Medical Monday; Off To Mad-Chest-Arrrr for the Sim Tech Sym

August saw us (myself and my fellow two Techs) on a day trip to... MAAAAAAAD-CHESTARRRR

Or rather, the inaugural Sim Tech Symposium, held at Manchester Uni.

So, this was a gathering of Medical Sim Techs, from the Uni and Hospital fields, from all over the UK and further afield, for a mega conference. Spoiler alert, it was bloody AWESOME and I absaloutely loved it. 

However, I had also been asked to present a workshop on using low-fi and upcycled stuff in Sim. Being as the NHS tends towards the 'embrace your inner Womble' end of the budgets for day-to-day training, I've become quite good at this sort of thing. I thought I'd be doing a bit of show and tell, up to the stage of the Teams call where I found I'd be running a workshop of up to 25 people. Something I've not really done since I worked in a school, though Scouts has given me a certain amount of experience doing this sort of thing.

First up, trying to come up with a project we could all do in about 40 minutes, with minimum tools and materials. I decided to do a broken-bone simulator.

A bumper batch of brushes...

I ended up building a simple jig to cut them all to the same sizes.

Thinking about my Life Choices.

More Thinking About My Life Choices, whilst cutting 25 wooden rulers to size.

Cutting up a popped giant beach ball. Thank goodness my Scouts are so incredibly destructive with their games equipment.

The parts which were handed out (with instructions).

And there we go. Taped to the human arm (and covered with one of those nylon tubes you hide tattoos with), or under the skin of a robot, they look the part.

Of course, it wouldn't just be making stuff. I had to give a presentation, and I thought it would be best to show off some of the stuff I've made too.

"Excuse me sir, why do you have your little girl in the boot of your car?"

"It's alright officer! She's not mine! No wait-"

Honestly, it's great we weren't pulled over on the way there or back. I ended up going on leave straight afterwards too, so Kitty here spent the week sat on my living room floor.

Manchester Metropolitan Uni, home for the day.

I was given an art classroom to set up in, ably assisted by my gaffer, Lead Tech Lee.

Hello Kitty!

Plenty of room to spread out the practical demonstration pieces.

The workshop went by in a blur; everyone present seemed to find it interesting anyway. I did ask if people at the back could sneakily vape or flick-V's at me, to really take me back to my days teaching practical's to Year 9's.

A higher class of Beige Buffet!

Look at this place...

...compared to our little hospital, this places looks like something out of a cleaner version of Blade Runner.

In the afternoon, I took part in a workshop run by a couple of very talented techs from a Czech Uni, where we cast some sections of spinal column.

I really don't like blowing my own trumpet...

...but there's my name, up in lights on the top left! I didn't win, but didn't mind, as I was in excellent company. Again, the day was brilliant, and I am really looking forward to doing this again next year.

This Month in British Railway Modelling; A Seaside Cafe

The colourful, crowded, bonkers finale of the run of colourful summer projects for British Railway Modelling; the Seaside Cafe. My esteemed editor sent me a seaside cafe kit alongside the sand and shingle and such for the beach... I chose to split it into two articles as I reckoned it would justify separately producing the two briefs, instead of rolling it into one.

The inspiration for the beach had been Criccieth, not least because at the end of the promenade is Dylans, the cafe in this marvellous building designed by the esteemed Sir Clough Williams Ellis.

The kit is by Gaugemaster, and is a H0 scale kit of a foreign prototype. It had no interior, and was quite nice, if needing some modifications.

Interior, and kitchen (you'll notice in the above I failed to put a doorway through to the main part of the cafe, a bit of an oversight for somebody who worked in bloody catering for over 7 years. I did go back and modify it).

And again, I went down the colourful, kitsch route; map pins for balloons again, as it looked way too bland inside. Hey, it's the 90's in this project, nobody gave a stuff about the environment.

Speaking of colourful, kitsch tat, the last of the 00 scale inflatables and things made for the projects, some cheapy figures that needed some spot-repainting, and some truly excellent 3D-printed seagulls.

Other elements to add a bit of colour to the scene were some beach huts, made from Peco garden shed laser-cut kits.

Lots of room for cameos in amongst the chaos of a busy summer lunchtime. Gulls raid the overflowing bins...

...kids and parents chasing runaway toys...

...holiday-makers at the huts...

...trains rattle past, almost unnoticed...

...families play on the beach.

Yep, colour, chaos, and kitsch. Loved doing this run of projects, but ready to do something a bit darker and moodier now. That said, I've got a seaside-ish Cambrian Coast project to do for Hornby first, though that should brighten the Autumnal months a little.

And in the mag. On the cover too!

 

Medical Monday; Paediatric Chest Drain

So here we go, with needing to modify another airway trainer for an A&E Insitu, so we can do a practise procedure that we'd normally do with meat. Chest Drain insertion training is something we'd generally do up in the lab, with animal ribcages covered in stretched skin. Not something we can do down in A&E (or ED as we're meant to be calling it now apparently- perhaps dropping the word 'Accident' will persuade people not to come in, and cut down on those waiting lists eh).

This is Kitty. She, like her plastic sister Frankie, was built from spare parts found in the A&E store. Specifically, she needed new lungs, repairs to her head, chest cavity, and a replacement hip joint. She has become a She permanently, partly to hide the head damage, and partly because the moulded, skin-toned plastic hair is bloody awful. Kitty- built as a Kit of parts. 

So, we needed to do a Chest Drain insertion. Poking a hole in the robot kids was out of the question, so Kitty drew the short straw. Anyway, an important part of the procedure is getting the insertion in the right place, with regards to the ribs, so I'd need to make her a rib cage. Broadly the same procedure as with the adult thoracotomy model, but made a litte trickier by her compact side. I drilled 4 holes and coping-sawed out a hole into her chest cavity.

As with the Thoracotomy model, I used airway kit to make the ribs, in this case, Paeds LMA's which we had on strength (and never use).

They were a bit too flexible, so I strengthened them with oxygen piping.

Making more right-angled bracing from cable troughs. As with the Thoracotomy model, this was to hold internal organs in place (though there was less room for them here with the gubbins for the CPR.

The 'lung'; this was a bit of a short-notice addition, and is just a balloon filled with teddybear stuffing. I'm working on a plan however, to fill this with fluid so a proper chest-drain prodedure can be carried out.

To make this model re-usable, the outer layer of skin needed to be removable, so I used some scavenged bolts, and a piece of the same flesh-coloured felt-backed material from the C-Section trainer.

Not, perhaps, the neatest solution, but it does the job. As this hopefully shows, there's a layer of thick foam (for the muscle wall), and the ribs are held with cable ties drilled through from the plastic chest wall, through the pipe robs, and back out again.

Detail of the cable-ties holding the ribs in.

Modifications were needed to the plate for the CPR compressions; the trouble was, Kitty needed to stay in use as an airway trainer, which meant cutting a slot out to clear the ribs. This also then needed a new central brace to support the plastic plate that sits under the stomach. Not a graceful solution perhaps, but it does the job.

Low-budget patient transfer; normally we move the kids in a wheelchair, but Kitty doesnt bend very well. Strapping her to the flatbed helped, though I ended up covering the whole shebang with a blanket so as to not spook the normal people in the main hospital (passing the canteen and shops) as I wheeled her back and forth.

As an aside, even though it has nothing to do with the scenario, the teddy is present as it's 'hers'. All the kid-robots and task trainers have a teddy of their own, which travels with them for insitus. It's a Human Factors prompt, how the treating medical staff interact with the child, and the toy, is one of those pointers for how well they treat the patient and display their bedside manner. 

So, the scenario. Poor dear was playing in the garden, punted her ball out into the road, ran out to get it, and was mashed by a prat in a Range Rover (the two terms often being synonymous here in Bradford) who did a runner.

A few additional wounds- but this time, not too many. We often have a 'distracting' wound (head injury, broken arm) on these, to distract from the 'real' one, but not this time as we wanted the focus on the chest drain requirement. That said, I felt the poor kid needed some road-rash, bruising, and grazing, just for reality.

Blocked and spinal-boarded, with a pelvic binder, which made her scream like a banshee.

On which note, that was something that had to be improvised. See, Kitty is no robot, so has no onboard electronics, and hence, no sounds. So I ended up taking Hallie's controller, and rigging up a set of speakers hidden under the head-end of the bed, so I could play the vast variety of screams, shrieks, cries, and such that me and one of the previous techs, Polly, recorded.

The procedure went very well; the staff recognised the problem, acted accordingly, and in went the chest drain. Once again, it was amusing to have Doctors worried about cutting into the mannequin; we've done too good a job training them not to go anywhere near the robots with a knife. In through her normal skin, the vinyl/felt, the foam, and into the chest.

Patient survived the procedure, ready to be stablised and blue-lighted to either Leeds or one of the specialist kids hospitals.

Pipe out, and you can hardly see the damage. A little glue on the skin layer, and a bit of repair on the vinyl and felt, and you'll never know it had been cut.

Another interesting little project, with room to develop it further, and to a higher level of fidelity. Plus, Kitty will be getting to have a bit of an adventure; by the time this is published, she'll have been to the National Sim Tech Conference in Maaadchester in order to demonstrate upcycling and low-fi construction techniques in Sim.