A Human Simulator mimics a patient physiologically

Monday, April 25, 2005

After the ether By Maryann Gogniat Eidemiller FOR THE TRIBUNE-REVIEW Monday, April 25, 2005 Anesthesiologists are medical doctors who specialize in anesthesia, he explained. They oversee teams of nurse anesthetists -- many of them men -- who are increasingly well trained. "Anesthesia was the first specialized area of nursing," said Daniel Stairs, a nurse anesthetist and assistant director of the Westmoreland-Latrobe school. Nowadays, La Roche College, near Pittsburgh, offers the academic portion of a master's degree in anesthetics, with students earning clinical credits for the program through several schools of anesthesia in Pennsylvania and elsewhere. One is the Westmoreland-Latrobe school, on Route 136, near Greensburg, PA and another is affiliated with Allegheny Valley Hospital in Natrona Heights. "As our knowledge base continues, we are constantly having to add more and more classes," said Howard Armour, a nurse anesthetist for 30 years and program director of the Westmoreland-Latrobe school since 1980. "We have to keep up with the new anesthetics that are being used, and with the new monitoring equipment." Students practice the latest techniques on mannequins, learning to insert breathing tubes and introduce drugs into the spinal column. The most sophisticated simulators are computer programmed to mimic human responses. Students at the Westmoreland-Latrobe school practice on a mannequin that's used in the trauma program at Conemaugh Hospital, in Johnstown, one of the school's clinical sites. "The human simulator mimics a patient physiologically," Armour said. "It responds the same way that a patient would. The chest rises, and there are vital signs, and it's so realistic that sometimes it's scary, especially when the simulator opens its eyes." The University of Pittsburgh School of Nursing, which has its own training program, utilizes an entire learning center equipped with mannequins that simulate heartbeats, blood pressure and breathing. They even have computerized voices that can complain about pain and won't let up until the student does something about it. "They have pulses on the wrists, carotid artery and the groin," said John O'Donnell, a nurse anesthetist and director of the university's Nurse Anesthesia Program. "They are set up in a high-intensity audiovisual lab that has the ability to record digitally and to overlay the vital signs of the mannequin. "They are also used in crisis training," he said, so students learn to respond to rare but life-threatening events, such as uncontrolled bleeding, drug reactions and heart attacks. The center has recently acquired a simulator the size of a 9-month-old infant. "The biggest error is in thinking that children are small adults, but their organs and their physiology are not mature," O'Donnell said. "Anesthetic agents that work a certain predictable way in adults are not at all predictable in children, who require almost an entirely different subset of skills in anesthetic management."