the boxes.Then open the cases by clicking "Go" button.
Opening window (1) (2) (3) (4)
(5)
(1) Mode：Switch over the program between "simulator K : basic cases for total patiet simulation" and
"simulator K2: advanced arrythmia auscultation training (sounds and monitor only).
(2) Go: Open the selected cases.
(3) Cancel:Close the opening windows
(4)Help:
(5)Cases for simulation: 4 cases can be selected at one time by a single click.
The individual selection of the case can be canceled by clicking the same line again.
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C3. Running the simulation
Click the window of a case to activate, and click the button on the toolbar to start running the simulation.
Default duration time of the simulation is 30 min.
To open another set of cases, click button.
To quit the simulator "K" system, click . When you finish the session completely, follow the closing-down procedure.
Operation window
(1)
(2)
(3)
(5)
(1) Activated case: indicated by blue bar
(2) Name of the case
(3)Time: Set time duration of the simulation
Current:Elasped simulation running time
(4)Indication of heart & lung movement
(5)Condition of simulated patient
(6) Indication sign for setting cardiac impulses
(7)"at present" line
(8) File buttons
(9) Operation buttons
(10)Systen configuration buttons
(11)Display preference buttons
(12)Information buttons
(4)
(6)
(7)
(8)
(9) (10) (11) (12)
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C4. Running the simulation: Caldiology Patient Simulation
In "Simulator K" mode, thorough bedside examination including auscultation, palpation and observation can be performed. A findings are appropriately synchronized by the system to simulate an actual patient.
(1)Auscultation: Heart sounds and murmursGenerated digitally by 4 built-in speakers (5 speakers for aortic stenosis) on the manikin. Synchronized phonographs are shown on the monitor for further comprehension during training.
The following are auscultory sites on this simulator. aortic area: A pulmonary area: P tricuspid area: T mitral area: M carotid artery area (aortic stenosis only) Please note :During auscultation, turn off the valve switches for cardiac impulses and respiration. The noise from the mechanism may interfere with the proper sounds.
Physical findings replayed on tha manikin body
(1) Heart sounds and murmurs
(2) Respiration (movement and sounds)
(3) Artery pulses
(4) Jugular vein wave
(5) Cardiac impulses
(6) ECG(monitor)
A P
Tracheal sounds
MT
Heart sounds and murmurs
Vesicular sounds
PCG
Respiratory abdomen movement
Carotid artery
Jugular vein
Brachial artery
Radial artery
Femoral artery
RVLV
DLV
Cardiac impulsee
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(2) Auscultation / Palpation: Respiration Tracheal and vesicular breath sounds and abdominal movement are simulated in cases with HR 60. This is helpful to study Rivelo-Carvallo phenomenon, respiratory splits and murmurs.
Please note : Turn on the valves switches for respiration to replay the abdominal movement.
(3) Palpation: Artery pulsesPulses can be felt at 8 sites: the bilateral carotid, brachial, radial and femoral arteries.Pulse waves are monitored on the screen simultaneously.The pulses at the radial and femoral artery are designed to delay.
(4) Observation : Jugular vein wave The movement of the jugular vein wave can be inspected on both sides.
(5) Palpation: Cardiac impulses By turning on the valve switches on the model unit base in accordance with the indication on the case window, cardiac impulses accompanying each case can be replayed. These impulses allow palpation and inspection at the right ventricle(RV), the left ventricle (LV) and the dilated left ventricle(DLV).
(6) Electrocardiograph (ECG) Grid can be displayed like a real electrocardiograph when the simulation is paused.
C5. Run the simulation: Advanced arrhythmias auscultation training
In "K2" mode, various arrhythmias can be learned by observing electrocardiographs and auscultating heart sounds.(1) Heart Sounds: The same as in Simulator “K.” However, carotid artery areas are not available for auscultation.(2) Electrocardiograph：The same as in simulator “K.”
Indication Valve switches for cardiac impulses
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Operation: Simulator LSAT: D1-D3D1. Open the LSAT system
Going through procedures B1-B5, Microsoft Windows 2000Pro is started up.Open theLSAT system by double-clicking at the icon.
D2. Chosing a case
Choose a group of cases by clicking one of the category buttons.Then select a case by clicking a name listed in the box on the right side. Please note: <H> indicates that the case is replayed with normal heart sounds. Most cases are provided with 2 options, with and without heart sounds.By clicking OK button on the top, or double clicking at the case name, the selected case is opened up.
Opening window
Category buttonsCase list
OK: open a case
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D3. Running the simulation
Click button on the toolbar to start running the simulation.
Default duration of the simulation is 30 min.Changes and differences in lung sounds on each area can be distinguished using an actual stethoscope.The numbers at the left side of the sound chart indicates the number of speakers embedded in the torso model.Both posterior and anterior lung sounds are programmed for training.
The posterior/anterior sounds can be switched over by rotating the torso model.Please note: The sound sets are played on only one side at a time. It is not possible to play both posterior andanterior sound simultaneously.
Operation window
Sound chart:Anterior Sound chart: PosteriorSpeaker numbers Speaker numbers
Anterior Posterior ClockwiseCounter clockwise
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To open another set of cases, click button.
To quit the LSAT system, click .
When you finish the session completely, follow the shut-down procedure.
Explanation button opens useful explanation window for each case.
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System configuration E1-E4E1 :Display preferences
By clicking monitor button, display configuration window is opened up.
When the 'Free' setting is marked each element can be selected separately to create user's own display.
The prepared display settings can also be swiched over by using function keys during the simulation.
Simulator K LSATF1: Standard
F2: ECG and PCG
F3: PCG
F4: ECG
F5:Free
F1: All area
F2: Right area
F3: Left area
F4: None
F5:Free
E2 :Sound Volume
By clicking the volume button, volume adjustment window opens to adjust the sound volume of
each embedded speaker.
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E2 :Air pressure, simulation speed and time of duration.
By clicking the volume button, the speed/time control window opens to adjust air pressure for
cardiac impulses (Simulator K only), speed of simulation and duration of the running time.
Please note: The running speed affects the sound frequency. When the simulation runs rapidly, the
pitch of the sounds becomes higher and makes a higher tone accordingly.
Air pressure control works
for Simulator K only
E3 : Display color preference
By the control button, color control window is opened.
E4 : Toolbar
From the toolbar button, elements of toolbar can be selected
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System Closing-Down :F1-F12After the session, please close the system safely following the procedure below.
1)Click the "X" mark and quit the simulation system.
2)Quit the windows.
3)Turn off the monitor.
4) Turn off the power switch on the base of model unit(s).
5)Turn off the amplifier.
6) Turn off the power switch on the side of control box.
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Please note: After a long session or use for a certain period,
please drain the water from the compressor by pushing the
drainage button at the bottom of the control box.
Simulator "K" Total Synchronicity of 88 Real Case Physical Findings
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Simulator "K2" ECG: Arrhythmia simulation
12 Normal casesS2 split(-) HR:60-
S1 split(+)
S2 split(+)
S3 wide split
S3 gallop
S4 gallop
Plumonic ejection sound
S3 and S4 gallop
Innocent murmur
Midsystolic click sound
S2 split(-) HR:72
S2 split(-) HR:84
14 Heart diseasesAortic stenosis
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Hypertropic cardiomyopathy
Mitral steno-regurgitation
Pulmonic valnular stenosis
Atrisl septal defec
Ventricular septal defect
Tricuspid regurgitation
Acute mitral regurgitation
Patent ductus arteriosus
Mitral valvular prolapse
Dilated cardiomyopathy
10 ArrhythmiasSinus arrthythmia
Sinus tachycardia
Sinus bradycardia
Ventricular premature contraction (1)
Ventricular premature contraction (2)
Ventricular premature contraction (3)
Sino atrial block
Atrio-ventricular block
Atrial fibrillation
Atrial flutter
D-1 VPC (quadrigeminy)
D-2 VPC (trigeminy)
D-3 VPC (bigeminy)
D-4 VPC (couplet)
D-5 PVC (repetitive)
D-6 PVC (R-on-T type)
D-7 Non-sustained VT
D-8 Vent tachycardia
D-9 Vent Flutter
D-10 Vent Flutter
D-11 Vent R (Sinus Cond)
D-12 Accel Vent Rhythm
D-13 Agonal Rhythm
C-1 VVI pacemaker
C-2 Atrial Pacemaker
C-3 Vent Pacemaker
C-4 AV Seq Pacemaker
C-5 ICRBBB
C-6 CRBBB
C-7 CLBBB
C-8 CLBBB
C-9 CLBBB (by AMI)
C-10 WPW syndrome
C-11 WPW syndrome
C-12 WPW syndrome
C-13 VPC (solitary)
B-1 Atrial Flutter
B-2Ⅰ AV block
B-3Ⅰ AV block & CRBBB
B-4Ⅰ AV block (digital)
B-5Ⅰ AV block (mobitzⅠ)
B-6Ⅰ AV block (mobitzⅠ)
B-7Ⅰ AV block (3:1&4:1)
B-8Ⅰ AV & CRBBB
B-9 Paroxy atr tachy
B-10 AV Junc R (SVST)
B-11 AV Junc R (PAT)
B-12 AV Junc R
B-13 AV Junc Contraction
A-1 Normal sinus R
A-2 Sinus tachycardia
A-3 Sinus arrhythmia
A-4 APC solitary
A-5 APC bigeminy
A-6 Ectopic pacemaker
A-7 Wondering pacemaker
A-8 Coronary sinus R
A-9 Sinus bradycardia
A-10 S S Syndrome
A-11 Atrial Fibrillation
A-12 Atrial Flutter
A-13 Atrial Flutter Fib
LSAT 35 Cases are available for training.
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Breath soundsNormal Standard
mildly weak
mildly strong
mildly rapid
loud heart sound
Abnormal Weak: left lower area
Weak: left upper area
Weak: whole left through
Absent: whole left through
Weak: right lower area
Weak: right upper area
Weak: right left through
Absent: whole right through
Consolidation
Adventitious soundsCoarse crackles Right lower area
Both lower areas
Right middle area
Left lower area
Both upper areas
Whole thorax
Fine crackles Both lower areas
Both lower and middle area
Whole thorax 1
Whole thorax 2
Wheezes Upper and middle area
Around trachea and upper area 1
Around trachea and upper area 2(polyphonic)
Rhonchi Whole thorax
Around trachea and upper area
Around trachea and upper area (polyphonic)
With an inspiratory wheeze
Miscellaneous continuous sounds Stridor
Squawk
Miscellaneous Pleural friction rub: left lower area
Pleural friction rub: left lower and middle area
Hamman’s sign
Vocal fremitus (palpable at both side of the chest)
M8481 Simulator “K Plus” M84 Cardiology Simulator K
M81 Lung Sound Auscultation System
External Speaker System
Instruction Manual
KYOTO KAGAKU CO.,LTD
External Speaker System for M81, M84, M8481 This system facilitates for the auscultation training by amplifying the sound of both the Cardiology Patient Simulator “K” and the Lung Sound Auscultation “LSAT”.
1. Component of systems ① Amplifier HST-2S 1 set <Front view> a b c d e
Left speaker Right speaker
a. Individual On/Off Switch: To switch on/off in left/right speaker b. Channel Selection Dial: To select the particular audio channel corresponding to
each auscultation site (built in speakers) on the manikins. (See page 9 and 12 of the M8481 instruction manual for the correspondence relationship.)
c. Volume Control Dial: To adjust the sound volume of each speaker. d. Tone Control Dial: To adjust the tone quality of each speaker. e. Main Power: To turn on/ off the power supply.
<Rear view> f g h i
Power cable
f. Audg. Audh. Rig
Audio cable
io output connector 1: Connector for a manikin. io output connector 2: Connector for a manikin. ht terminal: Audio output terminal for the right speaker.
i. Left terminal: Audio output terminal for the left speaker.
② External speaker 2 sets ③ Speaker cable 2 sets
2. Set-Up ① Connect the audio cable from the amplifier to the audio output connector on the back of
the PC.
② Connect the manikins to the amplifier at the audio output connector 1 (f) and/or output connector 2(g). Connector 1 and 2 have the same function and the manikin can be connected to whichever is convenient.
③ Connect the external speakers to R/L terminals of the amplifier by speaker cables. The terminals marked by the same color (red-red/ black-black) on the amplifier and the speaker are to be connected.
④ Plug the power cable from the amplifier into the power supply. r
Rear wall of the PC
I/O output Audio output
Audio cable
Audio cable
3. Operation ① Turn off both individual On/Off switches (a) and turn the both volume control doals (c) to
MIN before turning on the power. Then switch on the main power (e).
② Run Simulator “K” or “LSAT” system according to the instruction manual. ③ Turn on one of the individual On/Off switch (a). ④ Select an audio channel by the channel selection dial (b). ⑤ Adjust the volume with the volume control dial (c) to the audience size and environment.
Please note: In some cases, sound quality might be impaired when the sound volume is too high.
⑥ Turn off the individual On/Off switches while auscultation on the manikin is being performed.
⑦ Left and Right speakers can be run at a same time. By setting the channel selection at different position, comparison of auscultation areas can be smoothly demonstrated.
⑧ After the training sessions, turn off both the individual On/Off switches, turn the volume control dial to MIN and turn off the Main Power.
4. DOs and DON’Ts Ａ）Keep this device from the high temperature, high humidity and direct sunlight. Ｂ）Keep this device from shock or other physical impact. Ｃ）Do not disassemble the amplifier or speakers. Ｄ）Disconnect the power supply out while the system is not used. Ｅ）Do not mix up the connection of audio terminals. The same color terminals are to be connected (red/red, black/black)
Incorrect connection may cause breakage in the amplifier.
Ｆ）Do not make the volume too high. Sound quality may be impaired by high volume. It may also cause breakage in the speakers. Adjust the volume carefully from lower
volume, especially for cases of loud sound like stridor.
Ｇ）Turn off the both individual On/Off switches or to turn volume control dial to MIN during auscultation.
H）Do not use this speaker system without connecting the simulator manikin. Otherwise it may cause deterioration in the quality of the sounds..
USA & North America: Kyoto Kagaku Co., Ltd. US Office
3109 Lomita Boulvard, Torrance, CA 90505 Telephone +1-310-325-8860 Facsimile +1-310-325-8867
Email:[email protected] MEM Training Centre:
Kyoto Kagaku Co., Ltd. Tokyo Branch 5-20-4 Koishikawa Bunkyo-ku Tokyo, Japan 112-0002
Inquiries & Ordering:Telephone +81-75-605-2510Facsimile: +81-75-605-2519
URL: http://www.kyotokagaku.com/Email: [email protected]
Head Office: Kyoto Kagaku Co. Ltd.
15 Kitanekoya-cho, Fushimi-ku Kyoto, Japan 612-8388
KYOTO KAGAKU CONTACT & ORDERING INFORMATION
