Welcome to Deltex Medical's guide to using the EDS.
The course objectives will give you an understanding of:
- How to set up and use the EDS
- Probe insertion and focusing
- Doppler and arterial signal identification
You may also find the course Getting Started with the EDM+ useful for details on the monitor’s functions.
All of your personal data will remain private and will be used solely for the purpose of Deltex Medical e-learning.
This course is for information only and is in no way intended to be a replacement for the Instructions for Use and the Operating Handbook, which should be referred to for full instructions.
Note: Local laws apply in all cases. The products shown in this course may not be available in all markets.
The EDS is designed for teaching the placement and signal acquisition of the esophageal Doppler probe.
Signal detection is more sensitive than in a patient, because there is less absorption of the Doppler wave.
The arterial line is also simulated and can be calibrated against the Doppler signal to give continuous cardiac output and unique combination parameters.
The EDS can be used for a group tutorial or one-to-one sessions.
Simulator patient characteristics
After setting up the monitor, select 'New patient' followed by ‘Auto-number’ and enter the following patient data:
- Age – 68 years
- Weight – 83 kg (183 lb)
- Height – 180 cm (70 in)
...then press 'Accept data'.
Note: In patients, the descending aorta increases in diameter as you get older so age has the biggest influence on the algorithm used by the EDM+ to calculate Stroke Volume.
Insert the Doppler probe via the nose with the beveled edge facing upwards until Marker 3 is aligned with the nostril.
Slowly rotate the probe through 360 degrees to look for a signal.
Pause to allow the spring in the probe to relax. If the optimal signal is not located, withdraw the probe 1 cm at a time and turn in the opposite direction to look for a signal between Markers 2 and 3.
The control pad allows the simulator signal to alter to represent different clinical situations.
A Doppler waveform shows the velocities of the red blood cells as they pass through the descending thoracic aorta. The area under the curve is the Stroke Distance (SD) or Velocity-Time Integral (VTI).
SD is converted to Stroke Volume (SV) using a nomogram based on age, weight and height.
The EDS can also simulate the arterial waveform normally slaved from the main patient monitor. This is displayed below the Doppler signal.
Calibration against the Doppler signal is quick and easy at the touch of a button. Cardiac Output is then available from Pulse Pressure Wave Analysis.
The simulator also displays those parameters calculated from combining the dual technologies, such as Cardiac Power and Cardiac Power Index.
Please visit the course on 'Pressure Monitoring Mode' for more information.
In real patients, the shape of the Doppler flow reflects the speed and direction of red blood cells, thus different waveforms will be reflected when the probe is positioned by different structures.
Once the optimal signal is found, the EDS can be used to experience the effect of a fluid challenge.
In real patients, data can be captured and downloaded to records as well as any change in response being tracked on the EDM+.
- Check that there is an adequate amount of gel in the EDS
- Use the probe to gently mix the gel to remove large pockets of air
- Increase the power on the control pad
- Change the probe.
Interference (noise) on waveform
- Consider locating further away from non-EDS electrical equipment
- Rotate EDS horizontally by 90 degrees.
Green light flashing on control panel
- This may happen if the probe has been moved up or down very quickly. Switch the power off to re-set.
Difficulty moving probe in simulator
- If probe movement is stiff, this usually indicates that too much gel has been added to the EDS.
- Switch off and disconnect the power cord prior to cleaning
- Clean the simulator at least once per month with mild detergent – refer to handbook
Posted in USA