Laerdal Virtual IV User Manual
Virtual I.V.
Directions for Use
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Self-directed I.V. learning
SIM-001-W00 rev E
Virtual I.V.
Directions for Use
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Virtual I.V.
Directions for Use
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Virtual I.V.
Directions for Use
Tabl e of Cont ents
CONTENTS
1 Introduction 5
2 Benefi ts, learning objectives and features 7
3 Setting up the system 15
4 Quick start user guide 23
5 Using the haptic device 31
6 System overview 37
7 Training Sequence 53
8 Administration 65
9 Packing up the system 83
10 Frequently asked questions (FAQ) 89
11 Single case model list 95
12 Support 101
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Tabl e of Cont ents
Virtual I.V.
Directions for Use
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Virtual I.V.
Directions for Use
Introduction
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Virtual I.V.
Directions for Use
Introduction
1 INTRODUCTION
The Virtual I.V. Self-Directed Learning System is designed to provide both the novice student and
advanced practitioner with the opportunity to learn and practice the psychomotor skills of performing
intravenous catheterization in the context of patient case scenarios.
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.
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 Training’ video, ‘Help’ screens, and hints 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 both for instructors and students to make
best use of the training benefi ts offered by the Virtual I.V. Self-Directed Learning System.
• Directions for setting up the system, including the equipment included with product and the ‘care’ of
the haptic device. This section includes the Quick Start Set-Up guide, also included as a fold-out with the
product packaging.
• The Quick Start Reference guide, which provides the learner with rapid directions for use of the Virtual
I.V. simulator.
• An instructional manual for using the Virtual I.V. simulator, providing the various options for the administrator and learner of the training system.
• Simple overview of the debriefi ng and testing functions of the Virtual I.V. product.
• A frequently asked questions help guide for addressing any problems encountered with the
product, and resources for customer support.
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Virtual I.V.
Directions for Use
Benefits, learning objectives and features
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Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
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BENEFITS, LEARNING OBJECTIVES AND FEATURES
The Virtual I.V. Self-Directed Learning System provides a comprehensive environment for training in
the placement of peripheral intravenous catheters. It trains a broad range of cognitive and psychomotor skills in I.V. insertion, based both on practice patient case scenarios, and a competency training
mode where the student can climb the ladder of I.V. exper tise.
The general training objectives are conceptually illustrated in the Figure below. As part of our task
analysis of needle inser tion tasks and related critique of existing training technologies, we noted that
existing technologies are severely limited in terms of their training potential. Thus, other I.V. training
simulators are only capable of providing trainees with the most basic of needle insertion skills. This is
illustrated by the lower of the two learning curves presented in the Figure below, which achieves a relatively low level of skill. As a result, the value of this system to customers would seem to be severely
limited, as experienced and advanced medical personnel have nothing to gain by using it.
In contrast, the Virtual I.V. Self-Directed Learning System provides a system to customers that will
take learners much further through the needle inser tion “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 them the opportunity to practice techniques and, more importantly, refine the necessary decision-making skills needed to successfully complete more complex
venous access tasks.
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Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
2.1 Learning Objectives
The Virtual I.V. Self-Directed Learning System provides the learner with the ability to:
Overcome initial discomfort and fear associated with performing the procedure.
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• Perform Differential diagnosis of patient cases, related to placement of a peripheral I.V. in different
regions of the arm and hand.
• Select proper equipment, including needle gauge, from an inventory.
• Perform Standard Precautions and site preparation prior to I.V. needle insertion.
• 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 ‘proper’ hand position for performing the procedure - this is critical to a successful and skillful
completion.
• Palpate for vein location.
• Perform appropriate orientation and angle of I.V. needle insertion.
• Detect I.V. insertion into a peripheral vein.
• Secure the catheter and fi nish the procedure of I.V. cannulation, including wound dressing and fl uid
administration as appropriate to the patient case scenario.
• Be presented with automated debriefi ng, including identifi cation of critical and non-critical errors, and
video and animation depicting ideal performance.
• Progress through a tiered hierarchy of ever more diffi cult patient cases, ranging from beginning student
through advanced practitioner.
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Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
2.2 Benefi ts for the Instructor
• Track learner competency history, including test results. Record student performance and compare
results using easy-to-understand ratings and recognized standards.
• Metrics-based assessment of student performance to facilitate effective feedback and guidance to
students.
• Administration mode, for confi guration of the simulator options and tracking the performance of stu-
dents.
• 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 defi ciencies and remediate using a range of case scenarios and basic science
tutorials.
• Full integration with the Laerdal Competence Management System Version 1.8 allows remote instructor
oversight and education management.
2.3 Benefi ts for the Student
• Learn and practice needle procedures through interaction with life-like patient anatomy in real-world
scenarios.
• 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.
• Full integration with the Laerdal Competence Management System Version 1.8 allows
students to remotely review progress and understand problem areas.
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Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
2.4 Overall Features
1. Integrated with the Laerdal Competence Management Version 1.8 system
a. Allows remote (internet based) access to user progress and account management for both
the instructor and learner.
2. There are over 20 case scenario specifi c and site specifi c simulation variables that add huge depth
and variability to the product, encompassing the variability of human anatomy and physiology.
3. Each case scenario debriefi ng is driven by the corresponding procedure, providing a very
accurate instructional environment for each case.
4. There are 8 possible cannulation sites for each model, each with individualized debriefi ng criteria.
Site availability and assessment is driven by the particular details of each case scenario. That is over
29 different models times 8 sites for a total of 232 different insertion sites, not to mention the variability that comes from the different case scenarios.
5. Updated 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 specifi c skill weaknesses in an intuitive format.
6. Pre-existing conditions including in-place equipment for users to fi nd alternatives to the most desir-
able insertion sites; IV infi ltrates; and other complications add a sense of urgency to the procedure
and provide the user with an accurate portrayal of real life situations.
7. The system supports arterial palpation at the wrist, allowing the pulse to be felt by the user, defi ning
artery location.
8. Practice Mode Patient Selector: This feature allows the learner to defi ne which level, medical condi-
tion and particular case they want to practice and presents a preview of the patient arm.
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Virtual I.V.
Directions for Use
Benefits, learning objectives
and features
9. Many patient complications that arise during 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 debriefi ng module.
b. If the needle is larger than the vein, the vein will blow. This adds signifi cant 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 suffi ciently large enough to be cannulated.
10. Expanded Equipment items and procedure steps add depth, understanding, and a sense
of immersion to the simulation experience:
a. Hand washing is included for proper training.
b. Different 3D sized needles
i. 2 different lengths (one inch and one half and inch)
ii. Different gauges from 14 to 24 are different sizes in the simulation.
c. Bio-Hazard Container
d. T-connector (Lock w/extension tubing)
e. Different pumps for Pre-Hospital and In-Hospital careers.
f. Manual fl uid delivery of a bolus is available for Pre-Hospital cases.
g. Different equipment availability for the Pre-Hospital and In-Hospital careers.
11. 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. Site selection prior to equipment selection.
c. Improved User Interface with more intuitive and consistent behavior.
d. 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. Improved model orientation.
v. Precise targeting for optimal needle positioning.
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Virtual I.V.
Directions for Use
Benefits, learning objectives
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12. Procedure Simulation
a. Medically correct fl ushing and extension tubing application.
b. Extension tubing and locks are automatically fl ushed prior to application and come with the fl ush
attached. This allows for proper line setup and fl uid administration.
c. C-band can be removed while the needle is inserted in the site, as may be the
standard for some practitioners.
d. Flash visible along catheter (confi gurable based on the type of catheter used).
13. Anatomical Viewer
a. Anatomical viewer with stage loading reduces wait times.
14. Debriefi ng
a. More comprehensive debriefi ng ensures the learner performs the procedure
correctly, or is negatively assessed.
b. More error animations and vignettes that are more directly tied to specifi c errors.
c. Assessment of equipment usage, complications and procedure tasks.
15. Increased Instructor Confi gurability
a. Many confi gurable items tailor the product to either the Pre-Hospital, In-Hospital or
Military environment and allow the instructor to confi gure the product to meet their local require-
ments.
16. Haptic Device Calibration by the user
a. If confi gured by the instructor, the user will be allowed to calibrate the haptic device.
17. Improved Case Scenario presentation with patient image and vital signs.
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Virtual I.V.
Directions for Use
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Virtual I.V.
Directions for Use
Setting up the system
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Virtual I.V.
Directions for Use
Setting up the system
3 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 inop-
erable.
• 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 opti-
mize 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:
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• After completing procedure, remove the catheter from the device CAREFULLY and SLOWLY
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Virtual I.V.
Directions for Use
Setting up the system
WARNING
Precautions when using the haptic device
• The 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 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 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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Virtual I.V.
Directions for Use
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
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:
Setting up the System
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(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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Virtual I.V.
Directions for Use
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.
Setting up the System
(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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Virtual I.V.
Directions for Use
Virtual I.V.
Directions for Use
Setting up the System
(6) Remove the haptic device needle from the software packaging and plug it into the connector at the back
of the haptic device.
Setting up the System
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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 Virtual I.V.™ Self-Directed Learning System. Note the location of the haptic
device directly in front of the monitor.
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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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Virtual I.V.
Directions for Use
Quick start user guide
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QuickStart User Guide
Virtual I.V.
Directions for Use
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Virtual I.V.
Directions for Use
QuickStart User Guide
QUICK START GUIDE
Turn on the computer. To start the application, click on the Virtual I.V. section of the
boot screen.
1. 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.
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Virtual I.V.
Directions for Use
QuickStart User Guide
2. Choose Career
You will be presented with a choice of Three different training careers: In-Hospital, Pre-hospital
and Military. Click on the profession that was selected by your instructor.
3. Main Menu
This screen presents a menu of options, including:
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Competency Training Mode: A progressive, tiered hierarchy of case studies and required skills that
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ranges from beginning student (S1) to advanced practitioner (P3).
• Practice Cases: Individual cases can be tried from all of the levels, for practicing skills without record-
ing assessment.
• Anatomical Viewer: This module presents a three-dimensional (3D) model of the arm that can be
used to identify structures and learn anatomy.
• Procedure Training: This video introduces the beginning student to the techniques and skills required
for intravenous catheterization.
• System Tutorial: This video shows the trainee how to use the Virtual I.V. simulator.
• Competency Review : This module shows the learner record in competency training.
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Virtual I.V.
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QuickStart User Guide
4. Select Practice Cases
Select the level of difficulty, medical specialty and the case you would like to practice. When you
select a particular case, a preview of the patient arm is displayed. Click the right arrow on the naviga-
tion toolbar to go to the selected case.
5. Read Case Scenario
The text presents an overview of the case, a preview of the patient arm and the patient vital signs. In the
Student levels, there are highlights presented as bullet points. Advance to the next screen by selecting
the right arrow at the bottom right of the screen.
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Virtual I.V.
Directions for Use
QuickStart User Guide
6. Site Selection
Choose from left or right arms and the most appropriate site for cannulation based on the case
scenario.
7. Equipment Selection
Click on the items that you want to collect to per form the procedure, based on the case scenario.
These items will appear in the equipment toolbar on the left hand side of the screen and will be available for use in the intravenous access procedure. Once all necessary equipment has been selected,
advance to the simulation screen by clicking the right arrow.
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Virtual I.V.
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QuickStart User Guide
8. Simulation Screen
This screen provides the basis for per forming the cannulation procedure. It shows an arm of the
patient described in the case. When you have completed the simulation, advance to the debriefing
screen by clicking the right arrow in the navigation bar. The arm can be rotated by clicking the middle
mouse wheel and moving the mouse, and zoomed by scrolling the middle mouse button.
Overview
The equipment you have selected appears in the equipment toolbar at the left of the screen. You can
use any of these pieces of equipment at any time by clicking on the corresponding icon.
At the top of the screen are 3 buttons that allow you to review the case scenario (Case Scenario),
select more equipment (Equipment), or select a different site for catheterization (Site Selection). You
can select these throughout the procedure.
Certain procedural steps can be performed by clicking on the corresponding icons. These icons are
located around the left periphery of the circular simulation window.
At the bottom of the simulation window are three disposal containers (trash can, sharps container
and bio-hazard bag). Dispose of equipment into the appropriate receptacle once it has been used.
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Virtual I.V.
Directions for Use
QuickStart User Guide
9. Debriefi ng
The top of the Debriefing screen shows your total score, the procedure and constricting band times,
whether you have successfully completed the procedure, the case level, and other information.
The rest of the Debrief ing screen displays the Cannulation Events, Critical Errors, and Non-Critical
Errors.
Cannulation events present general subcutaneous animations of what occurred during your cannulation attempts. Click on the movie icon next to the cannulation event to view the animations.
Positive and Negative critical and non-critical assessment headings and specific assessment errors are
displayed below the cannulation events.
Clicking on the movie icon next to a negative assessment heading will play a short vignette describing how to perform the relevant portion of the procedure correctly. Once you have reviewed your
debriefing advance to the next screen.
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