Spontaneous respirations

[sherry65]

How can I "turn off" the spontaneous respirations during CPR and intubation? Also, does anyone have any suggestions for keeping the HPS "alive" during ACLS protocol? I always set the ischemic index sensitivity, but I have noticed that he spirals during the 2 mins of CPR and I have to change rhythms to keep this from happening. Thanks

[John Edwards]

:cool: Question during ACLS codes if you truly don't want mannequin to die then reset to cardiac override to sinus rythm then turn that sceanrio off. you can toggle back and forth using the PNCI Treatments overlay easy to push drugs and or you open mutiple screens by opening up cardivascular (heart cardiac override to sinus) then HPS alive at end no death. To open mutiple screens go to detach tab press F9 key you should have opened up another screen it helps when the facitators need a function as of yesterday.
I hope that helps let me know I have tried it many ways and that is the best.
As far as the message above I think you posted in the wrong place this about Human Patient Simulation not Stimulation last time I checked!:confused:

[JSlimmon]

A quick way to stop the breathing is by setting the fixed neuromuscular blockade to 100%, that will stop the sim from breathing, if you want him to start breathing again, change it back to 0%

[sherry65]

I do send the simulator into cardiac override using the sinus rhythm, with all the tabs I may need detached. The problem is the participants want to respond to this change in rhythm on the monitor, when in fact, this rhythm is only to keep him "alive". I was hoping that there were some "tricks" that I wasn't aware of that would keep him in Vfib for instance for 2 mins of CPR without spiraling. Thanks for the help

[vkozme]

Hi,
The problem with breathing, CPR during VFib and spiraling in 2 minutes is of totally different origin and it has a very simple solution.
First, open a new Standard Man patient and do not open any scenario. Then set cardiac rhythm override to Pulseless VTach (151) (or any other arrhythmia of your choice). The patient will remain in this condition indefinitely - with blood pressure of around 15/10 mm Hg (the actual number is not important). If the rhythm is set to override and is not model-driven, it will remain the same until something changes it. There will be no spiraling.
Second, it is the scenario that brings dynamic changes into the simulation case. I am not sure what scenario you are referring to that destabilizes the patient after 2minutes. You may want to check how the transitions are set in this particular scenario. My guess would be that 2 minutes into the Vtach or VFib, the scenario proceeds to the deterioration if there was no correct treatment performed (such as electrical shock).
Using scenarios created by someone else, make sure that you and the author of the scenario are on the same page because every scenario is normally developed with some learning objective in mind. If your learning objectives are different from learning objectives of the scenario, you need to either create your own scenario or modify the original. I usually develop all our cases by myself.
Hope it helps.
Valeriy Kozmenko

--
Valeriy Kozmenko, MD
Director, Human Patient Simulation Lab
Assistant Professor of Clinical Anesthesiology
LSU HSC School of Medicine
2020 Gravier St
New Orleans, LA 70112

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