Simulance Trains Emergency Workers at Stony Brook University Medical Center

Stony Brook University Medical Center is going digital with its training of volunteer emergency medical technicians and paramedics. The program, called Simulance, uses computer technology, a state of the art robotic manikin, and an ambulance that is equipped with audio visual technology to record each training session.

Eric Niegelberg, Director of Emergency Medical Services at Stony Brook Medical Center, said that the program was conceived after a similar program was demonstrated at an EMS training program in the Midwest.

"We had seen programs like this before, but we have geared ours toward training the various volunteer departments on Long Island," said Niegelberg. The program has been designed to allow the Simulance to travel to volunteer departments and offer a training session someplace within their jurisdiction. "The simulation lab is meant to have the same environment a clinician would work in," said Niegelberg.

"This type of program is excellent because it gives our trainees a feel for what the situation really is," said Brad Maier, ex-Chief of Babylon Village Fire Department "we do sometimes attend programs that involve simulation, but never in the area that we cover."

The vehicle, which is essentially a simulation laboratory on wheels, is a retired ambulance that was taken out of commission after it had been replaced by newer vehicles recently purchased by the hospital. The hospital spent around $140,000 converting the retired ambulance to a state of the art simulation laboratory for EMS training. "The ambulance was totally repainted and we installed new floors to fix it up," said Niegelberg.

One of the features of the Simulance is a state of the art, fully interactive robotic manikin. According to Niegelberg, a training instructor can remotely command the manikin to exhibit appropriate symptoms for the exercise.

"The manikin is totally wireless. The instructor remotely generates all symptoms and reactions to treatment," said Niegelberg. The robotic manikin can talk, exhibit a pulse, bleed and even die. Rapid situation changes, similar to what medical technicians face in the field, offers the trainees experience in dealing with multiple symptoms as well as learning to think under pressure.

The ambulance is also equipped with a $60,000 audio visual digital monitoring system. The vehicle is equipped with four cameras, a digital video recorder, a 52-inch LCD screen built into the side of the ambulance and a generator to power everything if there is no place to plug the Simulance in. The cameras are strategically placed within the ambulance, three inside the ambulance and one outside so that trainees can be recorded in a full simulation. The portability of the manikin and monitoring capabilities of the vehicle allow instructors to design a simulation in which trainees would have to bring a gurney to the "victim" and bring the victim back to the ambulance to be treated and transported to the hospital.

The 52-inch monitor located on the outside of the ambulance enables instructors and classmates to watch the simulation from outside. The screen is actually able to work as four separate monitors. A press release on the Simulance states "using split screen technology viewers will be able to constantly see both the care being administered to the 'patient' as well as a full array of vital signs and ECG [electrocardiogram] tracings that the manikin is exhibiting."

The Simulance program is designed to train outside volunteer departments and will be run by senior staff members of the medical center's EMS department, once the training program gets off the ground. The medical center has distributed flyers about the program to every EMS agency on Long Island but has received no responses. Bob Delagi, Acting Director of Suffolk County EMS, said that he knows about Simulance but has never seen it. "I never saw it, I have never been invited to see it and I have never been asked to publicize it," said Delagi. According to Delagi he has seen no sign of the University Hospital pushing Simulance. "I have not seen them encouraging organizations to use it (...) they are not offering any real incentive to use it."

Niegelberg insists that Suffolk County EMS is aware of the program and attributes the lack of response to the holiday season. In terms of results, Niegelberg said the training program is still too new to estimate the improvement it will have on the quality of care given by emergency service technicians and paramedics. Delagi said that Suffolk County EMS has a good feeling about the program. "The EMS system would welcome the opportunity to use it [Simulance] to enhance the EMS educational process."