Interesting Opportunity: The Sim Man’s Woes, a Postbac Gem

Picture this: You are a young attending doctor, having just recently finished your fellowship in emergency medicine. You are near the end of a grueling 12-hour shift when a five-year-old patient is admitted into the hospital with a bad cough. As the doctor assigned to his case, you perform a chest X-ray, which reveals the presence of masses in the central thoracic cavity. To gain more information about the patient’s condition, a CT scan is required.

While laying the patient down to sedate him prior to the CT scan, the patient’s cough becomes a crisis situation as his heart rate plummets and he nearly stops breathing. You realize that the relaxation of his chest muscles upon lying down has pushed the masses into his lungs, cutting off his pulmonary circulation. However, you quickly push this thought out of your mind as you focus on reviving your patient. The question is: how?

This is a situation that was acted out using one of the patient simulators during ICU Simulator Rounds, a program that provides training for doctors who are doing a fellowship in Critical Care Medicine at the NIH Clinical Center. All postbacs affiliated with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) are permitted to attend the Simulator Rounds as volunteers, and others too, space permitting.

The doctor responding to the simulated situation, in the first year of a Critical Care fellowship, was quick on his feet, rapidly firing out instructions that ultimately saved the patient’s life. While a plastic mannequin in an emergency situation is perhaps not as thrilling as an episode of Grey’s Anatomy, it’s definitely more informative.

In the two Simulator Rounds sessions that I observed, I learned, among other things, that Amiodarone is an anti-arrhythmic, Ca²⁺ channel blocker commonly used to treat various types of irregular heartbeats and that a “floppy” baby is one with inadequate muscle tone causing abnormal limpness. I was also surprised to find that defibrillator paddles have been replaced with self-adhesive electrodes; this runs contrary to paddle portrayal in popular TV shows.

Critical care nurse Nancy Muldoon runs the simulation sessions and is happy to take questions afterwards. She is very willing to review the scenario and the specific actions taken by the doctor in response.

If not for the learning experience, come to ICU Simulator Rounds to see some of the patient simulator’s snazzy features. There are three “patient” types: a baby, a child, and an adult. The adult can breathe, cough, wheeze, and even speak to communicate pain. The child has some alternate characteristics, such as the ability to sweat and turn blue.

Whatever your motivation, attending the ICU Simulator Rounds is a great volunteering opportunity available to NICHD postbacs—so don’t miss out! In fact, simulator sessions are required as part of the curriculum in many US medical schools. If you are planning to apply to medical school, this volunteering opportunity should put you ahead of the game.

To sign up for ICU Simulator Rounds, contact Brenda Hanning at hanningb@mail.nih.gov.