Patient simulators
A patient simulator generally consists of a full body trainer, resembling a person lying on a bed, that is connected to a vital signs monitor, a box of control hardware and a computer. The simulator is operated by a computer program that enables an operator to enter instructions into the computer program which modifies the simulator’s appearance and the monitored vital signs.
While they have previously been termed "high fidelity" (e.g. METI HPS "Stan"; Laerdel Simman 3G), "medium fidelity" (e.g. SimmanTM) and "low fidelity" (e.g. Resus AnnieTM), it is preferable to describe patient simulators in terms of their functional capability and specific features, as these determine their suitability for different training objectives.
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More simple simulator limited to basic procedures although can achieve high psychological realism with skilled instructors |
Moderately sophisticated simulator allows invasive procedures such as insertion of chest drain |
Highly sophisticated simulator allows real-time monitoring of expired respiratory gases and anaesthetic agents; invasive CVS monitoring and mechanical ventilation |
Detailed descriptions of other patient simulators can be found at the manufacturers' websites:
A description of the "Stan" simulator is provided below as an example.
STAN has sophisticated physiological and pharmacological modelling, which enable an infinite number of scenarios that represent normal physiological states, responses to drugs or pathological conditions, the latter including acute infection, trauma, cardiac failure, as examples. In each scenario his neurological, cardiovascular and respiratory vital signs change in relation to each other, reflecting his underlying condition. Stan, the "patient" breathes out carbon dioxide and the computer operator is aware of the gases and anaesthetic agents he inhales. The importance of this is that he will become hypoxic, just like a real patient, if not adequately oxygenated. Users can also observe movement of his chest, pupils, and eyelids, listen to heart and breath sounds, and ask STAN questions – which he will answer, if awake.
STAN's airway may be controlled with a mask, a Guedel airway or an endotracheal tube, and procedures such as cricothyroidotomy, pleural aspiration, urinary catheterisation, and insertion of an intercostal catheter may be performed. STAN will also respond to IV fluids, inotropes, cardiac massage, and defibrillation.
STAN can be connected a range of vital signs monitors. At the SCSSC he is connected to a Datex AS3 monitor, which is similar to monitors used in many operating theatre settings. It is possible to monitor cardiac electrical activity, non-invasive blood pressure, arterial, central venous, and pulmonary artery pressures, concentrations of gases and anaesthetic agents, cardiac output, neuromuscular function, and temperature. Generally, the characteristics are pre-determined by the SCSSC staff to suit the course requirements.
