ZADP  team  members  started  simulation  sessions  with  the  anaesthesia  MMeds  several  years  ago.  Zambia  Emergency  Simulation  Training  (ZEST),  as  it  was  termed,  has  continued  intermittently  since  then.    

During  the  current  major  haemorrhage  and  transfusion  project,  our  team  were  tasked  with  providing  multi-­‐disciplinary  in  situ  simulation  on  major  haemorrhage.  This  was  to  identify  system  issues  that  were  influencing  management  of  major  haemorrhage,  and  for  staff  education.      

One  challenge  we  were  faced  with  was  the  lack  of  equipment  to  provide  fidelity  in  simulation.  We  had  access  to  basic  mannikins,  but  no  dedicated  monitoring  system  to  display  vital  signs  of  the  ‘patient’  during  simulation.  We  initially  used  a  free  software  application  for  PC.    This  was  complicated  and  did  not  work  particularly  well,  prompting  us  to  look  for  another  solution.  

One  such  idea  was  to  use  software  that  was  available  cheaply  for  iPad.  We  would  also  need  some  way  to  secure  the  iPad,  to  protect  it  and  stop  it  from  ‘walking’!  

Stripping  out  the  old  monitor  and  mounting  the  iPad  

 

 

Major  Haemorrhage  simulation  in  Phase  3  operating  theatres  

 

Emmanuel  Mwale  from  UTH  Biomedical  Engineering  with  Nathan  Oates  (ZADP)  and  the  completed  

simulation  monitor  

 

After  some  discussion  with  the  wider  ZADP  team,  two  refurbished  iPads  were  purchased.  One  of  these  

was  then  mounted  permanently  inside  an  old,  non-­‐functioning  monitor.  The  iPad  screen  replaced  the  display  of  the  monitor.  Emmanuel  Mwale,  (head  of  UTH’s  Biomedical  Engineering  Department)  and  his  team  sourced  the  monitor.  Once  the  iPad  was  secured  inside,  the  monitor  was  mounted  to  a  stand.  Blood  pressure,  oxygen  saturation,  and  ECG  cables  were  added  for  additional  realism.  The  second  iPad  functioned  as  a  controller  for  the  monitor.    

The  application  SimMon  was  loaded  onto  each  iPad  and  the  system  ready  to  go!  This  application  provided  all  basic  vital  signs  including  end-­‐tidal  CO2.    

The  monitoring  system  has  subsequently  been  used  successfully  in  a  number  of  simulation  sessions  in  the  operating  theatres,  and  also  for  the  MMed  exams.