Abby Nadeau
Community Editor

The learning never ends at Fairview Lakes Regional Medical Center in Wyoming.

Even though many doctors and nurses spend years upon years in school studying the human body there is always more to learn. In an effort to keep their staff updated on the latest in the medical field Fairview holds classes and conferences.

Now the group is working to go beyond the classroom and learn how their doctors and nurses react in emergency situations.

Fairview hospitals around the state are all going through simulations that evaluate how the doctors and nurses not only work together as a team, but how the hospital rooms operate with its staff.

And on Wednesday, Nov. 29 it was Fairview Lakesí turn to take a look at their team work.

SIM Woman

Sim Woman, creatively named for Simulation Woman, is a universal, one of a kind, dummy that can be programmed to go through almost any type of emergency a human can go through.

With the help of an air compressor participants in the simulation can check Simís pulse, check her heart rate and see her chest rise and fall.

She is completely controlled by a computer and its operator who can choose which reactions Sim will have.

She can be programmed to say almost anything and is able to tell her doctors what is wrong with her.

Sim has been known to have anything from an asthma attack to an allergic reaction where her tongue swells or she gets a skin rash.

The Simulation

About 1 p.m. on Wednesday afternoon a group of staff members from Fairview Lakes were brought into an obstetrician room in the ìBirthplaceî to meet their ìpatientî Sim.

Sim and her human part, Fairview staff member Angie Camper, greeted the Fairview staff.

Camper was presented as the real patient who was about to give birth. She would start out the simulation with her mother-in-law Sheila Humphrey.

The doctors and nurses were ìbriefedî like they would be on a shift change between nurses.

Cass Dennison, who works in the Birthing Center, stated that the ìpatientî scenario was that the patient was a 36-year-old, first time mother whose husband was in Iraq and that is why her mother-in-law was present. She came into the hospital already in labor.

After the briefing the group went to work just like it would if the woman was actually going through labor.

During labor the staff encountered an emergency that involved the birth of the baby.

The ìemergencyî was a prolapsed cord. A prolapsed cord is when the umbilical cord slips down before the babyís head.

Dennison stated that ìthis makes it impossible to deliver the baby vaginally.î

ìThe cord provides oxygen and nutrition to the baby and when the cord presents first, it will be clamped off with the pressure of labor and will, in essence, cut off the oxygen supply to the baby.

ìIt is an obstetrical emergency to which we need to respond very quickly in order to have the best outcome for the baby.î

To simulate birth, Sim was wrapped in cloth, similar to what doctors have to cut through to get to a baby in an emergency.

Sim will actually ìgive birthî to a child that has all of the same skills as its mother.

Therefore, if the baby is in distress while inside Sim the staff will know it.

Lessons learned

Doctors and nurses from a number of different departments took place in the simulation including: physicians from obstetricians, family practice and pediatricians; nurses from labor/delivery, operating room, anesthesia, house supervisors lab, pharmacy, diagnostics, hospital ìcode teamî, surgery techs, and respiratory therapists.

ìWe had our own unit ëteamí that prepared the simulation scenarios and summarized the learnings from each simulation. In addition, we had ëobserversí at each simulation whose job it was to evaluate specific elements that we wanted to see like specific teamwork and communication.î

Dennison added that Sim was first created in ìresponse to reduce the infant mortality rate.î

ìWe donít have a high amount [infant mortality rate], but one is enough,î Dennison said.

Dennison added that the purpose of the simulation is to see how people work together in an emergency with no patient at risk.

Part of the research of the project involves taping the entire process. Dennison stated that this is done so that in the debriefing part of the simulation the participants are able to see how they reacted to the situation and learn from it.

ìThe video tape is used as a way to learn,î Dennison said. ìWe are looking at all the different aspects of the process. Weíre looking at what we can do better.î

There are also two cameras placed in the room, one that is focused on the mother and the people around her and one on the baby and the people working with it.

She went on to say that the video tape will show if one person is overloaded in tasks and then the group will discuss ways to fix the problem.

Dennison said that the doctors and nurses at Fairview are a ìsafety focusedî group and that most of the time the video tape usually brings people together.

Dennison stated that the simulation on Wednesday went ìwell.î

ìOur team will regroup and summarize the learnings specific to this scenario simulation. In addition, we will review and prioritize the overall learnings from all the simulations and develop a plan to make changes appropriate to the findings.î

Dennison went on to say that the changes could ìoccur in the form of processed, paper work or even further, ongoing education to staff around communication and team work so we can continue to strengthen our responses to emergency situations.î

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