How do I set up a Postpartum Hemorrhage (PPH) scenario using my Avbirth device?

A step-by-step guide for preparing your Avbirth device, simulated fluids, and Standardized Patient for a realistic postpartum hemorrhage scenario.

Before You Begin

For a full, step-by-step visual walkthrough of setup, we recommend watching the Avbirth Out of the Box video in the Avkin Customer Portal before beginning. This video covers every step outlined in this document, including fluid setup, device connection, app navigation, scenario start, and clean-up.

Access the Avkin Customer Portal to review the Out of the Box Video and SP training resources before beginning setup.

To access the Customer Portal:
- Visit: www.avkin.com/customer-resources
- Navigate to the page dedicated to the Avbirth
- Watch the Avbirth’s Out of the Box video

Note: You will need a password to log in. If you don’t have the login details, please contact your Avkin representative or email support@avkin.com for assistance.

Important Tip: Watching the Out of the Box video before your first PPH setup is highly recommended for a smoother start to your simulation day.

Make sure that your Avbirth and both Avbands are fully charged.
Two IV bags of blood should be used in this scenario.
- (Instead of the typical setup of one blood bag and one Amniotic Fluid bag as in other scenarios.)
Insert both IV bags of blood into the fluidics compartment of your Avbirth. (Follow the instructions in the Out of the Box video located in the customer portal or use your user manual to complete this step.)
Ensure tablet or phone is charged and connected to your Avbirth via the Avkin App.
If desired, set out blood clots (included in your Avbirth kit) on a blue pad prior to starting the scenario.
- As the blood mixes with the clots during the simulation, it will create a more realistic appearance.
- Please note: If you intend to have your students weigh the blue pad at the completion of your scenario, please add a weighted item for an added level of realism.

Preparing the Device

Setup instructions can be found in the Out of the box Video (found within the customer portal) or in the Avbirth User manual.

Remove the silicone belly and open the fluidics chamber.
Connect both blood IV bags to the tubing within the chamber.
Place both blood IV bags inside the chamber side-by-side, folding excess material down.
Clamp the fluidics chamber closed.

Note: For PPH scenarios, no amniotic fluid is used. Blood will be the only fluid in the chamber, which will result in a “bloodier” birth than our standard scenarios.

Setting Up a Boggy Uterus

A boggy uterus is recommended for PPH simulations.

Adjust the stopcock so the “off” position is facing the opposite direction of the selected feature.
- For Boggy Uterus, the “off” position should be facing the opposite direction of this selection.

Preparing Baby and Placenta

Prepare the baby and placenta following the steps in the Out of the Box video (located within the customer portal) or follow the instructions found in your user manual.
1. Insert the umbilical cord into the baby.
2. Douse both the baby and placenta with a generous amount of baby (mineral) oil.
  1. Optional step: Apply simulated vernix to the baby for an additional level of realism.
Load the placenta and baby into the baby tube
1. Wrap the umbilical cord around the placenta and place both into the baby tube.
2. Position the baby with feet tucked and arms folded in front of the chest.
  1. Additional tips for positioning the baby can be found in the Knowledge Basse post titled "Avbirth: Baby Positioning Tips"
3. Close the baby tube lid, ensuring no limbs are pinched.
4. The lid should feel slightly resistant when closing. This is normal.

Note: More detailed instructions can be found in the Out of the Box video found within the Customer Portal or within the Avbirth user manual.

Connecting to the Avkin App

Note: If using a phone or a tablet (other than the one provided with your Avbirth) the Avkin app will need to be downloaded from the Google Play Store or Apple App Store. More detailed instructions for locating and setting up the Avkin app can be found in the Out of the Box video located within the Customer Portal.

Power on the Avbirth wearable.
Ensure your wireless connection and location are enabled on your phone or tablet.
Open the Avkin app on the tablet that came with your Avbirth, an alternative tablet, or phone.
From the Connected Devices screen, select the blue Avbirth tile with the baby icon.

Note: If you do not see this screen, please exit the app and ensure that your wireless connection and location are enabled, then try connecting your device to your app once again.
Select your Avbirth on the next screen.
If the connection is successful, you’ll see the main Avbirth screen with four orange tiles.

Priming the Pumps

From the main Avbirth app screen with the 4 orange tiles:

Press ‘Prime’ found at the bottom right of the screen.
- This fills the tubing so blood will flow immediately once the simulation starts.

If using Avbands (highly suggested):

Turn on the Avbands.
From the main Avbirth screen, press one of the orange circle buttons in the top left corner.
Select the Avband device tile, wait for the ‘Connecting…’ prompt, then press Start when prompted.
Ensure that the mode is listed as “Mirrored”.
1. If “Mirrored” isn’t displayed or if the Avband is listed as being “Independent”, click “Switch Mode” to switch to “Mirrored” mode.
You can change the LED color and vibration intensity from this screen.
Use your device’s back button to return to the Avbirth main screen.
Now the app and devices are paired and ready for simulation setup.

Preparing the Standardized Patient (SP)

It is beneficial for your SP to watch the Standardized Patient Training Video found within the Customer Portal before the simulation day.
1. The video helps to set the expectations for the simulation and informs your SP about how and when to react.
Make sure that your SP is dressed appropriately.
1. It is suggested that the SP wear leggings or shorts.
  1. Waterproof underwear, shorts, or pants could be worn if available.
Position the Avbirth on the SP.
1. Detailed instructions can be found within the Customer Portal or the Avbirth’s user manual.
2. For the PPH scenario, place a blue pad between the Standardized Patient and the device to help catch and contain the simulated blood loss.
Provide the SP and optional support person (or facilitator) with an Avband to wear throughout the duration of the simulation.
1. Remind the SP about the use of the orange emergency button prior to the start of your simulation.
  1. The button can be pressed once to alert the facilitator that the SP needs their assistance.
  2. If the button is pressed and held an emergency alert will appear on the app. The simulation should be paused immediately and the SPs concerns should be addressed.
Once the SP is placed comfortably on the hospital bed, you are ready to begin your simulation through the Avkin app.

Starting the Scenario

From the main Avbirth screen within the Avkin app:
1. Select “Prebuilt”
  - A pop-up window will appear titled “Prebuilt Scenario”
  - Select “Start New Scenario”
2. Choose a PPH scenario from the available list. You have two to choose from:
  - Normal Birth with Postpartum Hemorrhage - Abby Jean
  - Postpartum Hemorrhage 2
3. Once the scenario has been selected, press the start button found at the bottom of the screen.
4. To begin the birthing scenario, click the large orange “Start Scenario” button.
The progress of the delivery can be monitored or paused within the Avkin App.