Surgical Simulation: An Emerging Technology for Training in Emergency Medicine

1997 ◽  
Vol 6 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Scott L. Delp ◽  
Peter Loan ◽  
Cagatay Basdogan ◽  
Joseph M. Rosen
Keyword(s):  
Virtual Environment ◽  
Computer Model ◽  
Life Support ◽  
Surgical Simulation ◽  
Medical Training ◽  
Medical Personnel ◽  
Advanced Trauma Life Support ◽  
Training Experience ◽  
Training Environment ◽  
Wound Debridement

The current methods of training medical personnel to provide emergency medical care have several important shortcomings. For example, in the training of wound debridement techniques, animal models are used to gain experience treating traumatic injuries. We propose an alternative approach by creating a three-dimensional, interactive computer model of the human body that can be used within a virtual environment to learn and practice wound debridement techniques and Advanced Trauma Life Support (ATLS) procedures. As a first step, we have developed a computer model that represents the anatomy and physiology of a normal and injured lower limb. When visualized and manipulated in a virtual environment, this computer model will reduce the need for animals in the training of trauma management and potentially provide a superior training experience. This article describes the development choices that were made in implementing the preliminary system and the challenges that must be met to create an effective medical training environment.

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

1989 ◽  
Vol 4 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Miroslav Klain ◽  
Edmund Ricci ◽  
Peter Safar ◽  
Victor Semenov ◽  
Ernesto Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Life Support ◽  
Medical Personnel ◽  
The United States ◽  
Structured Interview ◽  
Advanced Trauma Life Support ◽  
Mass Casualties ◽  
Medical Systems ◽  
Preliminary Results ◽  
Medical Teams

AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

scholarly journals ATLS®: breaking new ground

2013 ◽  
Vol 95 (10) ◽  
pp. 333-333
Author(s):  
Stephen Bush
Keyword(s):  
Differential Diagnosis ◽  
Life Support ◽  
Medical Training ◽  
Trauma Team ◽  
Advanced Trauma Life Support ◽  
Generic Skills ◽  
The Uk

The inaugural Advanced Trauma Life Support (ATLS)® course was run in the UK in 1988 and now over 50 countries worldwide run an ATLS® programme and over a million doctors have been trained. In the early days of ATLS®, its message was ground-breaking. It introduced the ABCDE approach, the generic skills of the trauma team and goal directed care. At the time, this message was at significant odds with the accepted model of history, examination, differential diagnosis, investigation, refinement of the differential and then treatment. It is a testament to the effect that the ATLS® programme has had on medical training throughout the globe that this approach is now the convention.

Emergency Medical Training in the 82d Airborne Division: The Gulf War Experience

1993 ◽  
Vol 8 (4) ◽  
pp. 345-348 ◽  
Author(s):  
Leopoldo C. Cancio ◽  
Gary A. Goforth
Keyword(s):  
Life Support ◽  
Medical Training ◽  
Medical Personnel ◽  
Physician Assistants ◽  
Gulf War ◽  
Instructor Training ◽  
Desert Storm ◽  
Emergency Medical ◽  
Large Numbers ◽  
War Experience

AbstractThe 82d Airborne Division, as the Army's worldwide contingency division, places unique demands on its medical personnel. This was true particularly during Operations Desert Shield and Desert Storm in 1990–1991. An unprecedented emergency medical training program was carried out in preparation for the Gulf War.All levels of expertise were involved: non medical Combat Lifesavers, medics, physician assistants, and physicians. Courses provided included Combat Lifesaver provider and refresher training, Basic Trauma Life Support (BTLS) provider and instructor training, Chemical Casualty courses, and a Combat Surgical Skills course. Approximately 736 personnel, including 80 Saudi and allied physicians and medics, participated in these courses. Confidence and competence in handling war casualties at all levels was enhanced greatly. Prepackaged courses such as BTLS enabled the rapid training of large numbers of medical personnel under challenging conditions.

Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD
Keyword(s):  
Case Report ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Ultrasound Probe ◽  
Trauma Resuscitation ◽  
Highly Sensitive ◽  
Pouch Of Douglas

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).

Violencia en la formación médica

2020 ◽  
Vol 63 (2) ◽  
pp. 46-55
Author(s):  
Héctor García Hernández ◽  
Guadalupe Alvear Galindo
Keyword(s):  
Medical Practice ◽  
Medical Training ◽  
Structural Violence ◽  
Medical Model ◽  
Medical Personnel ◽  
Medical Culture ◽  
Cultural Violence ◽  
Direct Violence ◽  
Health Institutions ◽  
And Function

The purpose of this work is to provide elements to understand, in a broad way, the violence within medical training, since most of the work on the subject focuses on its consequences: for example, the physical and psychological conditions of violent acts in the medical training. The article begins with the concept of violence proposed by Galtung, that points out direct violence, structural violence and cultural violence. Then, it describes the hegemonic medical model as a sculptor of medical culture and its effect on medical practice and medical education. Afterwards, it describes the medical habitus and the hidden curriculum, two elements of the medical culture. The first one refers to how the medical personnel justifies the use of violence, the second one refers to what is taught about the structure, organization and function of the health institutions. Then, the article reviews the characteristics of the health institutions as spaces where an organized medical practice is crystallized in a rigid, hierarchical and vertical manner. We then focus on the worker/student conflict. These conditions are necessary for the appearance of direct violence in the medical training. Key words: Cultural violence; structural violence; direct violence; medical training; hegemonic medical model.

An exertional heat illness triage tool for a jungle training environment

2017 ◽  
Vol 164 (4) ◽  
pp. 287-289 ◽  
Author(s):  
Mike Smith ◽  
R Withnall ◽  
M Boulter
Keyword(s):  
Medical Personnel ◽  
First Aid ◽  
Heat Illness ◽  
Training Environment ◽  
Exertional Heat Illness ◽  
First Aid Training ◽  
Illness Recognition

This article introduces a practical triage tool designed to assist commanders, jungle training instructors (JTIs) and medical personnel to identify Defence Personnel (DP) with suspected exertional heat illness (EHI). The challenges of managing suspected EHI in a jungle training environment and the potential advantages to stratifying the urgency of evacuation are discussed. This tool has been designed to be an adjunct to the existing MOD mandated heat illness recognition and first aid training.

scholarly journals Collaborative Virtual Environment to Simulate on-the-Job Aircraft Inspection Training Aided by Hand Pointing

2005 ◽  
Vol 49 (25) ◽  
pp. 2216-2220
Author(s):  
S. Sadasivan ◽  
R. Rele ◽  
J. S. Greenstein ◽  
A. K. Gramopadhye ◽  
J. Masters ◽  
...  
Keyword(s):  
Virtual Environment ◽  
Visual Inspection ◽  
Training Environment ◽  
Virtual Training ◽  
Collaborative Virtual Environment ◽  
Feedback Training ◽  
Inspection Process ◽  
Safety And Reliability ◽  
The One ◽  
Inspection Performance

The human inspector performing visual inspection of an aircraft is the backbone of the aircraft inspection process, a vital element in assuring safety and reliability of an air transportation system. Training is an effective strategy for improving their inspection performance. A drawback of present-day on-the-job (OJT) training provided to aircraft inspectors is the limited exposure to different defect types. Previous studies have shown offline feedback training using virtual reality (VR) simulators to be effective in improving visual inspection performance. This research aims at combining the advantages of VR technology that includes exposure to a wide variety of defects and the one-on-one tutoring approach of OJT by implementing a collaborative virtual training environment. In an immersive collaborative virtual environment (CVE), avatars are used to represent the co-participants. In a CVE, information of where the trainer is pointing can be provided to a trainee as visual deictic reference (VDR). This study evaluates the effectiveness of simulating on-the-job training in a CVE for aircraft inspection training, providing VDR slaved to a 3D mouse used by the trainer for pointing. The results of this study show that the training was effective in improving inspection performance.

Sechs Jahre Advanced Trauma Life Support (ATLS) in Deutschland

2010 ◽  
Vol 113 (7) ◽  
pp. 561-567 ◽  
Author(s):  
M. Münzberg ◽  
L. Mahlke ◽  
B. Bouillon ◽  
T. Paffrath ◽  
G. Matthes ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support

Pediatric Emergency Medicine: A Developing Subspecialty

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 336-342
Author(s):  
Marilyn Li ◽  
M. Douglas Baker ◽  
Leland J. Ropp
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Emergency Departments ◽  
Life Support ◽  
Pediatric Emergency ◽  
Advanced Trauma Life Support ◽  
Full Time ◽  
Pediatric Emergency Medicine ◽  
Pediatric Hospitals ◽  
Pediatric Emergency Care

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.

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