Virtual ER

From the Sun Herald:

Welcome to State University of New York - Upstate Medical University's new virtual ER, where the patients are computerized mannequins - known as human patient simulators. They speak, moan, bleed, drool, urinate, blink their eyes and perform many other lifelike functions. Complex internal wiring and software allow each dummy to have a heart attack, break into a sweat from a bioterrorism attack or feign just about any other injury or illness.

The emergency medicine training center is equipped with oxygen, patient monitors, ventilators, a defibrillator and all the other equipment normally found in a real emergency room. Upstate got a $350,000 federal grant to buy three mannequins - two adults and a child - and set up the emergency simulation center. The center will add an infant simulator soon.

Human patient simulators are becoming an increasingly popular teaching tool for doctors, nurses and paramedics nationwide. The military uses them to train for mass casualties and NASA has used them to develop procedures for handling medical emergencies in space.

"If they make a mistake on the mannequin, it's not hurting a patient," said Richard Cherry, the center's technical director who orchestrates the emergency scenarios.

"You have the ability to stop, rewind the patient and start over again," said Dr. John McCabe, chairman of emergency medicine. "That's a wonderful teaching technique."

The simulators allow the medical school to create situations that can't be scheduled in the ER. "I might want to be sure my residents know how to manage an airway obstruction," McCabe said. "And yet those are pretty rare events."

Faculty apply makeup to the dummies to mimic bruises, cuts and head injuries. Packages of crushed saltine crackers are sometimes tucked under fake skin covering the dummy's rib cage to simulate the feel of broken ribs.

Residents are not told in advance what's wrong with the patient. They begin with the limited amount of information they can glean from the patient's chart. Residents respond to the exercises as if they were the real thing.

"Even though it's a rubber mannequin, they suspend their disbelief," Rodriguez said. "They get anxious and sweaty."