Run the application by clicking ** on the <MSE ECMO> short cut on the <Start> menu or the 'MSEHDTV.exe' file in the installation directory. You will be given the opportunity to start the application in one of three modes:
Choose <Unsupervised Simulation Mode> (the default selection) and click the <Start> button.
The system's three primary windows will appear. At the left-hand side of the screen is the <Inspector> window, to the right-hand side is the <Patient Monitor> and below this is the <Therapeutic Interface>.
Inspector Window:
The <Inspector> window is used to display textual or audio-visual information relating to the scenario and to allow the user to manipulate the virtual devices which can be used in the treatment of the patient.
Click the <Notes> menu item to view the notes which describe the patient in the current scenario. Click the <Prev> and <Next> menu items of this window to navigate the current document.
The <Investigations> menu item lists the investigations which are currently available for the patient. (Oxygenator Blood Gas Analysis is only available if an ECMO system is in use.)
The <Devices> menu item is used to visualise any of the 6 devices which are available to the user. These devices are a:
| • | Defibrillator and |
Click on <Devices><Nerve Stimulator> to display the nerve stimulator and then click on the <TOF> button to see the patient’s current ‘Train of Four’.
If you want to reposition the <Inspector> window, place the mouse at the top right-hand corner of the window's title bar and drag it while holding down the left mouse button. The position of the window will be retained when you next start the application. Refer to the section entitled 'Inspector' for a complete description of the functionality of this window.
Patient Monitor:
The <Patient Monitor> is based on a modern physiological monitor and is used to display the patient's current vital signs.
Click the <Display> button on the Patient Monitor and select the parameters which you want to view (for example, ECG, Direct Arterial Pressure and Central Venous Pressure). Click the <Display> button again to close the parameter selection window.
The parameters which can be displayed include:
| • | ECG, |
| • | NIBP, |
| • | Direct Arterial Pressure |
| • | Central Venous Pressure, |
| • | SaO2, |
| • | SaO2 waveform, |
| • | BIS, |
| • | Temperature, |
| • | Capnographic Waveform and |
| • | Inspired and Expired Gas values. |
If you want to reposition the <Patient Monitor>, place the mouse at the top right-hand corner of the monitor and drag it while holding down the left mouse button. The position of the window will be retained when you next start the application. Refer to the section entitled 'Patient Monitor' for a complete description of the functionality of this window.
Therapeutic Interface:
The <Therapeutic Interface> window is used to administer drugs and or fluids to the patient. The interface has four 'tabbed' pages:
| • | Bolus Drug, |
| • | Infusion Drug, |
| • | Fluids and |
| • | History. |
To explore the effect of giving adrenalin to a normal patient, click on the <Bolus Drug> tab and select <Adrenalin (100mcg/ml)> by clicking on it. A new window will appear. Slide the green slider until a dose of ~ 50 micrograms is indicated and click the <Give> button. Observe the effect of the drug on heart rate, blood pressure and ectopic activity over the ensuing minutes. Click on the <History> tab to review details of your therapeutic interventions.
If you want to reposition the <Therapeutic Interface>, place the mouse at the top right-hand corner of the window and drag it while holding down the left mouse button. The position of the window will be retained when you next start the application. Refer to the section entitled 'Therapeutic Interface' for a complete description of the functionality of this window.
**Throughout this document the terms 'Click' and 'Select' are used to refer to a left mouse button click.