Jan. 11, 2002
Volume XXXV, No. 2



Man or machine?

Interactive simulator breathes new life into anesthesia training

PHOTO Jerry Gelineau (left) practices intubating SimMan™ as Leonid Bunegin enters a medical scenario into the simulator's computer.

The man lying on the table looks like an ordinary patient. His chest methodically moves up and down as he breathes. A heart rate monitor blips out his pulse as an IV juts into his arm. Then, suddenly, the patient's chest heaves frantically, he stops breathing, and doctors rush to intubate. They slide a tube into the patient's airway as he lets out a groan.

Fortunately, he's only made of plastic and computer wires. He is SimMan™, a life-size, computerized mannequin manufactured by Laerdal Medical. SimMan™ will revolutionize medical training at the Health Science Center.

"This is cutting-edge technology," said Leonid Bunegin, an associate professor in the department of anesthesiology. "We are one of only 18 medical schools in the country using the SimMan™. The mannequin is the only one of its kind in San Antonio."

While other mannequins are in use at the UTHSC, none are quite as technologically advanced as the SimMan™. The "high-fidelity simulator" has palpable pulses, audible heart tones, breathes, and can even respond verbally with moans, groans and complaints. He is the size of the average man, but doctors can program him to fit any biological profile, male or female.

"The high-fidelity simulators are unique in that they are responsive to the actions performed on them," Bunegin said. "The SimMan™ can respond physiologically to a wide range of anesthetics and drugs. This allows the trainee to understand the action and interactions of the drugs before applying them to a human patient."

Students will begin training on the SimMan™ this spring. The mannequins are part of the newly developed human anesthesia simulation laboratory, directed by Bunegin and run by Jerry Gelineau, a research scientist at the UTHSC.

While SimMan™ will initially train anesthesiology residents and students, the mannequin is capable of reproducing trauma and cardiac life support situations. Bunegin plans to collaborate with faculty in the departments of emergency medical technology, physician assistant studies and respiratory therapy to create training programs for their students. Ultimately he hopes the system will be available to the medical community at large.

"We currently teach students to intubate in a clinical setting. We can't show them all the scenarios they may encounter in an emergency," Bunegin said. "With the mannequin, we can simulate any complication."

According to Bunegin, studies show that students who train on the mannequin are better prepared to treat patients when they enter a real emergency situation.

"The more the clinician practices, the more the procedure becomes a habit," Gelineau said. "The clinician immediately goes into a correction mode, knowing he or she has solved the problem before."

The human anesthesia simulation laboratory will consist of three mannequins: one in the School of Medicine, one at University Hospital and one at the South Texas Veterans Health Care System, Audie Murphy Division (VA). Each human anesthesia simulator costs $50,000 and was donated by the VA.

PHOTO The SimMan™ computer allows physicians to enter a variety of scenarios for student training.