The Laerdal SUN (Simulation Users Network) Conference opened today at the San Diego Hilton on Mission Bay with a very realistic simulation of an emergency involving a pregnant female during an overseas deployment by U.S. Navy medical personnel.
Staff from the Naval Hospital at Camp Pendleton, a brand-new 500,000-sq. ft., 42 bed hospital and teaching facility in Oceanside, Calif., did an amazing job of mixing video footage with a complex baby delivery and post-birth resuscitation of the mother, who went into cardiac arrest after experiencing severe blood loss.
After a team of medical specialists from both Camp Pendleton and San Diego Naval Hospitals completed the 25-minute resuscitation, the entire team sat on stage and conducted a post-simulation critique ("hot wash") that was informative and educational. They then discussed the merits of realistic overseass deployment scenarios and how simulation has proved beneficial to both hospital and active duty medical teams.
Increasing Realism & Fidelity in Simulation with Medical Moulage
Eric Christianson, MBA, NREMT-P, from WakeMed Health and Hospitals in Raleigh, N.C., presented multiple ways to add realism into simulations and get true emotional responses from students and other participants. He spoke about how to add sights, sounds and smells to simulation—including tips like burning a steak ("bovine tissue") with a Carter icing knife.
WakeMed has a very robust internal and mobile simulation program and has conducted more than 6,000 simulations. Chistianson also noted that their SIM Center has also been used to find the cause of, and correct, in-hospital incidents or errors.
One case profiled involved hospital staff getting confused by various color-coded "Christmas tree" oxygen connectors that were being misplaced on oxygen and suction regulators located side-by-side on the wall. Simulations uncovered the problem, and the hospital was able to resolve the issue by using only clear "Christmas trees" going forward.
Christianson then discussed tips and tricks that simulation staff can use to ramp up the realism of their simulations:
- Charts should be real and complex;
- X-rays add real challenges;
- Real labs make a significant contribution to the experience;
- Whenever possible, use real medication containers/bottles;
- Expired medications or wrong dosages are also good to use to challenge students' thoroughness and critical thinking skills; and
- Realistic moulage is more important than many people/educators realize to help replicate the patient experience.
He concluded by showing a simulation that was "produced" by adding fake organs under an improvised chest made by using a spare Laerdal manikin chest plate that he cut in half and then sewed ("sutured") closed to simulate a post-open heart surgery patient.