Thursday, May 23, 2002

New simulator no dummy

Children's Hospital practicing for pediatric patients

By Tim Bonfield,
The Cincinnati Enquirer

        Call it the medical equivalent of a crash-test dummy.

        Cincinnati Children's Hospital Medical Center unveiled on Wednesday the nation's first “portable simulated pediatric patient.”

        This high-tech mannequin, made by Florida-based Medical Education Technologies Inc., is designed to simulate a 7-year-old boy suffering medical problems ranging from extreme allergic reactions and drug overdoses to critical injuries.

[photo] Anderson Township paramedics Chris Remington (left) and Chris Kasperczyk assess the simulator of a child in a medical crisis.
(Michael E. Keating photo)
| ZOOM |
        It breathes. It blinks. Its pupils can dilate. Its heart rate can change. Its tongue can swell. It can recognize and react to simulated medications. It can even talk with the assistance of a person using a remote microphone.

        All these features can be used to train doctors, nurses, paramedics and others.

        Hospital officials say the yet-to-be-named, $220,000 ""PediaSim” mannequin gives medical teams an opportunity to improve performance at no risk to human patients. Its portability also is expected to expand training for life squads and other “prehospital” personnel who rarely get to practice skills needed for helping children.

        “This far exceeds anything we've had in the past. It really gives a true-to-life imitation,” said Lt. Fred Buop, a paramedic with the Anderson Township fire department who participated in a demonstration at Children's Hospital in Corryville.

        Until now, trainees practiced CPR and intubation techniques on less sophisticated dummies that could not react to successful treatment — or to mistakes.

        “We used to have somebody say, "Now the patient has stoped breathing.' It was all verbal. With this, if you're not paying attention and watching the vital signs, the child will decompensate. And the child won't warn you,” Lt. Buop said.

        Be it in the field or in the hospital, the PediaSim can be programmed to mimic many sorts of health problems. Listen with a stethoscope to different points on the chest and a person can hear the sounds of a heart murmur or only one lung functioning. A pulse can be felt at various points on the wrist, feet and near the groin.

        Medications can be mimicked by injecting doses of saline into an IV line, with a bar code scanner reading the syringe to tell the computer what kind of drug was used. A strong dose of stimulant, for example, immediately causes the dummy's heartbeat to race along with changes in breathing patterns and pupil dilation.

        Dr. Mary Patterson, an emergency medicine physician at Children's Hospital, said the mannequin will be used to train medical students, new residents, nurses, respiratory therapists, paramedics and others.

        “Part of the problem in prehospital care is the lack of real cases to practice skills. About 10 percent of all EMS runs involve pediatric patients. And only about 5 percent of those actually need advanced life support,” Dr. Patterson said.

        Eventually, emergency medicine trainers at Children's Hospital would like to have two of the dummies, one that could be kept in the hospital and another that could be devoted to mobile training, Dr. Patterson said.

        The PediaSim device involves quite a bit more than a rubber-skinned dummy on a stretcher. The system includes three black cubes, each about three feet per side, that house computer controls, medical gases and hydraulic fluids that snake out to the dummy.

        Staff members say it takes about a half-hour to set up the system.

        Since developing its first, adult-sized simulator seven years ago, METI has sold about 250 of its advanced mannequins to medical schools and training centers worldwide. Of those, 60 are pediatric models.

        The one at Children's Hospital is the company's latest upgrade, its first fully portable pediatric device, said company chief executive Lou Oberndorf.

        In the aerospace industry, pilots-in-training spend far more time in simulators than real aircraft to learn how to respond to critical situations. Only recently has technology become advanced enough to attempt sophisticated simulator training in medical care, Mr. Oberndorf said.

        “This is very cutting-edge technology that is literally changing the way medicine is taught,” Mr. Oberndorf said.


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