instruction manual - kyoto kagaku · 34 lung sound cases and one example of vocal fremitus are...

■ Starting up the software / Selecting the units・■ Error indicator system・・・・・・・・・・■ Operation screen・・・・・・・・・・・・■ Multi-unit operation・・・・・・・・・・

■ Exiting Simulation software・・・・・・・・・■ Turning off the control system's main power・

■ Turning on the unit・・・・・・・・・・・・・

■ Trouble shooting list・・・・・・・・・・・・■ Unable to boot the main unit・・・・・・・・■ Unable to select the units・・・・・・・・・・■ The error occurs during the session・・・・・■ How to change the connection mode to wired・

MW28

Lung Sound Auscultation Trainer “LSAT” ver.2　

Table of contents

Introduction

Preparation

Training

After Training

Trouble Shooting

● Product Supervision Chiharu Yoshii, MD., Ph.D., Professor, Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan

■ Before use / Features / Training skills・・・・・■ Warning / Caution・・・・・・・・・・・・・■ Set includes・・・・・・・・・・・・・・・・■ Parts names and functions・・・・・・・・・・■ How to use the unit separately・・・・・・・・■ Auscultation sites/ Cases・・・・・・・・・・・■ Classification of lung sounds・・・・・・・・・

P.1P.2-3

P.4P.4-5

P.6P.7P.8

P.10P.12P.13P.14

P.15P.15

P.9

P.16P.17P.18P.19P.20

InstructionManual

Caution D o n o t m a r k o n t h e m o d e l a n d i t s components with a pen or leave printed materials in contact with the model surface. Ink marks on the model are not removable.

1

Introduction Before useFeatures

MW28 Lung Sound Auscultation Simulator "LSAT" is designed for medical education training. Please do not use the product for other purposes. Any other use not in accordance with the enclosed guidelines is strongly discouraged. The manufacturer holds no responsibility for any accidents or damages resulting from such use.

For questions regarding this simulator, please contact our distributor in your area or Kyoto Kagaku. Our contact information can be found on the back cover of this manual.

・Sounds are recorded from actual patients and are reproduced by using a high quality sound system.・ An actual stethoscope can be used.・36 lung sound cases : posterior and anterior, with and without heartsounds.・Up to five simulators can be controlled by one wireless tablet.・The error indicator system facilitates maintenance of the system to keep “LSAT” in its best condition.

■Before use

■Features

■Training skills・Lung sound auscultation

2

Introduction WARNING

The safety rules below focus on the safety of the user; please read carefully before using the product.

This sign represents dangerous use that may lead to fire hazards or electrocution.

A circle with a cross represents actions that are strongly discouraged. This sign asks users not to attempt taking the simulator apart.

This sign represents harmful use toward the simulator or its parts that may lead to permanent damage or disfiguration.

This sign represents rules that we strongly encourage users to follow.

This is a major fire hazard. Please contact your local distributor or Kyoto Kagaku Co., LTD for repairs.

This can lead to a major fire hazard. Please contact your local distributor or Kyoto Kagaku Co., LTD for repairs.

This is to avoid electrocution.

Misuse may lead to damages and fire hazards.

This could lead to fire hazards, electrocution and injuries. Please contact your local distributor or Kyoto Kagaku, LTD for repairs.

This will prevent electrocution or fire hazards that may cause burns and damgages.

This can lead to f i re hazards and/or electrocution.

Such materials can lead to fire hazards and damages to the model.

Unplugging by the cord may lead to damages to the cord itself, fire hazards or electrocution.

This is to avoid to fire hazards and electro cution.

When the model or the control box becomes hot or begins to smoke, Warning immediately unplug the power cord.

Remove any dust that has accumulated on the power plug and insert completely into the power socket.

Do not handle the power cord with wet hands.

Use a power supply of AC 120V.

Do not attempt to take apart or remodel the product.

Unplug the power cord when the model is not in use.

Keep the model, its machinery and power cord away from water or detergent.

Keep flammable materials away from the product.

When unplugging the power cord, please hold by the plug and pull.

Do not bend, twist or damage the power cord.

■The signs below represent uses that may be dangerous or harmful.

■The signs below represent strongly recommended uses.

WARNING

WARNING

CAUTION

3

Introduction CAUTION

Do not apply excessive force or pressure onto the simulator. Please do not use the model for tracheotomy. This simulator does not incorporate tracheotomy training.

Do not mark the manikin with a pen or leave printed materials in direct contact with the model's surface. The inks marks on the manikin are not removable.

Do not install other software onto the computer; it may lead to system malfunctions.

Store the simulator away from direct sunlight. Store it in room temperature, away from heat and moisture to prevent discoloration or other damages.

Transport the simulator with caution. Hold the simulator by the handles when transporting. Do not hold the simulator by the screen, pole or the torso model. Carry with 2 or more people to carry it from one level to another.

Discoloration of the surface may occur over time. Discoloration of the model does not affect the function of the simulator.

Ensure to shut down your computer first.Then turn off the electricity power switch or unplug the power cord. Misuse may lead to damages.

Please use the simulator in a quiet environment.The setethoscope is extremely sensitive to sound.

CAUTION

Supply voltage: AC100-240V 50/60Hz 450VAAltitude: 2.000meters above sea-levelEnvironmental conditions: 5degreesC.-40degreesC.Relative humidity: Less than 80 per cent(no condensation)Overvoltage Category: 2Pollution Degree:2Power cord supply: Do not use power supply cords other than the one attached to this product.Clean-up: Clean the simulator with water or mild detergent. Clean the manikin with water or mild detergent and coat with baby powder. Be careful not to apply water or detergent on the internal machinery.To maintain stability, please do not apply lateral force to the pole.

4

Introduction Set includesParts names and functions

Before you first use "LSAT", ensure all components listed below are included in the unit.

■Set includes

A : 1 torso manikinB : 1 control PCC : 1 PC (built-in the unit)D : 1 AC adapterE : 1 power stripF : 1 LAN cableG : 1 LAN adapterH : 1 external speaker (built-in the unit) I : 1 lung T-shirt2 instruction manual -built-in help file of software operation -instruction manual

■Control PC

Power button

Touch-panel monitor

Power supply port*Connect the power cable to the port to charge the control PC.

*Subject to change.

A

B

I

D E F

G

*Subject to change.

5

Introduction Parts names and functions

■Unit PosteriorAnterior

LAN port

Speaker

Push to open

Light Light

Handle

Main power switch

Shelf for control PC

: Power is ON: Power is OFF

It is possible to play both posterior and anterior sound simultaneously at one time.NOTES

Slider for adjusting the volume of light intensity.*Subject to change.

6

The torso manikin is possible to be separated.POINT

Introduction How to use the unit separately

A

B

To separate : Push B buttonTo attach : Push A knob

Detach connection cables marked with red circles.

Connect unit to an AC adapter to start using.

AC adapter

1 2

3 4Hold the simulator by the handles at the both sides when separating.

Except for when using separately, always attach unit to base.NOTES

7

Introduction Auscultation sitesCases

■Auscultation sites

■Cases

PosteriorAnterior

1. trachea2. upper right lung field3. upper left lung field4. middle left lung field

A01 A02 standardA03 A04 mildly strong soundsA05 A06 mildly rapidA07 loud heart sounds

34 lung sound cases and one example of vocal fremitus are prepared.

C01 C02 right lower areaC03 C04 both lower areaC05 C06 right middle areaC07 C08 left lower areaC09 C10 both upper areaC11 C12 whole area

E01 E02 upper area 600-700HzE03 E04 upper area 350-450HzE05 E06 upper area 200-1000Hz

G01 G02 stridorsG03 G04 squawks

B01 B02 weak: left lower areaB03 B04 weak: left whole area(adhesion)B05 B06 weak: left whole area(pneumothorax)B07 B08 absent:right middle and lower areasB09 B10 weak: right whole areaB11 B12 absent: right whole areaB13 B14 weak: whole areaB15 B16 bronchial breathing

D01 D02 both lower areaD03 D04 both middle lower areaD05 D06 whole area(IPF)D07 D08 whole area(NSIP)

F01 F02 trachea and upper area 150-250HzF03 F04 trachea and upper area 150-450Hz (polyphonic)F05 F06 trachea and upper area 80-120HzF07 F08 whole area 80-200Hz

H01 H02 pleural friction rubs: right lower areaH03 H04 pleural friction rubs: left lower areaH07 H08 Hamman's signH09 H10 Vocal fremitus

0. upper left lung field1. upper right lung field2. middle right lung field3. middle left lung field

5. middle right lung field6. lower right lung field7. lower left lung field

4. lower left lung field5. lower right lung field6. right costphrenic angle7. left costphrenic angle

Normal

Coarse Crackles

Wheezes

Miscellaneous continuous sounds

Abnormal

Fine Crackles

Rhonchi

Miscellaneous

102 1

5

6

3

23

4 567

4

7

8

Introduction Classification of lung sounds

■Classification of lung sounds

Normal

Abnormal

Coarse Crackles

Rhonchi

Fine Crackles

MiscellaneousContinuous

Sounds

Miscellaneous

Play Lists

Wheezes

AdventitiousSounds

Discontinuous Sounds

Continuous Sounds

The American Thoracic Society developed a rational and clinically useful classification based on acoustic analysis of tape recordings and introduced the nomenclature. With this approach, lung sounds are categorized as continuous (wheezes, rhonchi, or stridor) or discontinuous (crackles). Crackles are further identified as fine or coarse. The terms “lung sounds” and “breath sounds” are usually used synonymously.

Adventitious lung sounds are superimposed on the breath sounds in certain circumstances and usually indicate disease. They are categorized as continuous (wheezes, rhonchi, or stridor) or discontinuous (crackles). Crackles are further identified as fine or coarse.

Discontinuous adventitious lung sounds are intermittent, nonmusical, and brief (duration of less than 25ms) noises. They may be fine crackles (relatively high-pitched sounds usually heard at the end of inspiration as air enters the acinar unit) or coarse crackles (the low-pitched, bubbling sounds that result from the accumulation of secretions in larger bronchi and trachea).

Continuous adventitious lung sounds are usually louder than the underlying breath sounds. The word “continuous” in this context implies duration of more than 250 ms rather than meaning a sound that continues throughout the respiratory cycle. Continuous sounds may be wheezes, rhonchi, or stridor.

Adventitious sounds

Classification oflung sounds

Discontinuous sounds

Continuous sounds

9

power strip

Audio cable

AC adapter

Preparation Turning on the unit

Follow the order of preparation procedure below so that the wireless connection works correctly. The unit may not boot with the improper order.

Connect the power cable to the outlet.

Outlet

Turn on the control system's main power.

Turn on the control PC power.

Confirm that the battery is charged before turning on the power. If the PC is out of battery power, connect the power cable to the control PC. *It is possible to use the control PC while it is connected to a power cable.

IMPORTANT

NOTES

1

2

2 1

3

Posterior

Main power: Power is ON: Power is OFF

Control PC power switch

Power cable port

10

Training Starting up the software

Confirming the wireless systems

Verify the icon of the wireless connection. * Default is set to wireless.

1

The softwares includes help menu for how to use the simulator.Tap the help menu　　 for more in detail.

NOTES

11

Training Starting up the softwareSelecting unit

Start up simulation software

Select a unit or some units to operate

From top menu, please select "LSAT2 Simulation" or "Playlist Maker".

Please tap some unit to operate and tap "OK."

"Playlist" of cases can be created.To create a playlist,1) Use the Playlist Maker. Select cases, set their sequence and runnning time for each, then name and save the list.2) Save a session as a playlist on K2 Simulation software. In the Playlist maker, data of recorded playlists can be edited and modified.

All fuctions of LSAT2 are managed by this software.

2

3

■LSAT2 Simulation Software

Softwares

■LSAT2 Playlist Maker

“Blue”：The unit selected by this control PC.

The button color indicate the status of each unit.

"Gray"：Not available to be controlled

Available to be controlled

Not available to be controlled

“Orange”：The unit already connected to another control PC and cannot be selected.

For K ver.2 users, the screen on the left will be displayed.

12

Training Error indicator system

Error indicator system

Error indication results

When activating "LSAT 2", errors are checked with the following screens.

When errors detected, the following screen is displayed. Cerify that all results are normal. When any error is detected, contact your local distributor or Kyoto Kagaku with error code.

1

2

Do not operate the control PC when error checking.NOTES

13

Training Operation screen

Simulation Software

Error indication has been completed, the simulation software is ready to begin.

1

Unit number

Classification of lung sounds

Cases

Case nameControl buttons

Save to playlist

HomeHelp menu

Case informationPreferences on control PC’s monitor screen

Volume setting of respiratory soundVolume setting of external speaker

Main monitor switch (ON/OFF)

Volume setting of heart sound

Heart rate

Blood pressure

Respiratory rate

Temperature

Light switch(ON/OFF)

Time lapseRunning time for manual setting

Switch to display on main monitor screen (ON/OFF)

Switching

Playlist Maker2

Add cases to playlistAdd cases to playlistAdd cases to playlistAdd cases to playlistAdd cases to playlistAdd cases to playlistAdd cases to playlistAdd cases to playlist Name of playlistName of playlistName of playlistName of playlistName of playlistName of playlistName of playlistName of playlist

Delete a playlistDelete a playlistDelete a playlistDelete a playlistDelete a playlistDelete a playlistDelete a playlistDelete a playlist

Help fileHelp fileHelp fileHelp fileHelp fileHelp fileHelp fileHelp fileHomeHomeHomeHomeHomeHomeHomeHome

Case explanationCase explanationCase explanationCase explanationCase explanationCase explanationCase explanationCase explanation

Delete a caseDelete a caseDelete a caseDelete a caseDelete a caseDelete a caseDelete a caseDelete a case

Scroll down playlistScroll down playlistScroll down playlistScroll down playlistScroll down playlistScroll down playlistScroll down playlistScroll down playlist

Scroll up playlistScroll up playlistScroll up playlistScroll up playlistScroll up playlistScroll up playlistScroll up playlistScroll up playlist

Copy a caseCopy a caseCopy a caseCopy a caseCopy a caseCopy a caseCopy a caseCopy a case

Open a playlistOpen a playlistOpen a playlistOpen a playlistOpen a playlistOpen a playlistOpen a playlistOpen a playlistCreate a new playlistCreate a new playlistCreate a new playlistCreate a new playlistCreate a new playlistCreate a new playlistCreate a new playlistCreate a new playlist

Overwrite and saveOverwrite and saveOverwrite and saveOverwrite and saveOverwrite and saveOverwrite and saveOverwrite and saveOverwrite and saveSaveSaveSaveSaveSaveSaveSaveSave

Case nameCase nameCase nameCase nameCase nameCase nameCase nameCase name Running timeRunning timeRunning timeRunning timeRunning timeRunning timeRunning timeRunning time

NoteNoteNoteNoteNoteNoteNoteNote

Cases to selectCases to selectCases to selectCases to selectCases to selectCases to selectCases to selectCases to select

14

Training Multi-unit operation

For example, while units 3 and 5 are selected by control PC B, those units cannot be connected with control PC A. In this case, turn off control PC B to disconnect the units 3 and 5 and to connect them with control PC A.

If you are working with a multi-unit operation, please do not attempt to select the same unit from various control PCs.

Control PC (A) Control PC (B)

A B

IMPORTANT

NOTE

Multi-unit operation

● Select the simulator units to be controlled. (Tap the unit numbers on the operation screen.) The units highlited blue is available to be controlled.

● Deselect the simulator units not to be controlled.(Tap the unit numbers on the operation screen.) The units highlited orange is not available to be controlled.

● Stop playing the case of each unit before controlling multiple units to play in same condition.

15

After Training Exiting softwareTurning off the control system's main power

Exit software

Turn off the control PC power

Turn off the control system's main power

Tap on the "Home" icon at the right top."Do you want to exit?" meddage appears, select "Yes."

Turn off control system's main power on the back of unit.

Control system's main power: Power is ON: Power is OFF

1

2

3

Tap on the "Exit" icon at the top menu."Do you want to exit?" message appears, select "Yes."

1 1

3

2 2

4

5

16

Trouble shooting Trouble shooting list

Unable to connect with wireless or unstable connection

Unable to boot the main unit with wireless connection

Network interference occurred.

There are physical obstructions for wireless connection or control PC is too far from the unit.

Power cable of the unit is not connected.


The main power of the unit is off.

Others

Clear the obstructions or close the control PC to the unit.

→ Case: Unable to Boot The Main Unit

→ Case: Unable to Boot The Main Unit

Connect the power cable.

Turn on the main power of the unit.

Cases Causes Solutions

Unable to select the units which liked to boot

Case: “Connection error” shut down the session and then the wireless connection get into not available.

The main power of the unit is off

Power cable of the unit is not connected.



The control PC does not correspond to the unit.

Others

→ Case: Unable to Select The Units

→ Case: The Error Occurs During The Session

Turn on the main power of the unit.

Connect the power cable.

Use the control PC corresponding to the unit.

Unable to hear the respiratory sound from the manikin

Unable to hear the heart sound from the manikin

Unable to hear the sound from the external speaker

Volume setting of the respiratory sound is “0”

Volume setting of the heart sound is “0”

Volume setting of the external speaker is “0”

→ Volume Setting of The Respiratory Sound

→ Volume Setting of The Heart Sound

→ Volume Setting of The External Speaker’sSound

Speaker connection may have problems.



→ Contact Us

→ Contact Us

→ Contact Us

17

Trouble shooting Unable to boot the main unit

Unable to boot the main unit

■ Case:The screen keep showing the sign below and it does not remedy despite several trials.

■ Cause and solution:1. The main units are not connected to power.→ Connect the cable to power and turn on the main unit.2. The main units are not turned on.→ Turn on the main units.3. Wireless network confusion may be happened around the models.→ Follow the solution 2 on the right.

For the multi-unit operation, be sure the control PC’s own main unit is turned on. The control PC is not able to operate when its own main unit is turned off.

ー Attention ー

■ Solution 2:Tap the cancel to back to the top page and try with wired connection mode.

↓

How to change the connection mode to wired: P.20

18

Trouble shooting Unable to select the units

Unable to select the units

■ Case:Units are not available to be selected on the screen below.

■ Cause and solution:1. The main units are not connected to power.→ Connect the cable to power and turn on the main unit.2. The main units are not turned on.→ Turn on the main units.3. Wireless network confusion may be happened around the models.→ Follow the solution 2 on the right.

For the multi-unit operation, be sure the control PC’s own main unit is turned on. The control PC is not able to operate when its own main unit is turned off.

ー Attention ー

■ Solution 2:Tap the cancel to back to the top page and try with wired connection mode.

↓The connection indicator is grayon the unit which are wanted to be used.


19

Trouble shooting The error occurs during the session

The error occurs during the session

■ Case:The software closed with showing the error display below.

■ Cause:Wireless network confusion may be happened around the models.

■ Solution:Try with wired connection mode.

↓



20

Trouble shooting How to change the connection mode to wired

The error occurs during the session

Tap the connection switch on left upper display to change the connection mode.

Connect the control PC to the LAN cable from the main unit .

1

2

・With the wired connection mode, only the connected unit can be controlled.・Touse some units with the wired connection, control the units by each control PC.

・The setting of wired connection mode will be automatically reset after turning off the system.

・Change the connection mode into wired each time when it is required.

ー Attention 1 ー

ー Attention 2 ー

LAN port


Caution D o n o t m a r k o n t h e m o d e l a n d i t s components with a pen or leave printed materials in contact with the model surface. Ink marks on the model are not removable.

2016/03/02

The contents of the instruction manual are subject to change without prior notice.No part of this instruction manual may be reproduced or transmitted in any form without permission from the manufacturer. Please contact manufacturer for extra copies of this manual which may contain important updates and revisions. Please contact manufacturer with any discrepancies, typos, or mistakes in this manual or product feedback. Your cooperation is greatly appreciated.

MW28

Lung Sound Auscultation Trainer “LSAT” ver.2

[email protected]

3109 Lomita Boulevard, Torrance, CA 90505-5108, USA15 Kitanekoya-cho, Fushimi-ku, Kyoto, 612-8388, JAPAN

TEL： 1-310-325-8860　FAX：1-310-325-8867TEL： +81-75-605-2510　FAX：+81-75-605-2519

E-mail

Kyoto Kagaku America Inc.Kyoto Kagaku Head Office and Factories:■ USA, Canada, and South America■ Worldwide Inquiries and Ordering

instruction manual - kyoto kagaku · 34 lung sound cases and one example of vocal fremitus are...

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