V 2.3 External Fetal Monitoring (Cardiotocography), Device Audio

Available for download on the Downloads page.

This release has been years in the making, with work beginning on the External Fetal Monitoring (EFM, cardiotocography) simulator in 2020, but then being placed on the backburner due to the pandemic and to make way for cross-platform porting… it’s finally complete and stable!

External Fetal Monitoring (EFM, Cardiotocography)

New features with the External Fetal Monitor include simulation of:

  • Fetal heart rate (FHR)
  • Fetal heart rate variability (baseline variability)
  • Uterine contractions via “toco”: set the frequency and the duration
  • Fetal heart rhythms (interval variability) including:
    • Baseline (minimal variability)
    • Accelerations
    • Early Decelerations
    • Late Decelerations
    • Variable Decelerations

All on the background of the standard cardiotocography strip! Just set the variables and let Infirmary’s patient modeling do the rest to create your simulation or educational materials (e.g. rhythm strips).

Additional features include:

  • Multiple “strip speeds” available on the EFM’s menu to fast-forward the simulation: 1:1, 1:10, 1:25 speeds are available.
  • Temporal smoothing implemented for obstetric rhythms: when you make changes to the “patient”, Infirmary smoothly transitions the changes into the future waveform drawings.

Device Audio (and Alarm improvements)

Improvements have also been made to the Cardiac Monitor, the Defibrillator, and the Intra-Aortic Balloon Pump simulators as well, mainly including audio enhancements!

  • Monitoring “beep” implemented for the Cardiac Monitor and the Defibrillator (sometimes called “anesthesia monitoring”)
    • Beeps a traditional tone on each heart beat, used to audibly keep track of heart rate and/or pulse oximetry in a busy environment
    • Can set to ECG mode: beeps on each QRS complex
    • Or can set to SpO2 mode: beeps on each SpO2 waveform and the tone changes depending on the SpO2 reading
    • Device alarms still sound in addition to the monitoring beep
  • Audio alarm for Intra-Aortic Balloon Pump’s augmentation alarm
    • A unique tone unmistakable among the cacophony of potential critical care alarms
  • Visual alarm improvement for Intra-Aortic Balloon Pump’s augmentation alarm


External Fetal Monitor (EFM) baseline tracing with moderate variability.
External Fetal Monitor (EFM) modeling early decelerations.
External Fetal Monitor (EFM) modeling accelerations.
Cardiac Monitor with options for audio monitoring via heart rate or pulse oximetry.

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