Enough is Enough

Stefan Frembgen, President/CEO of IngMar Medical

The death of George Floyd is a stark reminder that the demons of the past are also the demons of today. Police do not apply “protect and serve” to all of us who live in this country in the same way. We grieve not only for the senseless loss of black lives, but also for the loss of freedom from fear, the loss of opportunity, the loss of many of the basic things that we all claim that humans have a right to in their pursuit of happiness.

We must ask ourselves what contributions we are making to abolish the system of racism that still undeniably exists all around us. Our voice in the chorus of those who are envisioning a future without discrimination is critical.

No business exists in a vacuum, but in a framework where not only money and goods are exchanged, but values are shaped and upheld, and where people’s lives are touched in many different ways.

We, collectively, can be who we want to be. We have the power to shape our interactions with the world. We need to use this power to set the bar high. We need to use this power to actively promote the self evident truth that all people are created equal.

– Stefan Frembgen, President/CEO, IngMar Medical

A Trip to China


Amanda Dexter, clinical educator at IngMar Medical, recently helped conduct training at the Covidien Center of Innovation (CCI) – a state-of-the-art training and education center in Shanghai, China. “Improving Respiratory Care in the ICU” was the focus of the two- day continuing education course for select pulmonary critical care doctors. Directed by Neil MacIntyre, the two-day course included lectures and workshops on ventilation and airway management.

Amanda helped conduct hands-on training using the ASL 5000 Breathing Simulator and the QuickLung Breather at the following workshops:

  • Non-invasive Ventilation
  • Novel Ventilator Modes Designed to Optimize Synchrony
  • “Fix the Vent” Scenarios
  • Ventilator Emergencies
  • Oxygen Emergencies/Severe Hypoxemia

Special thanks to Neil MacIntyre and John Davies, both of Duke University Medical Center, and Kien Kong of Covidien for their help in the workshops.

 

New Video Demonstration on Test Automation with the ASL 5000

Answering the needs of our customers working in respiratory device development and manufacturing, IngMar Medical has developed the Test Automation Interface (TAI). The TAI enables users to integrate the ASL 5000 Breathing Simulator into their proprietary systems for automated device testing.

The TAI comprises a set of commands which control the ASL 5000 software from within a separate test software environment (i.e. LabVIEW, C, C++, etc.), a critical prerequisite for automated testing in product development and quality assurance. Multiple ASL 5000 systems can be run on the same CPU. Benefits of the TAI include time savings, accelerated development, and better control over testing protocols. Click here to watch a video demonstration.

Watch the video above to learn how the TAI helps you save time and gain consistency.

A Reflection on the AAMI/FDA Summit on Ventilator Technology

At the AAMI/FDA Summit on Ventilator Technology, great strides were made towards achieving a consensus on tasks to advance the safety of patients on mechanical ventilation.
Dr.-Ing Stefan Frembgen, President, IngMar Medical
Dr.-Ing Stefan Frembgen, President, IngMar Medical

As a leading advocate for the use of simulation in respiratory care, we are inspired by its strong endorsement by speakers at the conference. We identify three distinct areas where a widespread use of high fidelity respiratory simulation can be extremely beneficial.

For one, training in the use of ventilators can be greatly enhanced by the use of simulation in a clinically relevant setting. However, effective and efficient training beyond learning “knobology” will require the cooperation and consensus of the subject matter experts. One of the “actionable items” of the conference summary was to identify the 10 most relevant proficiencies for mechanical ventilation. If this were accomplished, we could make these items high priority learning objectives in our simulation curriculum modules.

Similarly, in the effort to improve user interface design and usability, simulation can play a vital role, as was underscored by both manufacturers and clinicians at the conference. Here again, a consensus on a battery of tasks and challenges to be molded into scenarios is of critical importance.

Lastly, the development and study of autonomous ventilation modes will benefit from rigorous bench testing faithfully emulating patient responses that the ventilator should be expected to manage autonomously. Studies and research identifying which patient conditions and transitions need to be included in evaluations of algorithms would give developers critical feedback before advancing to testing on actual patients. We invite your comments and suggestions and look forward to working together with you to accomplish the goals laid out before us last week.

Porcine Lungs Come to Life at UTMB

Porcine lungs powered by the ASL 5000 Breathing Simulator at UTMB
Porcine lungs powered by the ASL 5000 Breathing Simulator at UTMB used to demonstrate recruitment maneuvers.
The following story was shared by Jose Rojas, PhD, RRT, Department of Respiratory Care, University of Texas Medical Branch.

We have been using the ASL 5000™ Breathing Simulator to teach students aspects of pulmonary physiology as it applies to mechanical ventilation. One approach is to integrate the ASL 5000 with human patient simulators that are connected to mechanical ventilators. This approach allows faculty to recreate actual patient scenarios in a safe environment where students can get hands-on experience with the adjustment of ventilator settings and interpretation of ventilator graphics.

The ASL 5000 also allows us to compare the response of different ventilators to similar patient conditions. Students are able to examine features such as tube compensation, flow trigger, and the mixed pressure-volume algorithms.

 

Many of the new generation ventilators have lung recruitment maneuvers that are sometimes difficult to demonstrate with lung simulators. We have been using commercially available porcine lungs (not the result of animal experiments) to enable students to explore the recruitment maneuver features on the Avea and Hamilton G5 and compare these to incremental PEEP increase.Jose Rojas

The use of the porcine lung to demonstrate recruitment maneuvers stimulated us to consider the possibility of using the ASL 5000 to investigate ways to improve protocols for the handling of ex-vivo perfused lungs. We believe this would provide interesting research projects for students and faculty. Many of the current ex-vivo perfusion protocols involve using positive pressure and high concentrations of oxygen to maintain isolated perfused lungs. The longest time that perfused lungs have been kept viable ex-vivo is about 10 hours. Using the ASL 5000 to model breathing, we would like to explore the possibility of extending survival time of ex-vivo perfused lungs. We believe that lowering the FiO2 and avoiding positive pressure ventilation could improve viability. Further development of this model could lead to advances in therapeutics related to airway clearance, mechanical ventilation, and airway pharmacology.

In the video below, the porcine lungs are attached to an Avea ventilator in the CPAP mode (no pressure support) with 10 cmH20 CPAP. The ASL 5000 is set as a single compartment model that is generating approximately 30 cmH20 pressure and programmed to breathe at a rate of 20 breaths per minute.

Do you have an interesting application of your own? Click here to share!

Automated Product Verification at CareFusion

An automated product verification station with the ASL 5000 at CareFusion
Automated product verification station at CareFusion provides efficiency and consistency.

For over a decade, the ASL 5000 Breathing Simulator has been an essential tool for product development and quality control in the respiratory device industry. With the recent development of the Test Automation Interface (TAI), life just got a lot easier for a group of test engineers at CareFusion. The TAI is a feature of ASL 5000 Software 3.4 or later which enables users to integrate the device into their proprietary software for automated device testing.

Mark Blair, Sr. Principal Test Engineer at CareFusion, uses the ASL 5000 for product verification. According to Mark, the use of the TAI in combination with the ASL 5000 “allowed us to automate our product verification test set-ups and data acquisition.” He believes that the time savings and increased efficiency has been extremely beneficial, but he was quick to point out another major advantage of the system.

“The thing this gives us is consistency. It has truly become a pure measurement – always executed and interpreted the same way. You get a repeatable, objective acquisition of the measurements.”

The TAI comprises a set of commands which control the ASL 5000 software from within a separate test software environment (i.e. LabVIEW, C, C++, etc.), a critical prerequisite for automated testing in product development and quality assurance.

Do you have an interesting application of your own? Click here to share!

Training Tool Helps Respiratory Therapists Breathe Easier

Simulation instructor & student 5010A state-of-the-art lung simulator is allowing hundreds of Alberta Health Services (AHS) staff to practice life-saving respiratory procedures and prepare them for real-life scenarios.

The ASL 5000 Breathing Simulator is a device that can simulate lung activity for a number of respiratory conditions – including H1N1, acute respiratory distress and asthma attacks – in a range of patients, from neonatal to the elderly. It is used to train clinicians, primarily respiratory therapists, who assist patients who require a ventilator to breathe properly.

“Simulating scenarios in real time gives staff the chance to fine-tune their skills before they experience the real thing.”Brent Neil

“Critical lung illness or injury can be fatal and takes a number of different forms. Different lung conditions must be dealt with on a ventilator in a variety of ways. This tool helps ensure patients get the best possible care.”

Click here for the full story.