Laerdal Infant Virtual I.V. User Manual
Infant Virtual I.V.
Directions for Use
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Self-directed I.V. learning in Infants
SIM-002-W00 rev D
Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
Tabl e of Cont e nts
CONTENTS
Introduction 5
Benefi ts, Learning Objectives and Features 9
Learning Objectives 11
Instructor Benefi ts 12
Student Benefi ts 12
Feature List 13
Setting Up the System 17
Quick Start Guide 27
Logging In 29
Help 29
Navigation 31
Career Selection 32
Main Menu 33
Training Types 34
Anatomical Viewer 35
Procedure Video 36
System Tutorial 37
Competency Review 38
Performing the Procedure 39
Case Scenario 41
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Infant Virtual I.V.
Directions for Use
Tabl e of Cont e nts
Site Selection 41
Equipment Selection 42
Simulation (Procedure) 43
Debriefi ng 48
Administration and Account Creation 49
Instructor Main Menu 52
Learner Competency Review 53
Account Management 56
Confi guration 59
Calibration of the Haptic Device 60
Network Confi guration 69
Change Instructor Password 69
System Overview 71
System Icons 73
Basic Menu Screens 76
Procedure Simulation and Debriefi ng Screens 88
Packing up the System 103
Frequently Asked Questions (FAQ) 109
Support 115
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Infant Virtual I.V.
Directions for Use
Introduction
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Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
Introduction
INTRODUCTION
The Infant Virtual I.V.™ Self-Directed Learning System is designed to provide both the novice student
and advanced practitioner the opportunity to learn and practice the psychomotor skills of intravenous
catheterization on a range of pediatric cases, ranging from premature infants to infants 15 months of
age.
The simulator offers both an introduction to I.V. insertion, serving as a part-task trainer, and as a
tiered, progressive path to build the competence required for advanced practice.
The Infant Virtual I.V.™ Self Directed Learning System is designed to meet the training needs of those
responsible for placing peripheral intravenous catheters in the infant population. The simulator encompasses an extensive spectrum of infant patient models, case scenarios tailored to specific learning
objectives, pathophysiologic reactions, and complications. By combining realistic 3D visual effects and
haptic effects that allow you to feel the patient with whom you are working, a completely immersive
and authentic environment is created to optimize the learning process.
At the heart of the learning process is the comprehensive assessment of performance, competency
review mechanisms, and a complete competency training curriculum.
Novices will find that with every simulation, they will learn from their mistakes and complications,
learn from the automated assessment, remember critical steps and be able to improve their performance; while more expert practitioners will be surprised by the scope and realism of the simulation,
and its ability to accurately reproduce important training elements of the procedure.
This Learner Manual is to be used only as a reference for using the system, as the simulator provides a
‘System Tutorial’ video, a ‘Procedure’ video and ‘Help’ screens that can stand on their own for tutoring the student in how best to use the simulator.
This Manual includes:
• The Learning Objectives for this product, to serve as a guide for instructors and students to
make the best use of the training benefits offered by the Infant Virtual I.V.™ Self-Directed
Learning System.
• A feature list that summarizes the extensive list of product attributes that comprise the most
detailed learning system ever developed for training the skills required for effective intravenous
needle insertion in difficult pediatric cases.
• Directions for setting up the system, including the equipment that comes with the product, and
the maintenance of the haptic device. This section includes the Quick Start Set-Up guide, which
is also incorporated as a fold-out with the product packaging.
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Infant Virtual I.V.
Directions for Use
Introduction
• The Quick Star t Reference guide, which provides the learner with rapid directions for use of
the Infant Vir tual I.V.™ simulator.
• An instructional manual for using the Infant Virtual I.V. ™ simulator, providing the various
options for the instructor and learner of the learning system.
• Simple overview of the debriefing and testing functions of the Infant Virtual I.V. ™ product.
• A Frequently Asked Questions (FAQ) help guide for answering some of the commonly asked
questions regarding the system.
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Infant Virtual I.V.
Directions for Use
Benefits, learning objectives and features
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Benefits, learning objectives
and features
Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
BENEFITS, LEARNING OBJECTIVES AND FEATURES
The Infant Virtual I.V.™ Self-Directed Learning System provides a comprehensive training environment
for the placement of intravenous catheters in infants. Infants can be difficult to catheterize, because of
their small size and fragile veins. This simulator trains a broad range of cognitive and psychomotor skills
in I.V. insertion, based on a wide range of pediatric patient case scenarios.
The Infant Virtual I.V.™ Self-Directed Learning System provides an educational tool to customers that
will take learners through the complexity of the pediatric needle insertion ‘skill space’. By providing
intermediate and advanced skill level learners with the opportunity to practice procedures in the presence of realistic complications, the product provides the opportunity to practice techniques and refine
the necessary decision-making skills needed to successfully complete complex venous access tasks in
the infant population.
Learning Objectives
The Infant Virtual I.V.™ Self-Directed Learning System provides the learner with the ability to:
• Overcome initial discomfort and fear associated with performing the I.V. procedure on actual
infants.
• Perform differential diagnosis of patient cases, related to placement of a peripheral I.V. in different regions of the arm, hand, foot and scalp of a variety of pediatric cases.
• Select proper equipment, including needle gauge, from an inventory.
• Perform appropriate cleansing and site preparation.
• Learn the proper ‘feel’ of the procedure; from palpation, to needle insertion and feeling the
‘pop’, to threading the catheter, to skin stretch.
• Train the hand position for performing the procedure on a variety of relevant body parts specific to the pediatric case being presented.
• Perform appropriate orientation and angle of I.V. needle insertion.
• Secure and finish the procedure of I.V. catheterization, including site dressing and fluid administration as appropriate to the patient case scenario.
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Infant Virtual I.V.
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Benefits, learning objectives
and features
• Be presented with automated debriefing, including identification of critical and non-critical
errors, and video and animation depicting ideal performance.
• Progress through a tiered hierarchy of ever more difficult patient cases, ranging from beginning
student through advanced practitioner.
Benefi ts for the Instructor
• Track learner history, including test results. Record student performance and compare results
using easy-to-understand ratings and recognized standards.
• Metrics-based debriefing of student performance to facilitate effective feedback and guidance to
students.
• Instructor mode, for configuration of the simulator options and tracking the performance of
students.
• Improved Instructor control, to configure many items that tailor the product to either the PreHospital or In-Hospital environment as well as allowing the instructor to configure the product
to their local requirements.
• Simplify training and skills sustainment in an engaging training environment.
• Present the student with a customized training experience adjusted to their needs and performance level.
• Identify student deficiencies and remediate using a range of case scenarios and basic science
tutorials.
Student Benefi ts
• Learn and practice needle procedures through interaction with life-like patient anatomy in
real-world scenarios.
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• Test your skill against other learners and experts in the context of ever-increasing challenges. Track
your progress as you progress through the levels. Compare performance with national rankings.
• Select “Practice Cases” mode for quick play or “Competency Training” for more structured procedural
simulations and performance tracking.
• Learn and review proper I.V. insertion procedures, anatomy and physiology with dynamic simulations
and tutorials.
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Infant Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
• Full integration with the Laerdal Competence Management System Version 1.7.1 or above allows
students to remotely review progress and understand problem areas.
Feature List
1. The Infant Virtual I.V.™ incorporates the use of developmentally appropriate skills and considers
the specific needs of infants to promote a complete understanding of IV catheterization in the
infant.
2. Over 170 unique case scenarios (85 in each career):
a. There are over 20 case scenario specific and site specific simulation variables that add
huge depth and variability to the product, spanning the range of infant physiology and
pathophysiology.
b. Each case scenario debriefing is driven by the corresponding procedure, providing a very
accurate instructional environment for each case.
c. Each case scenario focuses on specific learning objectives defined in the curriculum pro-
vided with the application.
3. There are 19 different infant models, ranging in skin color, weight, and age (from preterm to 15
months). Each model presents different challenges and characteristics in the context of IV catheterization.
4. There are 15 possible cannulation sites for each model, each with individualized debriefing criteria. Site availability and assessment is driven by the particular details of each case scenario.
That is over 19 times 15 (285) different insertion site models, not to mention the variability that
comes from the different case scenarios.
5. The Competency Review allows you to:
a. View individual case scenarios and cognitive test assessments.
b. View a learning curve for your entire competency training.
c. Focus in on the last 10, 25, or 50 cases to understand your current problems and overall
progress.
d. Identify specific skill weaknesses.
6. Pre-existing conditions including in-place equipment; finding alternatives to the desirable insertion sites; IV infiltrates; and other complications add a sense of urgency to the procedure and
provide the user with an accurate portrayal of real life situations.
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Infant Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
7. The Infant Virtual I.V.™ Haptic Device provides realistic feel in terms of skin stretch, palpation,
size, and insertion forces that are specific to the child. It also allows the user to perform a twofinger skin stretch technique that is appropriate to the procedure.
8. The system supports ar terial palpation at both temporal scalp sites and the arm, allowing the
pulse to be felt by the user, defining ar tery location. The pulse depends on the heart rate of
the patient.
9. Practice Mode Patient Selector: This feature allows the learner to define which patient and
medical condition they want for the practice case scenario by choosing the age, weight, skin
tone, and case type.
10. Many patient complications based specifically on infant physiology and issues that arise during
infant IV catheterization:
a. Accidental arterial punctures and how to deal with this error. Punctured arteries will
bleed from the site until pressure is applied. Correct recovery from accidental arterial
puncture is assessed in the debriefing module.
b. If the needle is larger than the vein, the vein will blow. This adds significant realism to the
simulation since the size of the vein becomes critical to correctly performing the procedure. Also, many veins that are visible are not sufficiently large enough to be cannulated.
c. If the C-band or occluding finger is left on the site while flushing, the vein will blow.
11. Equipment items and procedure steps add depth, understanding, and a sense of immersion to
the simulation experience:
a. Trans-illuminator; a concentrated light source for improved vein visualization.
b. Hand washing is included for proper training.
c. Syringe flushes that behave differently depending on whether you are inside or outside a
vein.
d. Holder hands to help stabilize the patient.
e. Availability of arm boards for joint/site stabilization.
f. Different 3D sized needles
i. 2 different lengths (one inch and one half and inch)
ii. Different gauges (26 GA needles appear very small on the screen, while 20 GA
needles appear much larger)
g. Bio-Hazard Container
h. T-connector (Lock w/extension tubing)
i. Rubber Band, to substitute for a C-band as used for premature and newborn infants.
j. Different pumps for Pre-Hospital and In-Hospital careers.
k. Manual fluid delivery of a bolus is available for Pre-Hospital cases.
l. Saline Wipe for removing cleansing agents after disinfection.
m. Different equipment availability for the Pre-Hospital and In-Hospital careers.
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Infant Virtual I.V.
Directions for Use
12. Usability
a. Navigation. The user can easily go to different sites, gather equipment, and even view
the case scenario, all while performing the procedure.
b. Procedure Screen Improvements
i. Easily understood and labeled icons.
ii. Haptic Device Interact icon that tells you when to interact with the haptic device
during the procedure.
iii. Sound when the needle is successfully engaged in the haptic device.
iv. Easy model orientation.
v. Precise targeting for optimal needle positioning.
Benefits, learning objectives
and features
13. Procedure Simulation
a. Medically correct flushing and extension tubing application.
b. Extension tubing and locks are automatically flushed prior to application and come with
the flush attached. This allows for proper line setup and fluid administration.
c. C-band can be removed while the needle is inserted in the site, as may be the standard
for some practitioners.
14. A na t o mical Viewe r
a. Complete body anatomical viewer of relevant structures with stage loading to reduce
wait times.
15. D e b r ief ing
a. Debriefing ensures the learner performs the procedure correctly, or is negatively
assessed.
b. Assessment of equipment usage, complications and procedure tasks.
16. Instructor Configurability; many configurable items tailor the product to either the Pre-Hospital
or In-Hospital environment as well as allowing the instructor to configure the product to meet
their local requirements.
17. Improved Case Scenario presentation with patient image and vital signs.
18. Cognitive questions that follow training guidelines for novice to expert users.
19. Fully integrated with the Laerdal Competence Management System.
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Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
Setting up the system
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Directions for Use
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Infant Virtual I.V.
Directions for Use
Setting up the System
SETTING UP THE SYSTEM
WARNING
Precautions when using the haptic device
• The haptic device is a precise and sensitive instrument. To ensure proper working order,
please handle with care.
• Dropping the haptic device, bending the needle or catheter, or other abuse may render the
device inoperable.
• To ensure proper functionality, calibrate the haptic device as required.
• Although the needle and catheter are blunt, they can still cause injury if used in an improper
manner. Be careful and always replace them in the needle holder after use.
• The catheter is tethered to protect against catheter misplacement. The tether can be removed
to optimize use of the device.
• Before starting the procedure, make sure that the needle is completely removed from the device
and that the catheter is completely attached to the needle. Here is a schematic of the
needle / catheter confi guration:
• After completing procedure, remove the catheter from the device CAREFULLY and SLOWLY
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Infant Virtual I.V.
Directions for Use
Setting up the System
WARNING
Precautions when using the haptic device
• The Infant Virtual I.V.™ Self-Directed Learning System has been designed to work on the computer
supplied with the product. The computer is an integral part of the system. It will not work on other
computer platforms, because of its requirements for very specifi c, high speed graphics capabilities.
Do not attempt to install and run this software on any other computer other than that which has
been provided by the manufacturer.
• No software should be installed on the computer supplied with the Infant Virtual I.V.™ Self-Directed
Learning System, except for those products supplied by the manufacturer of the software.
• Running any program, such as anti-virus software, on the computer supplied with the simulator, may
cause the Infant Virtual I.V.™ Self-Directed Learning System to crash or slow the simulation to an
unstable condition. This is a dedicated computer and should not be used for other purposes, except
those explicitly stated by the software manufacturer.
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Infant Virtual I.V.
Directions for Use
Setting up the System
This diagram, also available as a fold-out set of instructions that is included in the Infant Virtual I.V.™
packaging, explains the order of unpacking and installation of the simulator. Special attention should be
paid to unpacking the haptic device and plugging in the cables in the correct order and placement.
(1) Set-up and turn on the computer as indicated by the manufacturer:
(2) Plug in the power cord of the haptic device into the wall socket, but do not connect to haptic device:
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Infant Virtual I.V.
Directions for Use
Setting up the System
(3) Plug in the USB cord of the haptic device into the computer, but do not connect to haptic device:
WARNING
Do not discard your packing materials or shipping restraint.
You will need these to move/transport your device.
(4) Remove the haptic device and needle holder from the packaging:
(5) Completely remove the restraining strap carefully from the haptic device:
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Infant Virtual I.V.
(6) R
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Directions for Use
Setting up the System
(3) Plug in the USB cord of the haptic device into the computer, but do not connect to haptic device:
(4) Remove the haptic device and needle holder from the packaging:
(5) Completely remove the restraining strap carefully from the haptic device:
(6) Remove the haptic device needle from the software packaging and plug it into the connector at
emove the haptic device needle from the software packaging and plug it into the connec
the back of the haptic device.
he back of the haptic devic
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Infant Virtual I.V.
Directions for Use
Setting up the System
Plug the (7) USB cord and (8) Power Cord into the back of the haptic device. (9) Plug the power
cord from the wall socket into the power brick. The haptic device, which has been pre-calibrated by
the manufacturer, is now ready to use with the simulator:
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(10) The completed, set-up Infant Virtual I.V.™ Self-Directed Learning System. Note the location of
the haptic device directly in front of the monitor.
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Infant Virtual I.V.
Directions for Use
Setting up the System
(11) Before using the software, you will first need to obtain license keys for the modules you have
purchased.
(11.1) Exit the Boot Screen
(11.2) Contact your Laerdal representative for customer service agent to obtain the license module
key.
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Setting up the System
Infant Virtual I.V.
Directions for Use
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Infant Virtual I.V.
Directions for Use
Quick start user guide
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Directions for Use
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Infant Virtual I.V.
Directions for Use
Quick Start User Guide
QUICK START GUIDE
Turn on the computer. To start the application, click on the Infant Virtual I.V. section of the boot
screen.:
Logging In
Once started, log onto the application with one of two default users:
Username: demouser1
Password: password
Username: demouser2
Password: password
Login as Administrator to access Instructor features and create accounts:
Username: Administrator
Password: <Provided on the information sheet inside your desktop computer, or by Laerdal
Technical Service at 1 (800) 431-1055 EXT. 5596. This password will always work, even if you change
the Administrator password.>
Read further instructions to learn how to create new user accounts.
Help
Three types of help are provided throughout the product to familiarize you with the system and assist
you in the learning process. These include:
Tool-Tips or Hold-Over text
Tool-tips or Hold-Over text are provided on almost all of the interactive (and even some of the noninteractive) items on the screens. Hold the mouse cursor still on a particular button or icon on the
screen and you will see a brief pop-up description or explanation.
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Infant Virtual I.V.
Directions for Use
Quick Start User Guide
Context-Specific Help
In the navigation icon at the bottom right of every screen is a question mark. Click the question mark
to view help for that particular screen.
Guiding Messages
There are guiding messages at the bottom left of many screens that describe the required action.
Guiding messages are provided on the Case Scenario, Site Selection, Equipment Selection and
Simulation Screens.
The guiding messages at the bottom of the simulation screen change depending on your actions and
what task you are trying to perform. If you are stuck or do not know how to proceed, these messages should guide you through using the system.
Note: The guiding messages are not designed to help you successfully complete the
procedure; they are only designed to explain how to use the system.
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