ARTERY PUNCTURE AND INTRAMUSCULAR TRAINING ARM Parts identification: FAST-derm replacement skin (removable) Intramuscular injection pad (removable for cleaning) Training arm (includes one FAST-derm replacement skin) Arm tubing and luer locks Arm tubing clamps FAST-fluid management system: Collection bottle Upper tubing Upper tubing clamp Lower tubing FAST-fluid tower Pulse bulb Luer locks Syringe Lower tubing clamp 2
Assembly instructions: 1. Assemble the FAST-fluid tower by sliding the two base pieces together. 2. Secure by threading the small black rubber plug through the holes forming a circle. 3. Close clamps on upper tubing, lower tubing and pulse bulb tubing. 4. Prepare fluid for collection bottle with distilled water or saline. Note: To represent blood, tint fluid with red food coloring or use a mixture of simulated blood with distilled water or saline. 5. Remove cap on the collection bottle. Fill collection bottle to 800ML with fluid making sure to not fill past the upper tubing. Tighten cap on the collection bottle. 6. Set the filled collection bottle onto the FAST-fluid tower. Note: The height of the tower was designed to provide realistic flashback. Elevating the bottle to this level will increase the fluid pressure and assist in providing the flashback. 3
ARTERY PUNCTURE AND INTRAMUSCULAR TRAINING ARM Set-up instructions: 1. Connect the upper and lower tubing luer lock connectors on the collection bottle to the connectors on the training arm tubing. 2. Prime the arm s arteries by opening the clamps on the upper and lower tubing. Note: To prevent air lock during priming, lay arm and tubes on a level surface. Purging the air from arteries takes a few seconds. 3. Close the clamps on the upper and lower tubing. 4. Open clamp on the pulse bulb tubing. 4
Use instructions: System is now ready for use. A series of pulse bulb contractions will create a pulse. A very realistic pulse will be felt at both the radial and brachial sites when squeezed. 1. To perform radial arterial puncture: a. Have a partner press the pulse bulb to create a pulse. b. Palpate the radial artery in the arm. c. Follow the proper steps for performing arterial puncture.** 2. To perform brachial arterial puncture: a. Have a partner press the pulse bulb to create a pulse. b. Palpate the brachial artery in the arm. c. Follow the proper steps for performing arterial puncture.** 3. To perform an intramuscular injection: a. Locate the injection site on the upper part of the training arm. b. Follow the proper steps for performing an intramuscular injection** Note: Saline or water are recommended for the IM injection site **See the curriculum for steps on performing arterial puncture and intramuscular injections 5
ARTERY PUNCTURE AND INTRAMUSCULAR TRAINING ARM Cleaning and storage instructions: For best results, perform the following instructions at a sink. 1. Close all tubing clamps. 2. Keeping tubes above the arm, disconnect them from the collection bottle. 3. Place tubes into a sink or reservoir. 4. Hold arm above tubes, open both clamps and allow tubes to empty. Note: This works best if the arm is held high enough for the tubes to hang straight down and thus avoid kinks. Note: If the fluid used was tinted; use the syringe to flush with clean water. A. Fill the syringe with clean water. B. Stand the arm upright. C. Connect the syringe to the tubing and inject until full. D. Disconnect syringe and repeat steps three and four to drain the fluid. E. Repeat steps A to D as needed. 5. Empty collection bottle, remove cap and rinse with water. 6. Remove pulse bulb and rinse out with water. 7. Wipe the exterior of the arm with warm water. Pat dry with a clean cloth. Allow all parts to dry overnight. 8. Store trainer in a dry warm place out of direct sunlight. Care after intramuscular injection: 1. Remove the pad from the upper arm. Remove the interior sponge. 2. Rinse well using warm water. 3. Squeeze or wring out the additional water from the sponge. 4. Allow to dry overnight completely before inserting sponge back into injection pad. 6
FAST-derm replacement skin instructions: 1. Remove the FAST-derm replacement skin by gently pulling on the Velcro along the length of the slit. 2. Gently peel skin off. 3. Open additional replacement and slide the skin over the hand stump (fingers are pre-populated in the replacement skin) and gently over the length of the arm. 4. Close skin by securing the Velcro the length of the arm, starting at the hand and working your way down to the elbow. Additional care tips: 1. Needles: 22-gauge or smaller needles are recommended as larger needles reduce the life of the product. Puncturing the skin repeatedly for practice will lead to deterioration over time. Use sharp needles as dull needles may cause unnecessary damage to the skin and arteries. 2. Puncture Site: To extend the life of the arm, distribute injections along the accepted injection sites. 3. Use only distilled water or saline. Use of other solutions may block the tubing for the arteries. 4. Do not use iodine, betadine or other antiseptics to clean the site as they may stain the skin permanently. You may use alcohol pads. 5. Follow cleaning instructions above after each use. 7