It's been a busy few months at work (it's the NHS, when is it ever NOT busy) and whilst a lot of what I've been making is a bit... shall we say, graphic... to post on here, I thought I'd share this recent synthetic trainer I've knocked-up for the ED. Or Accident and Emergency, as we boringly used to call it. I don't know, maybe it's ED to make us more appealing to our prospective new American owners when we get privatised. Or Privatized, with a Z, as we'll be totally American-owned, not just the patient data.
Sorry, I'm rambling. So, the scenario was patient who'd been stabbed in the chest, nicking his heart. He dies on the table, and the Doctors have to crack open his chest and go-in for emergency heart surgery. Open the rib-cage and stop the heart bleeding. We do this on our CRISIS course, with whole pig torsos, which is graphic, if useful. That's in our lab, however, and wheeling a whole headless, legless pig through through the waiting room was likely to get us lynched, so I got asked if I could knock up a synthetic trainer.
After some thoughts, and experiments with plastic buckets, barrels and things, I thought about using a Rescusi Annie.
You know, these dudes/dudettes.
We have a full-body one, but it's too nice and useful to chop up. I remembered though that the legend that is Dr.Blood (yes, really) had a stack of knackered old Rescusi Annie torsos down in the basement of horrors which are the ED offices. Mainly because I dumped them down there a few years ago when we were desperate for space. I carried out a raid down there and retrieved them.
And here we are, this one is pretty representative of the state they were in, but then this would need to be a scrapper anyway.
Probably should have put the tigger warning here.
First pass at making a sternum, nice and strong... though I quickly realised this was stupid, as the point was to cut through it. A bit of strategic chopping later;
and a raid of the scrap pile, produced some cable troughing. All will be revealed in a few pictures time.
For the ribs, I turned to these ET tubes. These go out of date pretty quickly, and get dumped on us (as the robots aren't bothered about best-before-dates on medical equipment), and we had uggins -technical term- of them.
There's that cable-trough sternum.
I needed to chop-around the wooden supports to accommodate the pipes from the neck, as the patient would still have to be intubated.
That then left the problem of how to make a heart. It needed to be rubbery, and semi-flexible. I had some balloons left over from Scouts, and figured it would be best filled with wadding.
There was -unfortunately for him- a massive, old, rather over-stuffed teddybear sat up on the shelf in the workshop, intercepted on the way to be disposed of (long story, but we have a mass of teddies donated for Peadiatric sims, and nowhere really to store them, and because they're old and used we can't give them to the actual kids ward, and the local charity shops wont take teddies. I thought he was too nice though to go to the incinerators and so he's sat in the workshops for now). A quick few minutes with a Size 22 scalpel and there was the wadding I needed. Lovers of all things cute and cuddly be reassured, a bit of suturing afterwards, and he was back up on the shelf having done his bet for medical science.
There we go, the heart in place, a bit more cable troughing (and the plastic cover for an LMA) holding it in place. That just left the need to make some lungs, and so I turned to more inflatables from Scouts.
Our Scout Group meets in a school, and we end up using beachballs for games. Partly because we have no proper storage to keep games stuff, and also because it's quite hard to damage fittings and fixtures with inflatables. We also get through LOADS of them, because kids being kids, they love to burst them. So we buy in bulk these days. I thought the group could spare these two, not least because I was building this on no budget again.
Time for a summer-vibes thoracotomy.
Ready for the operating theatre!
Speaking of, here we are... Poor sod doesn't know what's coming. We did a bit more set-dressing on the day with the fake blood and things.
Pics of the op taking place were a bit tricky, as I was driving the Sim Pad (providing the live observation figures) from a corner under a ton of machinery.
It was quite funny- the staff are so indoctrinated not to cut into our robots, they had to be reassured by me, my boss, and a senior doctor running the sum, that they could indeed go at him with the tough0cuts and knife.
Fascinating to watch the pointy-end of medical treatment, in every sense.
The op went well, the trainer did its part.
This was the condition it was in afterwards- needs a new sternum (which is fine, I pinched loads of the cable troughing out of the skips), a mended skin, the ribs mending, and one of the beachballs didn't survive the scalpel, but otherwise, an hour or so in the workshop and good to go again.
The next one (at least, the next one I can post on here) should be a C-Section trainer.
