Simulation for Emergency Medicine Residency Training: A Sampling of Key Devices
Updated: May 10, 2018
In recent years, a growing number of emergency medicine residency programs have transitioned from using live animals to medical simulation and other human-based training methods. These methods allow trainees to improve their skills through iterative learning and repetitive practice. Numerous factors—including improvements in artificial tissue technology and an imperative to reduce and replace the use of animals in medical training courses—have led to a new era in medical simulation. The advancement of programmable mannequins, computer-based models, scenario-based realistic devices, and other forms of medical simulation has expanded the number of adult and pediatric scenarios which can be effectively simulated and incorporated into emergency medicine curricula. In this document we highlight only a few of the many simulation devices available for this field.
The most widely used trauma and surgical simulator in the world, the TraumaMan System is a high-fidelity human-body mannequin with lifelike skin, subcutaneous fat, and muscle. TraumaMan allows students to practice a variety of surgical procedures, such as cricothyroidotomy, chest tube placement, needle decompression, pericardiocentesis, intravenous cutdown, diagnostic peritoneal lavage, and ultrasound-guided interventions. Replaceable tissues provide each trainee with a first-cut experience and make this simulator ideal for team training scenarios.
SimMan 3G is a high-fidelity, full-body patient simulator that displays both physiological fidelity and pathology. It can be used to teach cricothyroidotomy, endotracheal intubation, retrograde intubation, chest tube placement, intraosseous needle insertion, intravenous insertion, and urinary catheterization. SimMan 3G can be programmed to simulate a multitude of scenarios requiring defibrillation, cardiac pacing, and the administration of cardiac medications.
Human Worn Partial Task Surgical Simulator (a.k.a. “Cut Suit”)
The Cut Suit is a surgical training device worn by a course participant or actor which features breakable bones, interchangeable organs, and variable blood flow. It combines the sensation of working on live tissue with the realism of performing emergency assessment and treatment on a live patient. Wounds are created by the user, and the skin and other organs are repairable, allowing for multiple uses and team training opportunities. The Cut Suit can be used to practice open thoracotomy and intrathoracic exploratory surgery, hemorrhage control of gross organ structures, chest tube placement, cricothyroidotomy, and urinary catheterization.
CentraLineMan is a high-fidelity, partial-body simulator with an optional articulating head and replaceable tissues available to simulate a variety of patients (i.e., average, obese, and those with anatomical anomalies). It is the most widely used central venous catheterization simulator and allows trainees to practice vascular catheterization using ultrasound-guided or landmark-directed insertion. Repetition and iterative learning are important features.
Trauma Thoracotomy Trainer
The Chamberlain Group
Developed in collaboration with Massachusetts General Hospital to train residents in high stakes trauma surgery, the Trauma Thoracotomy Trainer is a high-fidelity simulator that features realistic skin and beating-heart technology. The Trauma Thoracotomy Trainer can be used to practice open thoracotomy, chest tube placement, aortic cross-clamping, pericardiotomy with open cardiac massage, and cardiac laceration with active bleed.
EnvivoPC Perfused Cadaver
Maximum Fidelity Surgical Simulations, LLC
The EnvivoPC simulator uses state-of-the-art technology—including simulated blood and a pump—to create a perfused cadaver that mimics heart function and circulation while allowing for hands-on training of procedures involving active bleeding. EnvivoPC can be used to perform a variety of medical procedures, including chest tube placement, cricothyroidotomy, central line placement, venous and arterial cutdown, open thoracotomy, hemorrhage control, and cardiac repair.
Emergency Thoracotomy Simulator
Operative Experience, Inc.
*Commercially available in late 2018
The Emergency Thoracotomy Simulator is a high-fidelity, partial-body simulator with replaceable tissues. This task trainer can be used to simulate a variety of invasive procedures, such as open thoracotomy, aortic cross-clamping, hilar clamping, one-handed cardiac massage, chest tube placement, and pericostal suturing.
BabySIM is an infant-sized, high-fidelity simulator featuring advanced physiology for trauma management and critical care. Trainees can experience seesaw breathing, cooing, crying, variable pupil size, and secretions from the ears, eyes, and mouth. It provides simulation scenarios for airway trauma or obstruction, defibrillation and cardiac pacing, needle decompression, chest tube placement, and intraosseous insertion.