Shroud-like Patient Simulator

[David Morris]

http://anesthesia.stanford.edu/VASimulator/sim.htm

The MedSim-Eagle Patient Simulator is a state-of-the-art realistic, hands-on 
simulator of the anesthetized or critically ill patient. A "hands-on" 
simulator is one in which the clinical environment and the patient are 
represented as real physical objects. A specially instrumented patient 
mannequin stands in for the patient, and real clinical equipment is used to 
make up the work environment.

The mannequin is based on a commercially available medical training patient 
mannequin. This mannequin supports many clinical activities. Complete airway 
management can be practiced including mask ventilation, endotracheal and 
endobronchial intubation, cricothyrotomy and transtracheal jet ventilation. 
The airway can be made "difficult" in several ways including changes in the 
neck/head alignment, incorporation of an intrapharyngeal mass, and 
laryngospasm. Other clinical features supported by the mannequin include 
ability to placeme of peripheral and central intravenous lines, a thumb that 
can be stimulated by real clinical nerve stimulators (and responds 
appropriately depending on what drugs have been given), palpable radial and 
carotid pulses, heart sounds and breath sounds. ECG leads place at 
appropriate electrode locations pick up the mannequin's electrocardiogram.

The mannequin's electromechanical computer controlled lungs are embedded in 
its chest (just like a person) and breathe spontaneously as well as by hand 
or mechanical ventilation. Lung mechanics can be adjusted by the computer in 
real time as appropriate. Incoming gases are detected and quantitated and 
their concentrations fed to the physiologic and pharmacologic computer 
models. The gases actually ventilate the mannequin, which itself produces 
CO2 (as determined by the mathematical models of metabolism and the 
circulation) which is expired by the lungs. Thus, any respiratory gas 
analyzer can be used to physically quantitate inspired and expired gases.

Drugs must be injected into working IV lines. We like to say "there are no 
magic drugs in the simulator -- you have to actually draw them up and give 
them". Their identity is input to the to the computer by the instructor. A 
standard anesthesia drug/supplies cart is in the simulator OR


[some features:]

Computer-controlled eyes. Eyes open and close and eye reflexes respond to 
stimulus.

Arm movement. Arm moves in response to stimulus when patient is not 
paralized .

Arm/Leg swelling. Arm and Leg can swell to simulate trauma.

Drug Editor. Allows user customization of drug default names, 
concentrations, pharmacokinetics, and pharmacodynamics.

More complete airway management training head and neck. Allows use of LMA, 
Combitube, and transtracheal jet ventilation or cricothyrotomy.

Better breath sounds and heart sounds.

Built-in gas analyzer. Allows automated quantitation of inspired gases and 
better servo control of VCO2.

Improved patient editor and library of pre-defined "abnormal" patients. 
Generic events can be customized to trigger and resolve by predefined 
clinical intervensions and rare events can be easily programmed.

New arrhythmias supported. (e.g. A Fib, A Flutter, Mobitz type II 2nd degree 
block)




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