Designed and manufactured by Limbs & Things Limited,Sussex Street, St. Philips, Bristol, BS2 0RA, UK.Telephone: +44 (0)117 311 0500 Fax: +44 (0)117 311 0501sales@limbsandthings.com www.limbsandthings.com

Part No: 065-025

Issue 2, September 2008© 2008 Limbs & Things

Advanced Venepuncture Arm

User Guide

Advanced Venepuncture Arm - Light Part No: 00290Advanced Venepuncture Arm - Brown Part No: 00298Advanced Venepuncture Arm - Black Part No: 00296

Advanced Venepuncture Arm - LightPart No: 00290

This product provides the ideal platform for all healthcare trainees needing to practise theskills related to venepuncture and IV cannulation. Designed with durability, realism and ease ofuse in mind, this product addresses the fundamental needs of clinical skills tutors, trainees andtechnicians alike.

Skills• Venepuncture • IV Cannulation

Features• Veins are:

- leak resistant when used at the correct pressure- easy to replace

• Can be used with vacuum blood collection systems • Realistic blood flashback from pressurised fluid system• Realistic, soft, flexible skin and underlying palpable veins • Easy to clean, service and maintain• Accessible veins: dorsal metacarpal, cephalic, basilic, and median cubital are easy to replace• ‘Closed’ blood flow system with no messy bottles to change • Pressure of blood can be easily adjusted• Can be adapted for professional-to-patient communication (role play) using AV Arm

Harness Part No: 00300

Package supplied • 1 AV Arm Skin - Light Part No: 00291• 1 AV Arm Veins Part No: 00292• 1 AV Vein Module Part No: 00295• 1 AV Mock Blood (500ml) Part No: 00294• 1 Refill Bottle Part No: 00303• 1 AV Arm Rest Part No: 00302• 2 lubricant sachets• 1 arm

Contents

Product information 00

Components 00

READ THIS FIRST: Basic fluid unit operations 1

Getting the Arm ready to use

Filling the fluid unit 3

Priming the Veins 4

Using the Arm 5

Emptying the Arm

Emptying the veins prior to replacement 7

Emptying the fluid unit prior to storage/transport 8

Removing the Skin 9

Fitting the Skin 10

Changing the Veins 11

Using the AV Arm Harness 13

Storing the Arm 15

0

Advanced Venepuncture Arm - BrownPart No: 00298

As per the Advanced Venepuncture Arm - Light.

Package supplied • 1 AV Arm Skin - Brown Part No: 00299• 1 AV Arm Veins Part No: 00292• 1 AV Vein Module Part No: 00295• 1 AV Mock Blood (500ml) Part No: 00294• 1 Refill Bottle Part No: 00303• 1 AV Arm Rest Part No: 00302• 2 lubricant sachets• 1 arm

Advanced Venepuncture Arm - BlackPart No: 00296

As per the Advanced Venepuncture Arm - Light.

Package supplied • 1 AV Arm Skin - Black Part No: 00297• 1 AV Arm Veins Part No: 00292• 1 AV Vein Module Part No: 00295• 1 AV Mock Blood (500ml) Part No: 00294• 1 Refill Bottle Part No: 00303• 1 AV Arm Rest Part No: 00302• 2 lubricant sachets• 1 arm

Important: handling & hygiene• Venepuncture training is a potentially messy process so always set the product up on a wipe

clean surface. The instructions supplied in this User Guide are designed to minimise the riskof any spillage. Even so, it is a good idea to keep paper towelling close to hand just in case.

• Do not wear ‘good’ clothes when training with this product. If mock blood does get ontoclothing it will not permanently stain them and can be washed out using a biologicaldetergent.

• If mock blood gets into the eyes flush with plenty of cold water.

• Observe normal hygiene procedures after handling the product and mock blood.

AV Arm Skin - BlackPart No: 00297(Depending on version bought)

AV Mock Blood (500ml)Part No: 00294(Replacement part)

Refill BottlePart No: 00303

Components

AV Arm Skin - BrownPart No: 00299(Depending on version bought)

AV Arm VeinsPart No: 00292(With adhesive fastening strips)

Fluid Unit(Not user serviceable. Must bereturned to Limbs & Things forservice or repair)

AV Arm Skin - LightPart No: 00291(Depending on version bought)

AV Arm RestPart No: 00302 0295

Water-based LubricantPart No: 00293

0

2

Connecting

When connecting the refillbottle or the Arm to thefluid unit, ensure that thethe tube with the blacksleeve attaches to the lefthand connector with theblack ring on it.

READ THIS FIRST: Basic fluid unit operations

1

Depressurising

Turn the release valve anti-clockwise to open it whenyou need to depressurise thefluid unit.

Pressurising

Turn the release valveclockwise to close it beforeyou can pressurise the fluidunit by squeezing thepressure bulb.

NOTEThere is a pressurerelease valve inside thefluid unit. This preventsdamage caused byoverpressurisation. If the cutoff pressure is reached a hissingsound will be heard asthe air is vented andthe pressure is droppedto a safe level.

Selecting

The red reservoir selectorlever on the front of thefluid unit selects which ofthe reservoirs will bepressurised.

Slide it to the left if youintend to pressurise the leftreservoir.

Slide it to the right if youintend to pressurise theright reservoir.

2

Close the valve on thepressure bulb. Pressurise thefluid unit into the grey zone.

Air in the right reservoirflows into the bottle forcingthe blood out of it and intothe left hand reservoir.

Keep the pressure in thegrey zone to ensure that thereservoir fills quickly.

1

IMPORTANTWhen filling the fluidunit, blood must alwaysbe fed into the left handreservoir.

Slide the reservoir selector tothe right.

Connect the refill bottle.

3

Once the blood reaches themaximum level of 300mlopen the pressure valve todepressurise the fluid unitand to stop bloodtransferring.

Disconnect the bottle.

The fluid unit is full andready to be attached to theArm.

Filling the fluid unit

3

2

Ensure both of the whiteclips on the arm tubes areopen.

Close the valve on thepressure bulb. Pressurise thefluid unit into the greenzone.

IMPORTANTDo not overpressurise(into the grey zone) asthis will cause blood toleak from the puncturesites in previously usedveins creating a messunder the Skin.

1

Having carried out ‘Fillingthe fluid unit’ (page 3),slide the reservoir selector tothe left.

Connect the Arm.

3

Air pressure in the leftreservoir forces the bloodout through the Arm andinto the right reservoir.

When there are no more airbubbles coming out of theArm close the white clip onthe right hand tube. Thiswill maintain the correctpressure in the Arm duringtraining.

The Arm is ready to use.

Priming the Veins

4

Maintaining pressure

As the blood level decreasesin the left reservoir thepressure will drop.

Maintain the pressure in thegreen zone during training.

Taking blood

Blood can be taken from thearm by using vacuumcollection devices such asVacutainer, or the moretraditional needle andsyringe method.

Cannulation can also beperformed on the product.

Removing trapped air

Occasionally during trainingrelease the clip on the righthand tube and allow bloodto flow through the Arm toremove any air bubbles thatmight have beenintroduced.

Using the Arm

5

Refilling the bottle

Squirt the contents of thesyringe into a container sothat at the end of thetraining session the bloodcan be poured back into therefill bottle.

Follow ‘Filling the fluidunit’ (page 3) when theleft reservoir is empty.

Reversing flow

The Arm can also bepressurised from the rightreservoir when there is asufficient volume of blood init.

Slide the reservoir selector tothe right. Open the clip onthe right tube and close theclip on the left tube. Ensurethe pressure is in the greenzone.

6

2

Ensure both of the whiteclips on the arm tubes areopen.

Close the valve on thepressure bulb. Pressurise thefluid unit into the greenzone.

IMPORTANTDo not overpressurise(into the grey zone) asthis will cause blood toleak from the puncturesites in previously usedveins creating a messunder the Skin.

1

Slide the reservoir selector tothe right.

Connect the Arm.

3

Air pressure in the rightreservoir forces the bloodout through the Arm andinto the left reservoir.

Eventually the right reservoirwill empty and air will flowthrough the veins. Once theamount of blood comingout is minimal, release thepressure and disconnect theArm.

Emptying the veins prior to replacement

7

2

Close the valve on thepressure bulb. Pressurise thefluid unit into the grey zone.

Air pressure forces the bloodfrom the left reservoir intothe bottle.

Keep the pressure in thegrey zone to ensure that thebottle fills quickly.

1

IMPORTANTWhen emptying the fluidunit the blood to beremoved must always bein the left hand reservoir.See ‘Emptying the Veins’(page 7).

Slide the reservoir selectorto the left.

Connect the refill bottle.

3

Once most of the blood hasbeen removed and only airis bubbling through the lefttube, release the pressureand disconnect the bottle.

Emptying the fluid unit prior to storage/transport

8

2

Gently pull the Skin downonto the wrist.

Gently pull the Skin off thewrist and onto the hand.The hand should graduallygo floppy as the Skin isworked off the arm.

1

Using both hands, roll theupper part of the Skin downover onto itself as far as itwill go. Do not force theSkin.

Fold the Skin down overonto itself again.

3

Once most of the Skin is offthe arm, hold the Skin bythe upper part...

... and remove it.

Removing the Skin

9

2

Align the Skin with theunderlying anatomy of thearm.

Gently work the Skin up thearm.

1

To make the Skin easier toattach, lubricate the armwith the supplied water-based lubricant.

Ensure that the hand,forearm and upper arm arewell lubricated.

3

Pull the fingers onto thehand.

Slide the Skin up to the topof the arm. Ensure that theridge around the insideengages with groove at thetop.

If necessary, slide the Skinaround slightly so that it fitsthe arm anatomy properly.

Fitting the Skin

10

2

Disconnect the 2 upperconnectors first.

Gently pull the lowerconnector out of the palm.Hold the transparent tubeand pull the vein out fromit.

1

IMPORTANTBefore changing theveins follow theprocedures ‘Emptyingthe Veins’ (page 7) and‘Removing the Skin’(page 9).

Remove and discard thestrips of tape runningaround the thumb, wrist,and the upper ACF area.(New tape is supplied withthe replacement veins).

3

Remove the vein and discardit. Avoid spilling any residualblood left in the veins.

Lay the new vein on thework surface in the correctposition (2 veins at the top,small hand veins at thebottom and the slant of themedian cubital matches thegroove in the vein module).

Changing the Veins

11

5

Attach the palm connectorand push the transparenttube back into the arm sothat the connector fitssnugly.

Fit the veins into thegrooves of the forearm andtape them in place.

4

Attach the top 2 veins andpush the transparent tubesback into the arm so thatthe connectors fit snugly.

Fit the veins into thegrooves and wrap thesupplied tape around theupper ACF area to holdthem in place. Get anotherperson to help you ifnecessary.

6

Ensure that the veins aroundthe hand fit in the groovescorrectly. Tape the vein intothe thumb area.

Settle the veins into thegrooves correctly. The arm isnow ready to have the skinfitted.

12

1

The AV Arm Harness isdesigned to fit over the rightshoulder and upper arm.

The Harness has a mountingpoint to which the Arm isattached.

1

The AV Arm Harnessallows for role playing tobe carried out.

It is available as anoptional accessory. Order Part No: 00300

2

Insert the mounting pointinto the end of the Arm ...

... and rotate the Arm untilit is screwed fully onto themounting point.

Using the AV Arm Harness (Optional extra)

13

4

Hold the Arm andcomfortably tighten thechest strap so that theHarness cannot move.

Set up your trainingscenario.

3

Get an assistant to supportthe Arm whilst the Harnessis placed over the rightshoulder and the chest strapis clipped together and thenloosely tightened.

Raise the right arm andsecurely fix the velcro straparound it.

14

Case: bottom layer

Bottom layer with additionalstorage:

a is for the AV Harness oradditional venepunctureequipment

b is for a 600ml/25cmkidney dish (not supplied)

a

b

Case: top layer

IMPORTANT If the product is beingtransported longdistances or beingshipped, the fluid unitshould always beemptied before storing itin the case.

Follow the proceduresdescribed in ‘Emptyingthe fluid unit’ (page00).3

Cardboard box

IMPORTANTThe fluid unit shouldalways be emptiedbefore storing it in thecardboard box.

Follow the proceduresdescribed in ‘Emptyingthe fluid unit’ (page00).3

Storing the Arm (Depending on version bought)

15

Notes

Notes Notes