“Understanding the use of the manikin and virtual intravenous catheter to simulate real-life patients for testing and training”
In this summer internship project, I chose to investigate the use of the manikin for medical and biological purposes to better understand its use and how the device works. In this post, I will be covering my findings as I continue to research and examine this device and its inner workings.
Table of Contents:
- Introduction
- Research
- The Use of Medical Manikins
- Anatomy And How to Use Manikins
- Media
- Appendix A
- Appendix B
Introduction
Manikins are utilized for many reasons, but in this investigation, we will examine the use of medical manikins in training and testing. We will start by doing research and finding out more about this topic before we will dive into using these manikins in practice, as well as dummy medical equipment and software used to simulate medical conditions.
Over the summer this post will gradually grow as I record my findings, answer questions, and find out more about the device. The post will be organized into sections that you can find in the table of contents above.
Research
In the research section, I will record my findings of medical manikins as well as model-specific information (size, manufacturer, etc). There are three main subdivisions in the research section: a specific subdivision on the use of medical manikins, information on their history. The next subdivision is about the structure of manikins and how they work. The third subdivision is about the specific model that I will be conducting my experiments on. This will include data about the model’s specifics, size, weight, and anatomy.
All research was done thanks to the google search engine. All websites used for information are linked to in Appendix A.
The Use of Medical Manikins
What are the uses of manikins and medicine? Medical manikins are used primarily to train learners on how to properly treat patients in realistic medical scenarios. They are used to simulate medical emergencies for medical trainees to accurately deal with real-life medical situations. Manikins have significantly improved the accuracy of medical professionals because they eliminate reliance on non-practical “textbook instruction”.[1] Another reason manikins are used as a primary method in many training scenarios is that a manikin allows for the trainee to practice on a non-living object first before moving onto real humans. The advances in modern technology have allowed for extremely realistic simulations including breathing dummies with palpable pulses and monitors that show EKG, blood pressure, arterial waveforms, and other measures normally used on living patients.[2]
Who uses medical dummies and who needs them? These devices are primarily used by nurses, EMTs, physicians, and military doctors to train recruits/trainees on how to properly care for, transport, and provide care to human patients without the need to do so with living individuals. Most medical students practice on a dummy during training phases. These manikins are widely used due to their realistic behaviors due to modern technology.[3]
Anatomy And How to Use Manikins
One of the top companies in the medical simulation industry is Laerdal — an international medical company that sells medical equipment and simulations. The manikins described and used in this and the following sections are the Laerdal Ultimate Hurt Manikin (please note that this model has since been discontinued by the Laerdal).[4]
It has been especially hard to find information about the specific model due to the fact that it was discontinued by Laerdal in May 2017. I was able to find an online manual from the company that included information on assembly and other general model information.
Ultimate Hurt is a full-body manikin resembling a trauma patient that is designed for training professionals in the emergency care and transport sector. As the manual state, the manikin “should provide many sessions of training when reasonable care and maintenance is practiced”. As I gathered information on the model, I listed resources and model specifications below.[5]
What skills does the manikin teach?
According to the “directions for use” found on the Laerdal website, the manikin teaches the following medical concepts to new students:
Oral intubation – a method of maintaining an open airway by placing a plastic tube into the trachea.[6]
Nasal intubation – same as oral intubation, however in the nose, used when oral intubation isn’t possible.[7]
Digital intubation – complete intubation without a direct view of the larynx or a laryngoscope (also known as blind digital intubation).[8]
EOA/PTL intubation – a two-tube intubation system inserted in a “blind” fashion.[9]
Combitube® intubation – intubation using a “Combitube” which is designed to provide an open airway in a hospital setting.[10]
Right mainstem intubation – when the intubation tube is placed beyond the trachea within the right main bronchus.[6]
Oropharyngeal and nasopharyngeal airway insertion – two methods used in keeping the airway open in an unconscious person.[11]
Bag/Valve Mask – a hand-held device that allows positive pressure ventilation to patients who cannot breathe.[12]
Suctioning techniques – suctioning allows us to remove mucus from the tracheostomy tube so that the patient can breathe normally.[13]
Wound management – the act of treating and caring for wounds and injuries found on the patient.
Carotid pulse palpation – the act of finding the carotid pulse to measure a patient’s heart rate.
Extrication – the removal of a person from entrapment in emergency medicine.[14]
Basic patient handling – the process of using equipment to move a patient so that medical professionals do not need to exert themselves.
Stomach auscultation to verify proper airway positioning – a technique used to examine the abdomen to confirm the proper positioning of the medical airway.
Media
Appendix A
[1] – “Medical Manikin: Healthcare Simulation.” HealthySimulation.com, 1 Oct. 2019, www.healthysimulation.com/medical-manikin/.
[2] – McMacken, Melissa. Mannequin-Based Simulations, 17 Oct. 2018, www.hopkinsmedicine.org/simulation_center/training/mannequin_based_simulations/.
[3] – Patient Simulators, Manikins & More, www.laerdal.com/us/nav/36/Patient-Simulators-Manikins-More.
[4] – Laerdal Medical. “Welcome to Laerdal Medical – Helping Save Lives.” Laerdal Medical, Laerdal Medical, 5 Feb. 2015, www.laerdal.com/us/.
[5] – “Ultimate Hurt, Directions for Use.” 2015. This is a pdf file and can be found at http://cdn.laerdal.com/downloads/f3742/Directions_for_Use,_Ultimate_Hurt_Rev_D_-_English.pdf
[6] – “Tracheal Intubation.” Wikipedia, Wikimedia Foundation, 10 June 2020, en.wikipedia.org/wiki/Tracheal_intubation.
[7] – Pruitt. “Nasal Intubation.” Emergency Physicians Monthly, epmonthly.com/article/nasal-intubation/.
[8] – Dr Chris NicksonChris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health. “Blind Digital Intubation • LITFL Medical Blog • CCC Airway.” Life in the Fast Lane • LITFL • Medical Blog, 21 Mar. 2019, litfl.com/blind-digital-intubation/.
[9] – EN;, Niemann JT;Rosborough JP;Myers R;Scarberry. “The Pharyngeo-Tracheal Lumen Airway: Preliminary Investigation of a New Adjunct.” Annals of Emergency Medicine, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/6431854/.
[10] – “Combitube.” Wikipedia, Wikimedia Foundation, 1 May 2020, en.wikipedia.org/wiki/Combitube.
[11] – Oral Airway Insertion, AmerraMedical, 26 Sept. 2018, www.youtube.com/watch?v=caxUdNwjt34.
[12] – “Bag Valve Mask.” Wikipedia, Wikimedia Foundation, 30 May 2020, en.wikipedia.org/wiki/Bag_valve_mask.
[13] – Support, SiteExecutive. Suctioning, 18 May 2017, www.hopkinsmedicine.org/tracheostomy/living/suctioning.html.
[14] – “Extricate.” The Free Dictionary, Farlex, medical-dictionary.thefreedictionary.com/extricate.
Appendix B
A list of contributors that made this internship possible:
- Author: Maxim Rebguns
- Image Credits: Dmitriy Ovcharenko
- Equipment: Dmitriy Ovcharenko
6/30/2020: From Dima: Maxim really great job. You used very professional format – excellent! Try to search for more details on both manikin and IV system, and also the software for both (there might be freeware / please do internet search).
7/26/2020: From Dima: Internship deadline is August 17, 2020. You have 3 weeks left, please note that it will not be possible to add text/data after this date due to the nature of summer internship and associated time limits.