1887
1 - Extracorporeal Life Support Organisation of the South and West Asia Chapter 2017 Conference Proceedings
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Poland is setting up its first regional ECMO program and relies heavily on the use of simulation in testing processes and training clinicians.1 As ECMO is a complex and expensive procedure, we developed an advanced ECMO simulator for high-fidelity medical simulation training.2–6 It can be used to modify any type of full-body patient simulator and allows for the creation of an unlimited number of scenarios. The system is equipped with an electronic core control unit (CCU) (Figure 1), a set of synthetic valves, pressure sensors, and hydraulic pumps. The major functions of the CCU are to stabilize the hydraulic system (flow of simulated blood, differential pressures in the arterial and venous lines), providing instant information about the system to the user via a display. Electric valves and sensors provide ‘on-the-fly’ information to the CCU about the actual system's status and it can be made to respond to specific instructions imitating the physiological circulatory system and simulating several scenarios (i.e. bleeding, low pressure, occlusion, reaction to proper and incorrect pharmacological treatment). It can be connected to an ECMO machine to act like the human body during ECMO run. Silicone tubes (modified polyethylene) that can be realistically cannulated using ultrasound imaging represent the artificial vessels. The CCU is made of electronic components that can be integrated to customize any mannequin as shown in Figure 1. The hardware includes both digital and analogue components that are controlled by a software run on a computer connected to the CCU via a serial port (RS232) (Figure 2). The software allows for the visualization of measurements obtained from the sensors and the control of the pumps and valves via electronic controllers. The controllers affect the ECMO circuit simulated blood flow, and hence the readings from the ECMO machine sensors, to recreate various clinical scenarios.Figure 1.  The modified patient simulator with circulatory loop prepared for VA ECMO cannulation and CCU (core control unit) for high-fidelity simulations.

Figure 2.  The ECMO simulator architecture.

Every component used can be easily replaced. The total cost of the simulator modification, excluding the cost of the computer or future mobile device, is approximately 200 USD, and the consumable parts cost about 20 USD. It has been used to help simulate successfully a range of scenarios.1 Although the system is currently tethered, the next prototype will include a wireless controller so that the system can be controlled from a mobile application. This advanced simulator allows for unlimited possibilities with regard to creating clinical scenarios. Our ambition is to become a reference ECMO training center in Poland so that our high-fidelity ECMO simulator can be used to its full potential and for the benefit of more clinicians and their patients around Poland.

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2017-03-20
2020-09-24
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References

  1. Puślecki M, Ligowski M, Stefaniak S, Zieliński M, Pawlak A, Dąbrowski M, Kłosiewicz T, Sip M, Karczewski M, Małkiewicz T, Gąsiorowski L, Telec W, Ładzińska M, Ładziński P, Perek B, Misterski M, Mrówczyński W, Sobczyński P, Panieński P, Łukasik-Głębocka M, Artyńska A, Gezela M, Buczkowski P, Czekajlo M, Jemielity M. Using simulation to create a unique regional ECMO program for the greater Poland region. Qatar Med J. 4th Annual ELSO-SWAC Conference 2017: DOI: 10.5339/qmj.2017.swacelso.79.
  2. Brum R, Rajani R, Gelandt E, Morgan L, Raguseelan N, Butt S, Nelmes D, Auzinger G, Broughton S. Simulation training for extracorporeal membrane oxygenation. Ann Card Anaesth. 2015; 18:2:185190.
    [Google Scholar]
  3. Broomé M, Maksuti E, Bjällmark A, Frenckner B, Janerot-Sjöberg B. Closed-loop real-time simulation model of hemodynamics and oxygen transport in the cardiovascular system. Biomed Eng Online. 2013; 10:12:69.
    [Google Scholar]
  4. Allan CK, Kleinman ME. Enhancing the power of simulation for complex clinical care. Pediatr Crit Care Med. 2014; 15:9:904906.
    [Google Scholar]
  5. Burton KS, Pendergrass TL, Byczkowski TL, Taylor RG, Moyer MR, Falcone RA, Geis GL. Impact of simulation-based extracorporeal membrane oxygenation training in the simulation laboratory and clinical environment. Simul Healthc. 2011; 6:5:284291.
    [Google Scholar]
  6. Fehr JJ, Shepard M, McBride ME, Mehegan M, Reddy K, Murray DJ, Boulet JR. Simulation-based assessment of ECMO clinical specialists. Simul Healthc. 2016; 11:3:194199.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): ECMO , patient simulator , scenarios and simulation
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