Tag: ASL 5000 Breathing Simulator

We love our ASL 5000 users, so in response to requests, we’ve launched an ASL 5000 Breathing Simulator User Forum on LinkedIn! We hope this platform enables our users to collaborate and share everything from teaching techniques, to success stories, to patient models, and more!

The content on this User Forum is intended to be user-generated, with little to no input from IngMar Medical. This is your opportunity, as ASL 5000 users, to meet and converse with other users of the product.

What users are currently discussing on the User Forum…

How do you define ventilator management competency?
How do you determine if a student is competent in ventilator management? Assessing MV proficiency levels can be complicated because there is no standardized rating scale. Some say competency is defined by the student’s comfort level with the ventilator. Others say it’s the ability to identify problems immediately or to have an extensive understanding of human physiology. How do YOU decide whether or not you students are competent in ventilator management?

Click here to join the User Forum and weigh in on the discussion!

Simulation training has been shown to be an effective method for medical education. But what about mechanical ventilation management specifically? A recent study at Summa Health System in Akron, Ohio, looked at the effectiveness of a mechanical ventilation boot camp for first year medical residents in surgery and emergency medicine.

The Summa Health study found that the boot camp was effective in increasing competency, knowledge, and confidence with ventilator management.

The three-day training incorporated hands-on scenarios using human patient manikins connected to IngMar Medical’s ASL 5000 Breathing Simulator.

“The ASL 5000 is the only simulator on the market that can manifest the wide variety of pathologic states necessary to provide cutting-edge training to my residents and fellows.“

Rami A. Ahmed, DO, FACEP, Simulation Medical Director, Summa Health System.

In addition to hands-on simulation, other didactic elements were used including: independent reading, a focused PowerPoint presentation, personalized feedback, and a supportive learning environment.

Learners were given identical pre- and post- intervention assessments in the course of the three-day training.

Three-Day Mechanical Ventilation Simulation Curriculum

Day 1: Pre-intervention Evaluation

• Pre-test confidence survey (5 minutes)
• Pre-test cognitive multiple-choice exam (25 minutes)
• Cases and evaluation by critical actions checklist (10 minutes each for 30 minutes total)
  • ARDS
  • Complete lung atelectasis secondary to mucus plugging
  • Pneumothorax in a mechanically ventilated patient
• Distribution of supplemental readings for independent study (estimated 4 hours of reading)

Day 2: Curriculum and Educational Intervention

• Case structure:
  • Two to three residents participated in the case (10 minutes)
  • Evaluation by critical actions checklist (evaluated during case)
  • Bedside debriefing by intensivists (20 minutes)
  • PowerPoint presentation review (15 minutes)
• Pathology reviewed:
  • ARDS
  • Complete lung atelectasis secondary to mucus plugging
  • Altered mental status secondary to overdose
  • Pneumothorax in a mechanically ventilated patient
  • Dynamic hyperinflation

Day 3: Post-intervention Evaluation

• Post-test confidence survey (5 minutes)
• Post-test cognitive multiple-choice exam (25 minutes)
• Cases and evaluation by critical actions checklist (ten minutes each for 30 minutes total)
  • ARDS
  • Complete lung atelectasis secondary to mucus plugging
  • Pneumothorax in a mechanically ventilated patient

Results: 

The post-test evaluation found significant increases in cognitive knowledge, clinical performance, and confidence.

“This study demonstrates the feasibility and effectiveness of a boot camp curriculum for residents on the basics of mechanical ventilation.“

The increase was attributed to numerous factors including the utilization of multiple teaching methodologies to accommodate different learning styles, the supportive learning environment, personalized feedback, and the opportunity for residents to touch and manipulate the ventilators to develop familiarity and reduce anxiety.

Read the full study.

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.

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!