Date: March 10, 2008
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Realistic birth training without the real-life risk

High-tech mannequin simulates emergencies in unique program

By CLAUDINE SAN NICOLAS, Staff Writer

POSTED: March 10, 2008

WAILUKU — A “pregnant” mannequin named “Noelani” is providing doctors and nurses at Maui Memorial Medical Center a way to practice handling realistic childbirth emergencies without risking the lives of mothers and their newborns.

The $22,000 mannequin is hooked up to a computer program that simulates various emergency situations, which rarely happen but nevertheless put pregnant moms and their babies at risk.

“This is awesome, especially for a new person like me,” said nurse Cindy Hansam, who has worked six months in Maui Memorial’s nursery. “It’s a great opportunity to learn from my mistakes.”

So far, about 20 medical professionals have participated in the first-of-its-kind training program. These include obstetricians, pediatricians, nurses, respiratory therapists, anesthesiologists and operating room personnel.

The mannequin “speaks” through a program trainer who comes up with realistic dialogue based on a given emergency situation. It simulates childbirth and has a microphone in its abdomen to give training participants a chance to listen with a stethoscope to a recorded fetal heart rate.

The “pregnant” mannequin and her baby can be intubated to provide it air or administer gas, and an intravenous tube can be inserted for nutrients, blood or medication. The “newborn” can be unattached from the mannequin by removing it from a velcro strip attached to a model umbilical cord.

By conducting drills with the mannequin, hospital staff as well as obstetricians and pediatricians can simulate rare, high-risk situations “as close to the real thing as possible,” said Shirley Chun-Ming, nurse manager of obstetrics at Maui Memorial.

During one recent simulation, a doctor and nurses went through an emergency in which a baby being delivered is “stuck” behind the mother’s pubic bone. The risk for the baby is that his or her blood supply could be cut off if the delivery isn’t completed quickly. Staff members considered an emergency Caesarean delivery, but they eventually were able to deliver the baby normally by pulling the mannequin’s legs back and applying gentle downward pressure in the appropriate area.

Maui Memorial is one of fewer than 50 hospitals nationwide using the simulator training program.

The mannequin’s costs were covered through a $15,000 donation from the Kiwanis Club of Kahului and $7,000 from the Maui Memorial Medical Center Foundation.

Most baby deliveries are normal, but there are times when catastrophic or critical events occur and teamwork is required of those in the Obstetrics Department and possibly in other areas of the hospital, such as the emergency room.

Obstetrician Dr. Nancy Rogers stressed that it is critical for nurses, doctors and other staff to communicate and work together well in emergency situations.

“It’s exceedingly important,” she said.

Chun-Ming said she was first introduced to the idea of training with the mannequin about two years ago at a Mainland conference she attended with Rogers. “I thought this was great, and I wanted to bring it to Maui,” she said.

Rogers agreed, saying the mannequin has a way of “leveling” the hierarchy among medical professionals “so that everyone feels comfortable enough to speak up.

. . . It’s a way of teaching teamwork and communication skills where no lives are at risk.”

“It’s helps our overall working relationships,” Chun-Ming added.

Lynne Pritchard, a simulator trainer and registered nurse at the hospital, said she’s become more confident about her ability and that of the professionals around her to respond to emergencies.

“I think we are ready to troubleshoot,” Pritchard said.

Claudine San Nicolas can be reached at claudine@maui news.com.

Registered nurses Carleen Wong (left) and Jessica Caudill of Maui Memorial Medical Center’s Obstetrics Department introduced a $22,000 “pregnant” mannequin during a training session last month.
The Maui News / CLAUDINE SAN NICOLAS photo