October 5, 2010

The PRACTICE of medicine: Maine hospital opens simulation center

Mannequins can simulate medical problems ranging from trauma and allergic reactions to heart attacks.

By John Richardson jrichardson@pressherald.com
Staff Writer

PORTLAND — Susie Lane remembers the first time she put a breathing tube into a patient's throat.

click image to enlarge

Dr. John “Randy” Darby, director of medical simulation, explains the use of medical simulation mannequins Monday at Maine Medical Center’s new $5.8 million, state-of-the-art simulation center at its Brighton Avenue campus in Portland.

John Patriquin/Staff Photographer

"You'd jump in and do it and hope you do it right," said Lane, an anesthesia technician who joined Maine Medical Center's open-heart team 21 years ago. "You never think you'll shake that much."

The next generation of doctors and nurses, and their patients, will have a huge advantage. Today, Maine Medical Center officially opens a $5.8 million, state-of-the-art simulation center at its Brighton Avenue campus.

Since this summer, the center has been using lifelike mannequins to simulate all kinds of medical problems, from irregular heartbeats to clogged arteries. Residents and medical students can practice everything from inserting breathing tubes to saving trauma and burn victims.

"(The mannequins) breathe, they bleed, they wheeze, they can have allergic reactions," said Dr. John "Randy" Darby, the hospital's director of medical simulation. "We have mannequins that deliver babies and have heart attacks."

Some of the most sophisticated mannequins cost more than $300,000 apiece.

Instructors stage the simulations and watch the training through one-way mirrors, sometimes adding challenges such as a slowing heartbeat or a power outage.

"We actually script incredibly intricate one-act plays," Darby said, standing in the surgery simulator next to a mannequin hooked up to catheters, heart monitors and an oxygen machine. "It's the exact same stuff we have in our operating rooms."

Each simulation session is videotaped so instructors and students can meet afterward in a debriefing room to talk about what went right and what went wrong. "That's where the real learning happens," Darby said.

When computerized patients won't do, the center hires actors who help teach communication and bedside manners.

On Monday, for example, instructors watched a video feed as Courtney Nall, a chief resident of family medicine, delivered the news to a "patient" that the woman has cancer. Rhonda LaPointe-Lachance, an actress, shifted in her chair and burst into tears as Nall handed her a box of tissues and tried to reassure her.

"We'll take it one step at a time," Nall said.

The new Hannaford Center for Safety, Innovation and Simulation at Maine Medical Center will be used primarily by the hospital's 200-plus medical residents and fellows as part of their field training. It also will be used by students from the Maine Medical Center-Tufts University School of Medicine, and by nurses, physicians and others throughout the hospital, Darby said.

Lane, the anesthesia technician, left her job with the open-heart team to teach in the center. She is now a simulation specialist in the skills lab, teaching residents and students how to help patients who are in respiratory distress or having a heart attack.

The lab also has a simulated human arm, for practice in drawing blood, and simulated skin, for practice in stitching wounds.

After her simulated session with the cancer patient Monday morning, Nall stopped in at the skills lab to tie some sutures.

"With medicine, I don't think you can ever practice too much," she said.


Staff Writer John Richardson can be contacted at 791-6324 or at: jrichardson@pressherald.com


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