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Evaluation of a Novel Field Suction Unit (SÜPEVAC): A Mannequin Crossover Trial

Baxter T, Grimmett W, Reardon D

Air Med J, 2021 08 03;40(6):455-458.
PMID: 34794789 DOI: 10.1016/j.amj.2021.07.001

OBJECTIVE: The purpose of this study was to obtain a quantitative and qualitative assessment of the SÜPEVAC unit (German Malaysian Medical Industries, Selangor, Malaysia), a novel field suction unit powered by a positive pressure gas source and capable of hospital-grade suction levels and rates.
METHODS: This was a randomized crossover trial in a simulated clinical setting to compare the SÜPEVAC unit with standard hospital wall suction. Twenty-two fellows of the Australasian College for Emergency Medicine, the Australian and New Zealand College of Anaesthetists, or the College of Intensive Care Medicine were recruited. Outcomes were assessed via a structured survey and measuring the time to view the glottis.
RESULTS: This study found there was no significant difference between the SÜPEVAC unit and wall suction with regard to suction time (P = .762; 95% confidence interval, -0.683 to 0.338) or qualitative assessment via the survey.
CONCLUSIONS: The SÜPEVAC unit is comparable with wall suction in a clinical setting. Further research is warranted.

Matched MeSH terms: Manikins*
Neurosurgical endoscopic training via a realistic 3-dimensional model with pathology

Waran V, Narayanan V, Karuppiah R, Thambynayagam HC, Muthusamy KA, Rahman ZA, et al.

Simul Healthc, 2015 Feb;10(1):43-8.
PMID: 25514588 DOI: 10.1097/SIH.0000000000000060

Training in intraventricular endoscopy is particularly challenging because the volume of cases is relatively small and the techniques involved are unlike those usually used in conventional neurosurgery. Present training models are inadequate for various reasons. Using 3-dimensional (3D) printing techniques, models with pathology can be created using actual patient's imaging data. This technical article introduces a new training model based on a patient with hydrocephalus secondary to a pineal tumour, enabling the models to be used to simulate third ventriculostomies and pineal biopsies.

Matched MeSH terms: Manikins*
Violent actions against children

Alhammami M, Ooi CP, Tan WH

Data Brief, 2017 Jun;12:480-484.
PMID: 28508027 DOI: 10.1016/j.dib.2017.04.026

We present in this paper a novel dataset (MMU VAAC) for violent actions against children recognition. This original dataset has been recorded using Microsoft Kinect with the usage of a child mannequin. MMU VAAC dataset contains skeleton joints, depth, and RGB modalities.

Matched MeSH terms: Manikins
Fulltext Natural features technique for non-contact three dimensional craniofacial anthropometry using stereophotogrammetry

Majid, Z., Chong, A., Setan, H., Ahmad, A., Rajion, Z.A.

Archives of Orofacial Sciences, 2006;1(1):42-50.
MyJurnal

This paper describes the use of stereophotogrammetry approach to measure and hence identify accurately threedimensional (3D) coordinates of important landmarks on a craniofacial surface. A "novel" technique dubbed as "natural features" technique was employed to accurately compute the 3D coordinates of selected craniofacial landmarks. The natural features technique involves the use of 3D coordinates of the natural features (such as acne, scar, corners of eyes, edge of mouth, point of chin, etc.) that appear on the craniofacial surface as an absolute stereophotogrammetric mapping control points. The 3D coordinates of the natural features were gained using digital photogrammetric bundle adjustment method. Validation of the proposed technique has firstly been carried out using mannequin and finally, it was applied on the real-life human faces. The result shows that the craniofacial landmark measurement accuracy of 0.8mm with one standard deviation can be successfully achieved by the proposed technique.

Matched MeSH terms: Manikins
Fulltext The Effects of Different Outdoor Environments, Sunglasses and Hats on Light Levels: Implications for Myopia Prevention

Lanca C, Teo A, Vivagandan A, Htoon HM, Najjar RP, Spiegel DP, et al.

Transl Vis Sci Technol, 2019 Jul;8(4):7.
PMID: 31360613 DOI: 10.1167/tvst.8.4.7

Purpose: Lack of outdoor time is a known risk factor for myopia. Knowledge of the light levels reaching the eye and exposure settings, including sun-protective measures, is essential for outdoor programs and myopia. We evaluated the impact of sun-protective strategies (hat and sunglasses) on maintaining high illuminance levels to prevent myopia.
Methods: A child-sized mannequin head was developed to measure light illuminance levels with and without sun-protective equipment, across a wide range of environments in Singapore, outdoors (open park, under a tree, street) and indoors (under a fluorescent illumination with window, under white LED-based lighting without window). A comparison was made between indoor and outdoor light levels that are experienced while children are involved in day-to-day activities.
Results: Outdoor light levels were much higher (11,080-18,176 lux) than indoors (112-156 lux). The higher lux levels protective of myopia (>1000 lux) were measured at the tree shade (5556-7876 lux) and with hat (4112-8156 lux). Sunglasses showed lux levels between 1792 and 6800 lux. Although with sunglasses readings were lower than tree shade and hat, light levels were still 11 to 43 times higher than indoors.
Conclusions: Recommendations on spending time outdoors for myopia prevention with adequate sun protection should be provided while partaking in outdoor activities, including protection under shaded areas, wearing a hat or sunglasses, sunscreen, and adequate hydration.
Translational Relevance: Light levels outdoors were higher than indoors and above the threshold illuminance for myopia prevention even with adequate sun-protective measures.

Matched MeSH terms: Manikins
Simulation study on quality of CPR between manual chest compression and mechanical chest compression devices performed in ambulance

Kamauzaman THT, Ngu JTH, Arithra A, Noh AYM, Siti-Azrin AH, Nor J

Med J Malaysia, 2021 03;76(2):171-176.
PMID: 33742624

BACKGROUND: Maintaining good quality CPR while transporting out-of-hospital cardiac arrest patients is very challenging. We aim to determine how different ambulance speed can affect the quality of chest compression performed either manually or mechanically.
METHODS: This was an observational manikin-based study. A total of 96 participants as well as two types of mechanical compression devices: Lucas-2 and AutoPulse, performed one minute of continuous chest compression on BT-CPEA programmed manikin while the ambulance travelled at different speeds, i.e., idle state, 30km/hr and 60km/hr. Seven outcome variables of chest compression were measured. Performance data of different groups of compressor were compared and analysed using repeated measures analysis of variance (ANOVA).
RESULTS: In manual chest compression, significant variation were noted among different speeds in term of average compression rate (p<0.001), average compression depth (p=0.007), fraction of adequate/insufficient compression depth and fraction of normal hands positioning with p=0.018, 0.022 and 0.034 respectively. Overall, AutoPulse and Lucas-2 were not affected by ambulance speed. Lucas- 2 showed more consistent average compression rate, higher fraction of adequate compression depth and reduced fraction of insufficient compression depth as compared to manual compression with p<0.001, 0.001 and 0.043 respectively.
CONCLUSION: In this study we found that ambulance speed significantly affected certain aspects of manual chest compression most notably compression depth, rate and hand positioning. AutoPulse and Lucas-2 can improve these aspects by providing more consistent compression rate, depth and fraction of adequate compression depth during transport.

Matched MeSH terms: Manikins
Fulltext The use of simulation technique among undergraduate nursing student

Mohd Said Nurumal, Mohammad Syafiq Mohamad Azizi, Muhammad Kamil Che Hasan

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):10-0.
MyJurnal

Introduction: Simulation is widely practiced as learning strategies in many disciplines including nursing. It is con- sidered an updated technological approach towards providing safe and sound patients care. Thus, this study was conducted to assess the level of knowledge among nursing students using a simulated mannequin for cardiovascular assessment. Methods: This is a cross-sectional study design focusing Year 4 nursing students at Kulliyyah of Nurs- ing, International Islamic University Malaysia (IIUM). A simulation mannequin was used for students performing a cardiovascular assessment. Level of knowledge was tested using an adapted questionnaire. The study was approved by the Kulliyyah of Nursing Postgraduate Research Committee (Ref: IIUM/313/DDAA/20/4/10) and IIUM Research Ethics Committee (Ref: IREC 2018-024). Results: A total of 57 nursing students involved in this study revealing good cardiovascular assessment knowledge. Majority of them reported that simulation exercise is one of the good learning strategies to enhance their capabilities and increase their confidence level. Conclusions: The results from this study could indicate that using technological simulation approach could provide a similar effect in performing cardiovas- cular assessment among nursing student IIUM. Future larger scale is needed including for any other disciplines in nursing to facilitate students’ preparation towards the real clinical setting.

Matched MeSH terms: Manikins
Fulltext The Performance of Flexible Tip Bougie™ in Intubating Simulated Difficult Airway Model

Mahli N, Md Zain J, Mahdi SNM, Chih Nie Y, Chian Yong L, Shokri AFA, et al.

Front Med (Lausanne), 2021;8:677626.
PMID: 34026801 DOI: 10.3389/fmed.2021.677626

This prospective, randomized, cross-over study compared the performance of the novel Flexible Tip Bougie™ (FTB) with a conventional bougie as an intubation aid in a simulated difficult airway manikin model among anaesthesiology trainees with regards of first pass success rate, time to intubation, number of attempts and ease of use. Sixty-two anesthesiology trainees, novice to the usage of FTB, participated in this study. Following a video demonstration, each participant performed endotracheal intubation on a manikin standardized to a difficult airway view. Each participant performed direct laryngoscopy and intubated the manikin using a conventional bougie and FTB, at least 1 day in between devices, in a randomized order. The first pass success rate was significantly higher with FTB (98.4%) compared to conventional bougie (85.5%), p = 0.008. The median time to intubation was significantly faster when using FTB, median = 32.0 s [Interquartile range (IQR): 23.8-41.3 s] compared to when using conventional bougie, median = 41.5 s (IQR: 31.8-69.5 s), p < 0.001. The FTB required significantly less intubation attempts compared to conventional bougie, p = 0.024. The overall ease of use, scored on a Likert scale from 1 to 5, was significantly higher in the FTB (4.26 ± 0.53) compared to the conventional bougie (3.19 ± 0.83), p < 0.001. This simulated difficult airway manikin study finding suggested that FTB is a useful adjunct for difficult airway intubation. The FTB offered a higher first pass success rate with a faster time to intubation and less required attempts.

Matched MeSH terms: Manikins
Evaluation of workshop for training house-officers and medical officers on medical emergencies using simulation for workplace preparedness

Thiruselvi Subramaniam, Ann Jee Tan

International e-Journal of Science, Medicine & Education, 2017;11(1):33-38.
MyJurnal

Background: House-officers and medical officers are at
the forefront during medical emergencies in the ward
and casualty which impose cognitive, communication,
social and system challenges and yet, training in this
area is commonly lacking. A workshop was conducted
using simulation to provide training on some acute
medical emergencies like cord prolapse, post- partum
haemorrhage with collapse, poly-trauma and acute
exacerbation of asthma.

Objective: To determine the effectiveness of simulation
in developing competency in managing selected clinical
emergencies.

Methodology: There were 22 participants consisting
of house-officers, junior medical officers and nursing
clinical instructors. Only doctors were included in
the study. Four medical emergencies were chosen viz.:
Cord prolapse; post- partum haemorrhage with collapse;
poly-trauma and acute exacerbation of asthma. The
simulated sessions were conducted using high fidelity
manikins and simulated patients. Simulated patients
were trained and moulage was applied accordingly. The
skills stations were on airway equipment and techniques
of application, latest cardiac life support algorithm and
hands on chest compression using manikins.

Results: A 5 point Likert scale used to rate the
sessions. The skills station had 65% (n=13) rating as
excellent and 35% (n=7) good. The skills simulation
was rated excellent by 75% (n=15) and good by 25%
(n=5) of participants. Verbal feedback was that it was
very refreshing, informative, and helpful in terms of
improving their skills.

Conclusion: The simulated skills training for the junior
doctors was very well received and maybe beneficial for
work preparedness and in the long run address patient
safety.

Matched MeSH terms: Manikins
Causes of stress and their change with repeated sessions as perceived by undergraduate medical students during high-fidelity trauma simulation

Pai DR, Ram S, Madan SS, Soe HH, Barua A

Natl Med J India, 2014 Jul-Aug;27(4):192-7.
PMID: 25668162

It is known that simulation training is associated with stress for the trainees, at all levels of trainee experience. We explored the factors which were perceived by the trainees to cause them the maximum stress related to their simulation experience and their temporal changes over three simulation sessions.

Matched MeSH terms: Manikins*
Reprint of: Cling film plastic wrap: An innovation for dead body packaging, preservation and transportation by first responders as a replacement for cadaver body bag in large scale disasters

Khoo LS, Lai PS, Saidin MH, Noor Z, Mahmood MS

Forensic Sci Int, 2018 Jul;288:242-255.
PMID: 29783180 DOI: 10.1016/j.forsciint.2018.04.017

Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.

Matched MeSH terms: Manikins
Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training

Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.

Resuscitation, 2014 Jul;85(7):945-51.
PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025

Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.

Matched MeSH terms: Manikins
Fulltext Shoulder strap fixation of LUCAS-2 to facilitate continuous CPR during non-supine (stair) stretcher transport of OHCAs patients

Chen CB, Chen KF, Chien CY, Kuo CW, Goh ZNL, Seak CK, et al.

Sci Rep, 2021 05 10;11(1):9858.
PMID: 33972647 DOI: 10.1038/s41598-021-89291-4

Early recognition and rapid initiation of high-quality cardiopulmonary resuscitation (CPR) are key to maximising chances of achieving successful return of spontaneous circulation in patients with out-of-hospital cardiac arrests (OHCAs), as well as improving patient outcomes both inside and outside hospital. Mechanical chest compression devices such as the LUCAS-2 have been developed to assist rescuers in providing consistent, high-quality compressions, even during transportation. However, providing uninterrupted and effective compressions with LUCAS-2 during transportation down stairwells and in tight spaces in a non-supine position is relatively impossible. In this study, we proposed adaptations to the LUCAS-2 to allow its use during transportation down stairwells and examined its effectiveness in providing high-quality CPR to simulated OHCA patients. 20 volunteer emergency medical technicians were randomised into 10 pairs, each undergoing 2 simulation runs per experimental arm (LUCAS-2 versus control) with a loaded Resusci Anne First Aid full body manikin weighing 60 kg. Quality of CPR compressions performed was measured using the CPRmeter placed on the sternum of the manikin. The respective times taken for each phase of the simulation protocol were recorded. Fisher's exact tests were used to analyse categorical variables and median test to analyse continuous variables. The LUCAS-2 group required a longer time (~ 35 s) to prepare the patient prior to transport (p

Matched MeSH terms: Manikins
Fulltext COVID-19 aerosol box as protection from droplet and aerosol contaminations in healthcare workers performing airway intubation: a randomised cross-over simulation study

Noor Azhar M, Bustam A, Poh K, Ahmad Zahedi AZ, Mohd Nazri MZA, Azizah Ariffin MA, et al.

Emerg Med J, 2021 Feb;38(2):111-117.
PMID: 33219133 DOI: 10.1136/emermed-2020-210514

BACKGROUND: Concerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. Its efficacy as a barrier protection in addition to the use of a standard personal protective equipment (PPE) is not fully known. We performed a simulated study to investigate the relationship between aerosol box usage during intubation and contaminations on healthcare workers pre-doffing and post-doffing of PPE.
METHODS: This was a randomised cross-over study conducted between 9 April to 5 May 2020 in the ED of University Malaya Medical Centre. Postgraduate Emergency Medicine trainees performed video laryngoscope-assisted intubation on an airway manikin with and without an aerosol box in a random order. Contamination was simulated by nebulised Glo Germ. Primary outcome was number of contaminated front and back body regions pre-doffing and post-doffing of PPE of the intubator and assistant. Secondary outcomes were intubation time, Cormack-Lehane score, number of intubation attempts and participants' feedback.
RESULTS: Thirty-six trainees completed the study interventions. The number of contaminated front and back body regions pre-doffing of PPE was significantly higher without the aerosol box (all p values<0.001). However, there was no significant difference in the number of contaminations post-doffing of PPE between using and not using the aerosol box, with a median contamination of zero. Intubation time was longer with the aerosol box (42.5 s vs 35.5 s, p<0.001). Cormack-Lehane scores were similar with and without the aerosol box. First-pass intubation success rate was 94.4% and 100% with and without the aerosol box, respectively. More participants reported reduced mobility and visibility when intubating with the aerosol box.
CONCLUSIONS: An aerosol box may significantly reduce exposure to contaminations but with increased intubation time and reduced operator's mobility and visibility. Furthermore, the difference in degree of contamination between using and not using an aerosol box could be offset by proper doffing of PPE.

Matched MeSH terms: Manikins
Fulltext Analysis of cricoid pressure application: anaesthetic trainee doctors vs. nursing anaesthetic assistants

Yahaya NH, Teo R, Izaham A, Tang S, Mohamad Yusof A, Abdul Manap N

Braz J Anesthesiol, 2016 May-Jun;66(3):283-8.
PMID: 27108826 DOI: 10.1016/j.bjane.2014.10.008

BACKGROUND AND OBJECTIVE: To evaluate the ability of anaesthetic trainee doctors compared to nursing anaesthetic assistants in identifying the cricoid cartilage, applying the appropriate cricoid pressure and producing an adequate laryngeal inlet view.

METHODS: Eighty-five participants, 42 anaesthetic trainee doctors and 43 nursing anaesthetic assistants, were asked to complete a set of questionnaires which included the correct amount of force to be applied to the cricoid cartilage. They were then asked to identify the cricoid cartilage and apply the cricoid pressure on an upper airway manikin placed on a weighing scale, and the pressure was recorded. Subsequently they applied cricoid pressure on actual anaesthetized patients following rapid sequence induction. Details regarding the cricoid pressure application and the Cormack-Lehane classification of the laryngeal view were recorded.

RESULTS: The anaesthetic trainee doctors were significantly better than the nursing anaesthetic assistants in identifying the cricoid cartilage (95.2% vs. 55.8%, p=0.001). However, both groups were equally poor in the knowledge about the amount of cricoid pressure force required (11.9% vs. 9.3% respectively) and in the correct application of cricoid pressure (16.7% vs. 20.9% respectively). The three-finger technique was performed by 85.7% of the anaesthetic trainee doctors and 65.1% of the nursing anaesthetic assistants (p=0.03). There were no significant differences in the Cormack-Lehane view between both groups.

CONCLUSION: The anaesthetic trainee doctors were better than the nursing anaesthetic assistants in cricoid cartilage identification but both groups were equally poor in their knowledge and application of cricoid pressure.

Matched MeSH terms: Manikins

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