Mannequins help hospital staff in war against COVID
Training simulations with dummies increasingly model coronavirus scenarios
At Surrey Memorial Hospital, the mannequins have more than a pulse.
They also have a heartbeat and eyes that contract in response to light. They can say `Ow!' if you don't have the right touch with a needle.
To reflect all the ethnicities at the hospital, the mannequins come in different skin colours from lighter to darker. There is a pediatric mannequin, a baby mannequin and a pregnant mom mannequin who can give birth.
Although all the high-tech mannequins may sound like the makings of a movie set for a medical drama, they all play their different roles in simulations meant to mimic real-life hospital situations — including evolving COVID-19 treatment protocols.
“Pretty much anything we would do with a person, we can almost accomplish with our mannequins,” said Lisa Ewart, clinical practice consultant and simulation program lead in Fraser Health. “When (medical staff) go out into the real environment, they can say, `We've practised this on simulation.' It gives staff the knowledge and confidence to say, `We can do this.' ”
The Surrey Hospitals Foundation is investing $100,000 in new simulation technologies, part of its $1.3 million contribution to the lab since 2015. The new money will be used to buy a mannequin “skin” for performing ultrasounds. As well, it will be used to add a simulated ventilator lung so a ventilator can be hooked up to a mannequin.
“It can mimic different patient problems that we see with COVID-19,” Ewart said. “It allows staff to figure out the best kind of care, and how to adapt current protocols and policies.”
The foundation said in a news release that the lab performed 217 COVID-19 simulations and trained more than 900 hospital staff between March and June 2020.
“We were doing back-toback situations, working with front-line staff and providing opportunity to practise new processes and changes that were coming into effect at a rapid speed,” Ewart said.
Since then, she estimated that about 90 per cent of all simulations are directly related to COVID-19. And the simulations have helped hospital staff learn how to communicate with one another while wearing full PPE, for example.
“It is gives them a safe, riskfree environment to come in and practise a situation,” Ewart explains.
The high-tech medical simulation at Surrey Memorial is the descendant of the original “blue box” simulation developed in 1929 for the aviation industry. Edwin A. Link made a blue box replica of the inside of an airplane cockpit that moved in a way similar to a real airplane to teach pilots how to fly.
By the 1960s, mannequins were being used to practise mouth-to-mouth resuscitation. In 1968, Harvey, the Cardiology Patient Simulator mannequin, was developed at the Miami Medical School.
At Surrey Memorial, Ewart said each simulation is based on a scenario or script about 15-minutes long. Each scenario includes details such as the patient's personal and family history, medication use and the cause of the hospital visit.
“It allows them to troubleshoot and consider all the possibilities, come up with a game plan and enact it,” she said.
The lab is also mobile. Ewart said equipment can be taken to other departments such as intensive care to educate more hospital staff and give them experience in situations they normally aren't exposed to. They can include trauma caused by a vehicle collision or a code blue, the term used to describe a medical emergency involving a cardiac or respiratory arrest.
One of the most often practised simulations, she said, is intubating a seriously ill COVID-19 patient. Intubating involves placing a tube into the patient's mouth or nose through the windpipe; the tube is connected to a ventilator to help the patient breathe. The procedure is done in cases where SARS-CoV-2 has so damaged the lungs that they can't expel carbon dioxide and provide enough oxygen.
“I think that's one we have practised over and over again,” she said.
“The way we've been able to say that our program has been successful is through the stories we've heard from front-line staff who say, `We practised the situation and a few days later I was involved in the same situation and knew exactly what to do.' ”