Healthcare Simulation News - Winter 2012

2 healthcaresimulationnews.com WINTER 2012

Faulkner State Community College inFairhope, Alabama, USA begins itspatient simulations at the point of care,whether it is in a campus restroom oroutside on the grounds. Here, a team ofstudents transports the METI iStan.

“We get visitors from all around theworld,” says Dr. Feroze Mahmood, of theBeth Israel Deaconess Medical CenterTEE imaging simulation center. Feroze,director of Vascular Anesthesia andEchocardiography, is also conductingresearch on simulation training.

The upcoming HSPN 2012 conferencewill feature more than 100 sessions onhealthcare simulation learning as well asevents, keynotes, a product showcaseand training courses for healthcare edu-cators and professionals.

HEALTHCARE SIMULATION NEWS CONTENTS

3 USF ATHLETICS MEDICAL TEAM TRAINS WITHPATIENT SIMULATION

The University of South Florida’s Bulls gain a new player for oneafternoon as iStan simulates a football injury in the field.

4 THE METI CUP COMPETITION AT THE AIR MEDICALTRANSPORT CONFERENCE (AMTC)

Top Air Medical Transport teams from Canada and the U.S.competed in three intense critical care simulations in St. Louis,Missouri this fall. HSN speaks to judges about what’s behindthe METI Cup, and why they return year after year.

7 MILITARY SIMULATION TRAINING IN BUDAPEST,HUNGARY AND FORT POLK, USA

Medical first responders incorporated advanced patient simu-lation into training at the NATO Military Medicine Centre ofExcellence (MILMED COE) in Budapest and at the U.S. ArmyBase in Fort Polk, Louisiana.

8 BETH ISRAEL DEACONESS MEDICAL CENTEROPENS AN IMAGING SIMULATION CENTER

Dr. Feroze Mahmood trains residents, anesthesiologists andcardiologists from around the world in a high-tech ultrasoundsimulation center.

10 HPSN 2012 CONFERENCE PREVIEWSee who is presenting this February at HPSN 2012,

an international gathering of top innovators inhealthcare simulation.

14 ASIA PACIFIC SIMULATION IN NURSINGEDUCATION CONFERENCE WRAP

Malaysia’s Nilai University College and CAE Healthcare hosttheir first simulation in nursing education conference for educators and students.

15 HPSN EUROPE CONFERENCE WRAP-UPThe seventh annual conference covers obstetrics, nurs-

ing, debriefing, virtual reality and center operations through alens of the theme, “Assessment through Simulation.”

On the Cover: An interdisciplinary medicalresponse team treats a METI iStan patientsimulator with a football injury at theUniversity of South Florida. Photo providedcourtesy of USF Health.

Healthcare Simulation News is publishedquarterly by CAE Healthcare, with U.S. officesat 6300 Edgelake Drive, Sarasota, FL 34240.Telephone: (941) 377-5562. Send your feed-back or article ideas to Kim Cartlidge [email protected]. Copyright 2012 byCAE Healthcare. All rights reserved.

USF’s Dr. Micki Cuppett, associate professor and director of the Athletic

Training Education Program.

SIMULATION BRIEFS HEALTHCARE SIMULATION NEWS

s college football seasonwas gearing up in thefall, one University ofSouth Florida player

attracted a horde of reporters and camerasduring an afternoon practice. The iStanpatient simulator, dressed in a full footballuniform, suffered a rare but life-threateningspinal injury on the field. The entire sportsmedicine team responded.

USF conducts sports injury simulationswith its athletic training majors, but thiswas the first multi-disciplinary effort, withfaculty and staff from the Sports Medicineand Orthopaedic Department, USFAthletics, the Sports Medicine and AthleticRelated Trauma Institute (SMART), TampaFire Rescue and additional staff from the

University of Tampa, St. Leo University andthe Tampa Bay Buccaneers.

“They talked to each other for the firsttime about a scenario,” said Dr. MickiCuppett, director of the Athletic TrainingEducation Program at USF Health. “Thatwas impactful. They continued the conver-sation after the debriefing.”

Local media covered the scenario, evenrecording iStan’s vocal responses to physi-cian’s questions. Since that day, Cuppett hasreceived a number of requests from collegeand professional sports programs that wantto create similar training exercises.

Serious football injuries are rare, butCuppett’s team at USF now has a script and aresponse plan that could save a player’s life.

At left, Dr. DavidLeffers, chair ofOrthopaedics & SportsMedicine at USF, workswith athletic trainersand paramedics tomove the injured player. Below, USFHealth OrthopaedicSurgeon Dr. CharlesNofsinger listens forbreath sounds. Photoscourtesy of USF Health.

METI iStan TrainsSports Medicine Teamon the Football Field

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WINTER 2012 healthcaresimulationnews.com 3

two-member air medical crew (AMC) prepares in the back of a helicopter en route to a sending facility,getting ready to treat a young woman who is 26 weeks pregnant and in active labor--or so they think!The pilot radios back that he is experiencing chest pain and can no longer pilot the aircraft, and the hel-icopter makes a hard landing. The crew members are injured, one with a broken arm and one with hear-

ing loss due to the crash. The pilot has an impalement injury, a closed head injury, and a broken pelvis, and is alsosuffering from an acute heart attack. They must work through their own injuries to save his life.

This was the final, 2011 METI Cup competition scenario at the Air Medical Transport Conference in St. Louis,Missouri. Three teams were given half an hour each to assess and treat the pilot, who was played by a METIman®high fidelity patient simulator. The scenario was made to feel as realistic as possible, with one competitor wearingan immobilizing arm sling and the other wearing a sound-blocking headset as they raced to save the pilot.

The METI Cup: Competition With a Learning Edge

HEALTHCARE SIMULATION NEWS THE METI CUP


A Joshua Granada and Carlos Tavarez of the Orlando MedicalInstitute crew compete in the final round.

THE METI CUP HEALTHCARE SIMULATION NEWS


Chief Judge Peter Gant, who isan emergency physician andCanadian-based Shock Trauma AirRescue Society (STARS) flight physi-cian, helped to create the METI Cupscenario based on his field experi-ence. “There’s a little bit of theatrics,because so many people arewatching, but in reality, having ahard landing is very possible, and ithappens not infrequently in theNorth American air medical trans-port industry. You may be injuredand have to take care of an injuredperson,” says Gant.

Air medical crews are oftencalled to treat critically ill or injuredpatients who need rapid transport,and they may travel by more thanone mode with a patient: fixedwing, rotary wing and ground.“Typically the level of acuity is high-er,” says METI Cup Judge Kelly Cox,senior director of Air Evac EMS, thelargest privately held air medicaltransport organization in theUnited States, “and the requestinghospital or ground service hasidentified that air can provide ahigher level of care.”

The annual METI Cup compe-tition is the largest and most chal-lenging skills contest for AMCs,drawing top competitors fromthroughout North America. Thecompetitive scenarios are based onreal cases and played out on METIadult and pediatric patient simula-tors, which emulate physiologicalresponses automatically.

Sherry Gauthier, STARS, 2011 METI Cup WinnerFor us, it involved endless hours studying, knowing our protocols and being critiqued and evaluated.

I definitely gained confidence in my knowledge and my performance as a flight nurse.”

Dave Allison, STARS, 2011 METI Cup Winner“Preparing for this has certainly helped me as a practitioner. Personally, the whole experience has been

amazing and grueling. Having the opportunity to represent our organization, meet some great people, anddo some traveling more than made up for the hard work involved.”

At top left, STARS team Sherry Gauthier and Dave Allison compete in the final round.Top right, transporting the gunshot wound patient in round two. Above, University ofMichigan Survival Flight finalists Mike Chesney and Joetta Vamos.

Dave Allison and SherryGauthier and of the STARSteam won the 2011 METI Cup.

Eleven, two-person air medical crews from Metro LifeFlight, University of Michigan Survival Flight, STARS,Native Air — Omniflight, University of MississippiMedical Center Aircare, Life Force Air Medical, Air Careand Mobile Care — University of Cincinnati, CarilionClinic, Orlando Medical Institute, Lifeflight of Maine andMedflight competed in the 2011 METI Cup at AMTC.

n the adult case, competitors were judged in part onhow quickly they could conclude that the gunshotwound was superficial and move on to treating the over-dose. “What we do is try to build cases that are broader

than the best people that come to this competition, that are going totake the best team the full time to solve what needs to be solved. It’stough because these teams are good!” Gant says.

The METI Cup final rounds always draw crowds to watch the bestof the best compete. The challenging scenarios generate talk andexcitement at AMTC. But the long-term benefit, say Gant and Cox, isthe learning that the teams put into practice every day.

Top teams often spend hours of their own time honing their skillsin preparation for the METI Cup. “While they are training, they are usingtheir colleagues at their base and discussing trauma cases,” says Cox. “Ithink the value of the crew’s training grows exponentially at the base,through the number of people who will become better cliniciansbecause of that one crew competing.”

Gant would like to see 20 teams compete next year. The moreteams who are studying, practicing and competing locally and region-ally to win a spot in the METI Cup competitions, the higher the level ofcare they are providing their patients. “It warms my heart to watchthese crews compete at their peak performance. You know they aretaking that level of care out into the field every day,” says Gant. “Thatis where the real difference is made.”

“We are unique in that we force the competitors to use the sim-ulator as found,” says Cox. “We try to use the mannequins to thefullest, so we don’t give them information that the mannequins cangive them.”

Both STARS and Air Evac incorporate simulation into their ongo-ing team training. “Simulation has been an absolute building block inour organization for the past ten years,” Gant says. “When a teamcomes back from a mission, if they had trouble with something, wecan go down to the sim room and go through it and practice. Ourcrews have to do a certain number of sim sessions each quarter.”

At the 2011 METI Cup, the eleven competing teams started offwith a pediatric simulation in which an eight-year-old presented withdiabetic ketoacidosis (DKA) and persistent vomiting which hadcaused significant hypokalemia. Each team had 20 minutes to assessand treat the child. “The ringer was that he had three days of vomitingand his potassium was very low. Every therapy we administer for DKAlowers potassium further, so the AMC had to manage a sick, hypoten-sive child who was in need of airway management, and they had totreat the potassium before the other therapies for DKA,” says Gant.

The second scenario took place in a remote site where a man hadintentionally shot himself. There was alcohol on the scene, and whilethe gunshot wound was superficial, the man was hypotensive butalso inappropriately bradycardic. A thorough check of the scene andthe patient would reveal the prescription bottle (in his pocket), whichconfirmed the drug Propranolol. The team had to deduce that he hada non-life threatening gunshot wound, had likely overdosed and hada toxic bradycardia.

“An overdose on beta blockers is difficult to deal with,these patients are very sick,” says Gant. “There are a seriesof usual therapies to try, and some new effective therapiesincluding the administration of high dose insulin.”

Each scenario attempts to incorporate current treat-ments and new practices to see whether or not the teamsare keeping up with literature and mastering new skills.The scenarios also require deductive reasoning. “Each caseis designed to force the AMC out of the envelope of nor-mal thinking,” says Gant.

The 2012 METI Cup will take place at theAir Medical Transport Conference in Seattle, Washington October 22-24, 2012.


I


MILITARY MEDICAL SIMULATION HEALTHCARE SIMULATION NEWS

✱In October, CAE Healthcare helped NATO introduce human patient simulationinto the First Responders Trainer Training (FRTT) course in Budapest, Hungary.The pilot course was hosted by the NATO Military Medicine Centre of Excellence(MILMED COE) in Budapest, which provides medical courses and training toNATO participating countries. Twelve experienced NATO medical instructors fromGermany, Holland, Hungary and Bulgaria worked in small syndicates using a Caesar™trauma patient simulator to perform advanced first aid, including practical usageof tourniquets, bandages and chest needle decompression.

CAE CAESAR SIMULATES BATTLEFIELD TRAUMA IN NATO TRAINING COURSE

Military Medical Simulation MEDICAL TRAUMA SIMULATION TRAININGAT FORT POLK ARMY BASEIn August, the U.S. Army’s Fort Polk, LouisianaArmy Base was the site of two days of medicaltrauma simulation training for soldiers prior torotation into “the box” at the Joint ReadinessTraining Center (JRTC). Soldiers from theMedical Exercise Support Battalion (MESB) andCombat Support Hospital (CSH) ran METI iStanand METIman patient simulators in the CSH’semergency room, operating room, andthroughout other sections of the hospital. Thesimulators were on loan from the 162ndInfantry Brigade stationed at Fort Polk, andtheir Tiger Medical Training Facility instructorsprovided the realistic training. The purpose ofthe exercise was to prepare the CSH for theirJRTC rotation and possible future deployment.

The Army’s Joint Readiness TrainingCenter is focused on improving unit readinessby providing highly realistic, stressful, jointand combined arms training across the fullspectrum of conflict. The JRTC training sce-nario is based on each participating organiza-tion’s mission essential tasks list, and many ofthe exercises are mission rehearsals for actualoperations the organization is scheduled toconduct. These exercises replicate both com-bat scenarios and unique challenges the inte-grated military services may face in combat,including interaction with insurgents, non-governmental organizations, the media andcivilians.

Imaging Simulation at Beth IsraelDeaconess Medical Center

hile the current wave inhealthcare simulation isto create complex, mul-tidisciplinary scenariosfor team training, onedepartment at HarvardUniversity’s teaching

hospital is taking an alternate, highly spe-cialized approach.

Beth Israel Deaconess Medical Centermay have the only simulation center that isdevoted solely to echocardiography train-ing for cardiologists and anesthesiologists.

Dr. Feroze Mahmood, Director ofVascular Anesthesia and Echocardiographyat Beth Israel Deaconess, trains residents on

how to conduct and interpret the transtho-racic (TTE) and transesophageal (TEE) ultra-sound examinations in the offices of theanesthesiology department, adjacent tothe OR.

“This is a one-of-its-kind TEE simula-tion center,” Feroze says. “We get visitorsfrom all around the world.”

The imaging simulation center is sep-arate from the Carl J. Shapiro Simulationand Skills Center, which serves the entiremedical center and opened in 2006. BethIsrael Deaconess has invested about $1 mil-lion in simulators and state-of-the-art com-puters for its imaging simulation center,which opened in 2008.

HEALTHCARE SIMULATION NEWS Beth Israel Deaconess


Dr. Feroze Mahmood, director ofVascular Anesthesia and Echocar-diography at Beth Israel DeaconessMedical Center, trains a residentwith the CAE VIMEDIX ultrasoundsimulator. W

being involved in the decision-making process,” says Mahmood.

At Beth Israel Deaconess,resident cardiologists and anes-thesiologists train twice weeklyin sessions that last 2-3 hourseach. The center also offers one-week intensives to outside physi-cians, and those sessions arebooked a year out. “With simula-tors, we can also train them inwhat normal and abnormallooks like,” says Mahmood.

As they teach, Mahmoodand his associates are studyingthe effectiveness of the training,and how many hours of simula-tion are required to gain TEE pro-ficiency. Each learner takes abaseline test and subsequenttests after each session.

Dr. Mahmood conducts thetests on the two CAE VIMEDIX™ultrasound simulators, whichstore learner data and enableinstructors to tailor their ap-proach to each resident.

Mahmood says, “The met-rics enable our researchers to seehow a student got to an answer.We know which images the

trainees are taking a long time toacquire. Some images are uni-versally challenging, and someare specific to the trainer.”

With practice, a learner’shand movements becomesmoother and more meaningfulas his or her speed increases,Mahmood says.

In the future, he would liketo take the TEE exam training astep further by developing com-plete patient scenarios.

“We want to build scenar-ios, such as severe mitral regurgi-tation, a valve problem,” saysMahmood. “We would expectthe trainee to go through asequential evaluation, to per-form linear measurements andDoppler calculation and comeup with a diagnosis.”

Dr. Feroze Mahmood willpresent a session on TEE imag-ing for anesthesiologists at theHSPN 2012 conference inTampa, Florida this comingFebruary 28-March 1. Find moreinformation about the confer-ence and presenters beginningon page 10.

Anesthesiologists beganusing (TEE) imaging during sur-geries in the mid-1990s, whenthe American Society ofAnesthesiologists first estab-lished guidelines for the practice.“It has gradually become anincredible monitoring modalityin the operating room, particu-larly for congenital heart surgery,valve replacement and lifethreatening situations,” saysMahmood.

“The TEE has become astandard of care in cardiac sur-gery,” Mahmood says. “Cardio-logists call it a road map to valverepair.”

During surgery, anesthesiol-ogists use the TEE to provideinformation about heart valvestructure and function, aboutwhen to wean the patient off thecardiopulmonary bypass ma-chine, and even about the suc-cess or failure of the procedure.

“We have become the eyesand ears of cardiac surgeons,and incisions have becomesmaller and smaller. Our role hasevolved from bystanders to


Beth Israel Deaconess HEALTHCARE SIMULATION NEWS

Dr. Feroze Mahmood Delivers Specialized Training to Residents, Anesthesiologists and Cardiologists

✱“This is a one-of-its-kind TEEsimulation center,” Dr. FerozeMahmood says. “We get visitorsfrom all around the world. TheTEE has become a standard ofcare in cardiac surgery, Cardiologists call it a road mapto valve repair.”

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Coming Up: HPSN 2012 Conference

HEALTHCARE SIMULATION NEWS HPSN 2012 CONFERENCE

This February, top simulation experts, educators, practitioners and students will gather inTampa, Florida for one of the largest annual healthcare simulation conferences in the world.HPSN features three days of training courses, educational sessions, keynote speakers and net-working. We spoke to a few of the educators about their upcoming presentations.

✱CAE HEALTHCARE TOSHOWCASE NEW PRODUCTS,EXPANDED SIMULATIONSOLUTIONS

HPSN 2012 attendees willget the first look at CAEHealthcare’s expanded line ofsimulation solutions and be ableto preview products that arecoming soon, including the firsthigh-fidelity birthing simulator.Here are a few highlights:

CAE Caesar™, the wireless,rugged patient simulator thatwas created for point-of-carefield training, will be operatingand on display in the productshowcase. Caesar is waterproofand has fully articulated joints aswell as advanced responses totreatments.

VIMEDIX™ is the ultrasoundsimulator for the thoracic andabdominal regions, and the onlysimulator offering the TEE, TTE,FAST and FOCUS exams on oneplatform. With a realistic man-nequin, a split screen with theultrasound view on one side anda 3D view of the anatomy on theother, and more than 50pathologies, VIMEDIX offers rapidmastery of ultrasound assess-ment.

The METI HPS, the goldstandard patient simulator withtrue oxygen and CO2 exchange,is now easier to operate with theMüse touchscreen interface. TheMüse interface allows more flex-ibility in programming the HPSphysiology without sacrificingthe advanced, realistic modeling.

When architect Malvin Whang ofHarley Ellis Devereaux beganplanning the new simulationcenter for the University ofCalifornia in San Francisco, hefaced a few challenges.

The simulation center wasto be carved into existing spaceon the second floor ofKalmanovitz library, which hadto remain fully operational dur-ing construction. The center hadto function as a multidisciplinarytraining hub for medicine, nurs-ing, dentistry a nd pharmacy stu-dents in one setting.

Whang and the project man-

agers will present a case studyof the project at HPSN 2012.“How do you get a simulationcenter from an idea to comple-tion? We divide it into threephases—planning, design andbuilding,” says Whang.

“People tend to think aboutthe design issues too early andstart designing before theystart planning,” Whang adds.“You have to understand whatyour curriculum and opera-tional needs are and what yourvision is first. You need that as aroad map.”

“Point-of-care ultrasound, also known as bedside ultrasound, is beingdescribed as the stethoscope of the future,” says Dr. Robert Amyot, cardi-ologist with Hôpital du Sacré-Coeur de Montréal and director of ultra-sound simulation products for CAE Healthcare. “For some organs andsome situations, it’s better than a manual physical exam.”

While cardiologists, radiologists and ob-gyns have relied on ultra-sound for decades, the use of imaging technology is now exploding


✱BUILDING A SIMULATION CENTER: AN ARCHITECT’S PERSPECTIVE

among non-traditional users,including paramedics, anesthesi-ologists, surgeons, intensivistsand even pediatricians, who canscan bones for fractures.

For example, the traditionalFAST (Focused Assessment withSonography for Trauma) exam,which scans for abdominal fluidin trauma patients, is a key triagetool in emergency rooms today.

“The TEE (transesophageal)exam is being used more andmore in the operating room,” saysAmyot. “Anesthesiolgists areembracing ultrasound to moni-tor high-risk patients.”

Medical schools in theUnited States are beginning toteach their first-year students toread and interpret ultrasound,which indicates that tomorrow’sphysicians will be proficient wellbefore they become residents,Amyot says.

This explosive growth inultrasound imaging productsand their applications has result-ed in a demand for educationand training. “The accuracy ofultrasound imaging is very oper-ator-dependent, so training iskey,” Amyot says.

Amyot will present "Point ofCare Ultrasound: TechnologySpreading Faster Than Exper-tise?” and the VIMEDIX ultra-sound simulator, at the HPSN2012 conference. The sessionswill be hands-on, offering atten-dees the opportunity simulatetransesophageal, transthoracic,abdominal and pelvic exams onthe VIMEDIX mannequin.

PHYSICIANS’ USE OF THE STETHOSCOPE OF THE FUTURE GROWING EXPONENTIALLY

✱ing tube is connected to airinstead of oxygen, and he hasbeen given the wrong medication,which has caused his confusion.

Dawn Schocken, DirectorCenter for Advanced ClinicalLearning at USF Health, createdthis patient safety simulation toencourage more thorough andhands-on training in hospitalsafety. “In the past, we haven’texplicitly taught this to medicalstudents. We teach it implicitly,but it’s not in a format that can

predict student’s response on thehospital floor,” Schocken says.

The simulation is based onprotocols put out by the Institutefor Healthcare Improvement(www.ihi.org). The aim is to beginteaching the culture of patientsafety early, instead of once a stu-dent becomes a resident or aftera negative event.

Schocken is following agroup of third-year students tofind out if the early exposure tosafety protocols translates to

HPSN 2012 CONFERENCE HEALTHCARE SIMULATION NEWS

FALL 2011 healthcaresimulationnews.com 11

At the University of South Floridain Tampa, medical students entera simulated hospital room wherean elderly patient with a urinarytract infection has rung for assis-tance to get to the bathroom. Hisanxious spouse stands at his bed-side. The man is confused, andthe room is rigged with morethan two dozen safety violations.

For example, the patient’sbed was raised earlier in the dayto draw blood, and it hasn’t beenlowered back down. His breath-

increased awareness andadvocacy when they becomeresidents. At the HPSN 2012 conference,Schocken will invite educatorsand clinicians to spot safety vio-lations in a simulated patientroom, and then help the partic-ipants build their own teachingscenarios to take back to theirinstitutions.


Air Force veteran and patient safety advo-cate John Nance, author of Why HospitalsShould Fly, will deliver a keynote address atthe HPSN 2012 conference in Tampa, FloridaFebruary 28-March 1.

A founding member of the NationalPatient Safety Foundation, Nance is an inter-nationally recognized broadcast analyst andadvocate for both medical safety and avia-tion safety. He is also a decorated Air Forcepilot and veteran of Vietnam, OperationDesert Storm and Operation Desert Shield.

Nance is known as a civilian pioneer increw resource management, which incor-porates communications, situationalawareness, problem solving, decision-mak-ing, and teamwork in order to promotesafety and efficiency.

In Why Hospitals Should Fly — TheUltimate Flight Plan to Patient Safety andQuality Care, Nance offers a new paradigmof patient-centered care. The book won theAmerican College of Healthcare Executives2009 Book of the Year Award.

“So what does it take to dramatically improve patient safety and service quality? It takesa host of new and different (and sometimes radical) methods centered on supporting thepeople on the front lines – those who actually take care of the patient.”

Why Hospitals Should Fly Author John Nance to Keynote HPSN 2012

Excerpt from Why Hospitals Should Fly by Author John Nance

✱

The 2012 METI Awards for Best Healthcare Simulation Video

Share your video and showcaseyour institution online! Winners will be selected by a popular vote of our

YouTube audience.

The winning videos will be shown at

the HPSN2012 conferenceSubmission deadline is

January 31, 2012Learn more at hpsn.

Take the Challenge!

We are still acceptingEMS nursing teams.

Learn more at hpsn.com

DON’T MISS THE FREE HPSN 2012 CONFERENCE FEBRUARY 28-MARCH 1 IN TAMPA, FLORIDA. REGISTER TODAY AT HPSN.COM

USF HEALTH: TEACHING MEDICAL STUDENTS TO SPOT PATIENT SAFETY ERRORS

HPSN2012

HEALTHCARE SIMULATION NEWS HSPN 2012 CONFERENCE


Malignant hyperthermia is a rarebut potentially deadly scenariothat can occur when a patient isanesthetized. Due to a geneticpredisposition or medical condi-tion, a patient may react to anes-thesia with a rapid rise in heartrate (tachycardia) and body tem-perature along with muscle rigid-ity. Complications can includecardiac arrest, brain or organdamage and death.

John Davanzo, director ofemergency and critical care serv-ices for St. Joseph MercyLivingston Hospital in Michigan,created a simulated malignanthyperthermia scenario with aMETI iStan patient simulator atthe request of the operatingroom staff. He and his team,which includes Critical CareEducator Amy Heeg andEmergency Medicine EducatorTeresa Rutt, have run the scenarioin several of the St. Joseph’s hos-pital system operating rooms.

“The scenario begins withthe team doing an induction,and the malignant hyperther-mia quickly follows,” Davanzosays. “There are specialized med-ications you give and protocolsyou follow. Catching the early✱COLLIN COLLEGE TEACHES

INTERDISCIPLINARYTEAMS HOW TO SURVIVETHE GOLDEN HOUR“The ‘Golden Hour’ is some-thing all EMS students aretaught,” says Jackie Langford,Director of Healthcare Simu-lation for Collin College in

McKinney, Texas. “It starts fromthe time the emergency inci-dent begins. For the bestchance to survive, the patientneeds to be rolling into theoperating room within an hour.”

Collin College has createdan interdisciplinary GoldenHour simulation that incorpo-rates EMS, nursing, respiratoryand surgical students. “Whenthey come in, they hit the floorrunning,” Langford says. “Thestudents can practice whatthey do and get to know whatthe other disciplines do.”

Langford plans to demon-strate the scenario at the HPSN2012 conference with eightstudents from Collin College.and a METIman simulator.

signs and symptoms, the risingCO2 and rising body tempera-ture, is really critical to havingthe protocols work.”

The protocols include admin-istering dantrolene, cooling thepatient down, and bringing thepatient out of anesthesia.“Dantrolene does not exist in theiStan medication library, so wehave created states that simulatewhat will happen if they givedantrolene,” Davanzo says.

“The first time we ran it, mytwo educators called me andsaid ‘it’s not working.’ I wentover iStan top to bottom, and aswe ran through it, we discov-ered that nobody had actuallyturned on the ventilatorbecause we had never had atraining mannequin that couldaccept a ventilator,” saysDavanzo. “It was such a perfectconfirmation of what we usesimulation for.”

Davanzo will present thescenario with iStan at the HPSNconference for OR, emergencyand anesthesia practitioners. “ I tis one of those high-risk, low-inci-dence kind of events whichmakes it even more important topractice,” Davanzo says.

✱pitals triaged the mock casual-ties amid the bustle of their fullyoperating emergency rooms.

Both human patient actorsand three patient simulators,including two METI iStans and aMETI Pediatric ECS, sufferedburns and blast injuries, includ-ing blast lung caused by theshock of the explosion.

Streck will present a casestudy of the chemistry lab disas-ter drill with a focus on the year-long planning process and logis-tics at the HPSN 2012 conference.

DARTMOUTH-HITCHCOCKMEDICAL CENTER: MASSCASUALTY DISASTER DRILLINVOLVES ENTIRE NEWHAMPSHIRE COMMUNITYIn September of 2011, the com-munity of Lebanon, New Hamp-shire simulated a high schoolchemistry lab explosion thatinvolved four hospitals, the Cityof Lebanon police and firedepartments, Golden CrossAmbulance Service and theentire student and faculty ofLebanon High School.

“We wanted to test theemergency and disaster drillplans and the decontaminationequipment,” says Gene Streck,simulation tech for Dartmouth-Hitchcock Medical Center. “Theschool principal wanted to testthe school’s emergency evacua-tion plan.”

The students, who wereunaware the drill was coming,had to be evacuated across afive-lane state road to a NationalGuard Armory, while local hos-

ST. JOSEPH HOSPITAL SYSTEM CREATES MALIGNANTHYPERTHERMIA SCENARIO FOR OPERATING ROOM

trauma moulage courses atHPSN 2012. For a fee of $175,learners will be able to sign upfor two courses and take hometheir created wounds, moulageboard and matching apron.

The beginner course willcover bruise staging, sputum,swollen lymph nodes, coffeeground emesis, wound strike-through, jugular vein distention,rashes and an i ntroduction tomoulage gels.

In the intermediate andadvanced courses, moulagedesigners will work with gels,

waxes and latex to create ahematoma, infiltrated IVs, asutured, post-op incision with anodorous infection discharge, anda JP drain. The trauma course willcover burns, deep lacerations,knife wounds and impaledobjects.

“We won’t actually put thesmells together because they arefairly lingering, but we will offerthat in the accessory moulagepiece of it,” Merica says.

Bobbie Merica will teachmedical moulage courses at HPSN2012 on February 28 and 29.

HSPN 2012 CONFERENCE HEALTHCARE SIMULATION NEWS


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MEDICAL MOULAGE:ADDING SENSORY CUES TO SIMULATION“Healthcare is a very sensory pro-fession: it’s what you see, smell,feel and hear,” says Bobbie Merica,founder of Moulage Concepts inChico, California. “Medical mou- -lage bridges the gap betweenreality and simulation.”

Medical Moulage, the art ofcreating and applying simulatedwounds for learning purposes, isa vital part of simulation in a vari-ety of healthcare fields. The real-istic-appearing wounds, fluidsand smells help learners assessand diagnose a practice patient.

“Your moulage tells a story,”Merica says. “It’s important that ittells the correct story, or it maysend learners down a path thatleads them away from scenarioobjectives.”

Merica creates moulagewounds from moulage gels,waxes, latex, and common prod-ucts you might find on a kitchenshelf. She has published a book,“Medical Moulage: How to MakeYour Simulations Come Alive,”which includes step-by-stepinstructions.

For example, when moulag-ing human patient simulators,cream-based cosmetics shouldnot be used without proper bar-riers. “Simulator skin is permeable,so I tell my classes it’s onlygroundbreaking if it comes backoff,” Merica says.

Merica will teach beginner,intermediate, advanced and

Research has demonstrated that the use ofultrasound to guide central line insertion inpatients reduces odds of infection and pre-vents complications. Central line placementis an essential technique in hospitals, mostoften used to administer medications, fluids,IV therapies, dialysis and for blood pressuremonitoring. As hospitals strive to reduceinfection rates, the practice of ultrasound-guided central line placement is growing.

Dr. Yanick Beaulieu, a cardiologist atHôpital Sacré-Coeur de Montréal and anassistant professor at University of Montreal,is an advocate of ultrasound guided centralline insertion for improved patient safety. Heis also the original developer of the web-

based CAE ICCU imaging training solutionand director of ultrasound education at CAEHealthcare.

Beaulieu is currently conductingresearch at the University of Montreal onthe use of a blended curriculum of e-learn-ing and hands-on simulation to teach med-ical residents ultrasound-guided centralline insertion and thoracentesis.

Beaulieu will present the blended cur-riculum and its benefits in relation to tradi-tional apprenticeship training at HPSN 2012.“There is a big clinical need for goal-directed,high-quality training,” says Beaulieu.“Simulation has a major impact on improvingpatient care and improves outcomes.”

MEDICAL RESIDENTS GAIN PROFICIENCY IN ULTRASOUND-GUIDEDCENTRAL LINE INSERTION THROUGH SIMULATION

✱DON’T MISS THE FREE HPSN2012 CONFERENCE FEBRUARY 28-MARCH 1 IN TAMPA, FLORIDA. REGISTER TODAY AT HPSN.COM

In October, 300 nurses from Asia and the United Kingdomcame together to participate in the First Annual Asia PacificSimulation in Nursing Education Conference hosted by NilaiUniversity College (NUC) in Malaysia with support by KinetikEdar and CAE Healthcare. The conference theme was“Engaging Learners to be Great Learners.”

The conference was opened in dramatic fashionwith the NUC Chinese Drummers who ensured that the dele-gates were wide awake to enjoy and actively participate in theconference! Mike Bernstein, president of CAE Healthcarebegan the day talking about simulation education and the his-tory of METI and CAE Healthcare before Madam Subramaniam

(NUC) roused the whole audience with her keynote suggesting that students could under-take some of their clinical hours in a simulated practice environment.

Following lunch, Professor Yamuchi (Nagoya University) focused on the quality aspectof simulation education before Amanda Wilford (CAE Healthcare) and Peevee Lacandola (StJudes’ College) led an interactive session focusing on using this technology for educatinglarge numbers of students, which included an ethical dilemma. The first day concluded witha conference dinner and entertainment provided by NUC students who performed a selec-tion of traditional and modern Malay singing and dancing.

Professor Donna Mead OBE (University of Glamorgan) opened the second day by

HEALTHCARE SIMULATION NEWS ASIA PACIFIC CONFERENCE WRAP-UP


✱Conference Wrap-Up Report:

FIRST ANNUAL ASIA PACIFIC SIMULATION IN NURSING EDUCATION CONFERENCE

exploring how you can use simula-tion as an effective educationalapproach. Following this, the dele-gates attended concurrent sessionsthat focused on many differingaspects of simulation ranging frompregnancy in cardiac arrest, mentalhealth, calculating medications andteaching learners to recognize a pul-monary embolus for example.

A Nursing METI Cup concludedthe conference with four teams com-peting. The team from SEGI College,Malaysia triumphed although all theteams gave excellent care to thepatient! Thank-you to Nilai UniversityCollege for hosting this event withsupport from Kinetik Edar.

By Amanda Wilford, manager ofinternational services, nursing andallied health for CAE Healthcare.

Above at left, Professor Donna Mead OBE and Madam Gnaneswari Subramaniam, head of theNilai University College Nursing Department, presented keynotes at the conference. Above,Marco Grit, Gary Eves, Madam Gnaneswari Subramaniam, Mike Bernstein, Dr. Chia Chee Fen(NUC Deputy President), Aminudin Jali (MD, Kinetik Edar), and Amanda Wilford.

HPSN Europe ConferenceASSESSMENT THROUGH SIMULATION

EVENTS CALENDAR HEALTHCARE


In November, CAE Healthcare hosted its seventh HPSN Europemedical simulation and education conference in Mainz,Germany. Bengt Littke, senior advisor with Gripen Marketing,Saab Aeronautics in Sweden, delivered a keynote address on

the use of simulators in military aviation. Jan-Joost Rethans, an associate professorwith the Maastricht University faculty of Health Medicine and Life Sciences, presenteda keynote lecture on standardized patients. The third keynote speaker, Dr. AndrewMcIndoe, consultant anesthetist at University Hospitals Bristol NHS Foundation Trust,spoke on using simulators to perform high stakes assessments. The workshop presen-ters covered a range of themes, including obstetrics, modeling, debriefing, virtual real-ity, center operations, and nursing.

✱

CONFERENCE HEALTHCARE SIMULATION NEWS

Above top, CAE Healthcare's Dr. Stefan Mönkdemonstrates the physiological model inMüse software.

Above, middle, conference attendees and theMETIman patient simulator.

At left, the CAE Healthcare organization teamfrom Germany pictured from left to right:Petra Trinker, Maxim Werle, Marco Luff,Kiriakos Samiotakis, Christoph Sossna,Markus Zimmermann and Sylvia Franz.

Jan-Joost Rethans fromMaastrict University deliversa keynote lecture.

CAE Healthcare Europe, Middle East, Africa andIndia team with distributors from Portugal,Hungary, France, Turkey, Spain, Poland, Romania,Russia, India, Austria and Saudi Arabia.

SAVE THE DATE! The HSPN Europe 2012 conference will take placeNovember 8-10, 2012.

Visit hpsn.com for information.

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PERMIT #1

MANASOTA, FL

Last HPSN Conference in Tampa, Florida!

■ NEW LEARNING TRACKS—choose from more than 100 hands-on sessions and training courses with new tracks for imaging and EMS.

■ New Products—see trauma patient CAE Caesar™, the METI HPS® with Müse, the CAE VIMEDIX™ ultrasound simulator, the surgical simulation line and more.

■ Exciting Events—enjoy The METI Cup Competition, The METI Video Awards, a welcome reception and networking opportunities.

■ Live Action—witness live, simulated scenarios as instructors train and debrief real students.

HPSN 2012February 28-March 1, 2012Tampa Marriott Waterside HotelRegister today at hpsn.com

Expect the unexpected at an all-new, CAE Healthcare HPSN conference.

© 2012 348- 1211

Healthcare simulation in the sunshine. What could be more inspiring? Join us for the last HPSN(Human Patient Simulation Network) conference on Florida's west coast. The conference is free!

Healthcare Simulation News - Winter 2012

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