CENTRUL DE SIMULARE MEDICALA "LifeSIM" este un proiect al CENTRULUI PENTRU DEZVOLTAREA RESURSELOR UMANE "For LIFE"

Advanced simulators

Advanced simulator for transesophageal and transthoracic echocardiography

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Heartworks is a simulator based on virtual reality used for learning cardiac anatomy, transesophageal(TEE) and transthoracic(ETT) echocardiography. It includes the following packages:

Anatomy package:

– it offers a three-dimensional, virtual heart, highly detailed, that can be analyzed from different angles of incidence and can be rotated around any axis, with over 150 separate intracardiac structures, labelled and described;
– any selected structure can be simultaneously highlighted in the text and displayed within the 3D model;
– a number of predefined areas of the heart can be displayed separately or in combination to demonstrate anatomical relationships.

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Transesophageal echocardiography package:

– introduces the facility for real time TEE image simulation;
– a realistic TEE probe with authentic controls inserts into the mouth of a life-size upper-body manikin;
– any structure selected in the 3D model is highlighted in the simulated TEE image, and vice versa;
– this mode allows people interested in TEE to visualize clearly the relationship between the 2D TEE image represented on the screen and the underlying 3D anatomy of the heart.

Transthoracic Echocardiography package:

– allows real-time simulated TTE imaging of the virtual heart;
– the anatomy display includes a representation of the chest wall, ribs, sternum and spine as well as great vessels, lungs, pericardium, diaphragm and liver.

Advanced simulator for abdominal, transvaginal, fetal ecography and FAST examination

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This advanced simulator allows health professionals to practice ultrasound diagnostics just as under real conditions, on over 200 cases. With two dummy torsos and four dummy transducers available, this system covers ultrasound diagnosis scenarios in the internal medicine, emergency, cardiology and gynaecology departments. Scan data is organized into thematic modules ranging from beginner to advanced difficulty. It allows loading of huge 3D original ultrasound data and MRI and CT data, synchronized to ultrasound window. Participants can be evaluated using a performance report that can be printed or exported in electronic format. Simulator curriculum is continuously developed by partner clinics, based on the clinical cases offered by them.

Advanced simulator for endovascular catheterization, based on virtual reality

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This simulation solution can be used in a variety of interactive training formats, individual or team training, for teaching and practicing techniques, procedures and teamwork in angiography and interventional training field.

It is a portable high-fidelity endovascular simulator enabling hands-on procedural training for clinicians and medical professionals. It allows training with the same devices used in clinical practice: diagnostic catheters, guide wires, catheters, micro catheters, stent and angioplasty balloons, embolic protection devices, etc. It provides the opportunity to explore the entire vascular system, using realistic full-body landmarks.

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The software modules include a large number of clinical cases in order to challenge the learner’s technical skills, clinical decision making abilities and procedural proficiency. The simulator also allows virtually hemodynamic monitoring and management of complications occurred during procedures, manual contrast injection, administration of medication, as well as detailed and timely assessment of the participants using a performance report.

The scenarios are designed in collaboration with professional medical organizations and offer a high degree of realism. For training modules in neuroradiology field, the simulator allows trainers to introduce the CT images and to create their own scenarios.

The simulator includes the following software modules:
– Coronary angiography and angioplasty;
– Cardiac rhythm management;
– Peripheral angiography and angioplasty;
– Embolization of cerebral aneurysms;
– Strokes;
– Carotid artery intervention (stenting);
– Renal artery intervention;
– Renal denervation;
– Iliac artery intervention / femoral artery;
– Uterine fibroid embolization;
– Intervention “Below the knee”;
– Transseptal puncture;
– Endovascular aortic repair (EVAR);
– Thoracic endovascular aortic repair (TEVAR);
– Appendix atrial occlusion;
– Percutaneous aortic valve implantation.

Advanced simulator for bronchoscopy, based on virtual reality

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This simulator is designed to improve bronchoscope dexterity through hands-on training.

These following features allow fast and easy usage:
– user-friendly interface;
– easily tansported;
– robust construction.

It consists of three main parts:
– a replica of a video bronchoscope, a desktop sensor and a dedicated laptop with software program;
– the replica video bronchoscope is connected to the small desktop sensor;
– the sensor registers movement of the insertion tube and translates this into a three-dimensional virtual airway displayed through the software on the laptop screen.

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The user can progress through a range of upper and lower airway scenarios receiving instant feedback as well as scoring metrics, recording and playback options. The ORSIM provides comprehensive training for a common diagnostic procedure, which until now has required lengthy specialist training. Based on its size, simplicity and economy, it is suitable for large training organizations as well as individual practices.

Advanced simulator for upper and lower gastrointestinal endoscopy, based on virtual reality

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Using advanced modeling technology, lifelike anatomic detail and realistic touch feedback, physicians can now experience diverse complications and scenarios while building confidence and proficiency.

Key features:
– realistic force feedback and graphics dynamics;
– true-to-life physiological responses and tool behavior;
– comprehensive training package, including administrator-friendly course planning features
– customizable skill training and case scenarios;
– extensive performance metrics;

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– fundamental skills: navigation, mucosal examination, targeting, retroflexion, and loop reduction;
– comprehensive colonoscopy skills training and procedural situations;
– while interacting with a virtual reality simulation of the human colon, physicians train to navigate through the entire large intestine, from rectum to cecum, at different difficulty levels;
– for each pathology the location and severity can be changed;
– colonoscopy features: biopsies/sample pathologic lesions, various polyp removal;
– intubation training cases;
– clinical cases: Crohn’s disease, sessile adenoma, ulcerative colitis;
– upper gastrointestinal endoscopy: esophageal intubation;
– the system offers a performance report based on measurements taken during exercises, which allows self-evaluation and progressive skills improvement.

Advanced simulator for otoscopy, based on virtual reality

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OtoSIM is an integrated system that dynamically improves the accuracy of diagnosing pathologies of the ear through experiential and interactive learning. It presents a realistic ear geometry and proprietary database of over 200 high-resolution images of various ear pathologies, accompanying detailed educational descriptions. The software module has an intuitive, easy-to-use graphic interface, landmarking function to highlight specific features to be viewed through an otoscope and allows connection at the same time of 6 units to deliver a consistent message and efficiently use instructor time.

Advanced simulator for ophthalmoscopy, based on virtual reality

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The simulator for direct ophthalmoscopy represents a highly effective in training system based on virtual reality. It is designed for fundamental skills in clinical ophthalmology and consistent performance in diagnosing using direct ophthalmoscopy.

The simulator is used in the way that doctors would actually handle an ophthalmoscope. Students look through the eyeball and may consult patients of different ages and different sex. Highly realistic retina can be examined like it would be real.

The simulator provides an immediately objective feedback after every virtual examination. Instructors will be able to access students accounts via a secure web portal. This way teachers can track the progress of training and can objectively evaluate the true skill level of students as they progress through the curriculum.

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The curriculum contains a selection of the most common retinal pathologies every medical student must be able to recognize, such as optic disc edema (including papilledema), diabetic and hypertensive retinopathy, or vascular occlusions. Frequent exposure to pathologies in different stages and varying degrees of severity fosters a solid foundation of how to diagnose specific pathologies. This is difficult to achieve when training on healthy fellow students.

Complex, interactive, full-size birthing simulator able to simulate normal and pathological birth

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Noelle is one of the most complex simulators in obstetrics and maternal-child care, being of the most trusted high-fidelity birthing simulator in the world.

It is worldwide recognized as an integral part of their simulation based training program — whether in a sim lab, in-situ, or mobile unit.

It can simulate:
– normal birth (cranial presentation);
– breech birth (complete, incomplete);
– vacuum or forceps assisted delivery;
– shoulder dystocia, using specific methods: McRoberts maneuver, suprapubic pressure, Gaskin maneuver, Muller maneuver etc;
– cesarean delivery, in a normal or complicated delivery scenario;
– postpartum hemorrhage;

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– management of eclampsia;
– placenta previa;
– prolapse of the umbilical cord;
– amniotic fluid embolism and its effects on maternal and fetal vital signs.

Obstetric-gynecology module:
– realistic anatomical landmarks including bilateral ischial spines, coccyx and pubic bone; fetus with placenta (with removable pieces to simulate placenta retention), umbilical cord, birth canal, dilating cervix;
– equipped with two mobile fetuses, one for cranial presentation and one for breech presentation;
– birthing fetus with fontanelles and sutures, realistic landmarks, jointed arms and legs, umbilicus, and placenta; fetal heart sounds audible before, during and after delivery;
– allows: ephisioraphy procedure; vacuum or forceps assisted delivery, change of change the maternal vital signs parameters, cardiotocography observation during the scenario.
Software:
– it includes standard scenarios, but allows trainers to create their own scenarios as well;
– it includes a recording function in order to allow the assessment of learners, as well as to get feedback on the performed procedures.

Advanced simulator for cardiopulmonary auscultation

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Harvey has been used for teaching and assessing bedside cardiac skills for over 30 years. The simulator and all the accompanying learning materials have been created and are continuously updated at the University of Miami with a consortium of physicians and educators representing medical centers worldwide.

Harvey can teach and test cardiopulmonary bedside skills that transfer to real patients.
Harvey and the teaching materials associated with the simulator can also teach and test pathophysiology, laboratory evaluation, differential diagnosis and treatment.

Harvey may be used to train many different types of healthcare professionals at many different levels of their training and in many different settings.
The appropriate use of Harvey must include integration into the required curriculum and the testing of outcomes.

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Exemples of simulated pathologies:
– mitral stenosis with mild tricuspid regurgitation;
– mitral stenosis & regurgitation;
– aortic regurgitation, chronic;
– aortic regurgitation, acute;
– aortic stenosis;
– hypertrophic obstructive cardiomyopathy;
– cardiomyopathy;
– acute pericarditis;
– primary pulmonary hypertension;
– atrial septal defect;
– ventricular septal defect;
– patent ductus arteriosus;
– pulmonary stenosis;
– coarctation of the aorta;
– tetralogy of Fallot;
– pulmonary stenosis;
– hypertension;
– mitral Valve Prolapse, Isolated click & murmur.

Tehnical features:
– simulates almost all cardiac pathologies, changing blood pressure, pulse, heart sounds, breath sounds and lung sounds;
– 30 heart diseases;
– 12 digital operated pulses;
– 9 areas for cardiac auscultation;
– 6 areas for lung auscultation;
– the amplitude of impulses may be individually changed;
– stethophones that may be used by multiple learners.

Advanced simulator for intensive therapy and advanced life support scenarios

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Hal sets a global standard for medical simulation.

Features:
– endotracheal intubation, normal or phatological (visible tongue edema, pharyngeal swelling, and laryngospasm) and selective intubation;
– multiple upper airway sounds synchronized with breathing;
– view vocal cords with Sellick maneuver;
– perform an emergency cricothyrotomy or tracheotomy;
– control rate and depth of respiration and observe chest rise;
– select independent lung sounds;
– real CO2 on exhalation;

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– allows the connection to real mechanical ventilators;
– bilateral needle decompression at second intercostal space;
– compliance and resistance can be varied while connected to the ventilator;
– ECGs are generated in real time with physiologic variations;
– heart sounds may be auscultated and are synchronized with ECG;
– measurable blood pressure;
– Korotkof sounds;
– monitor oxygen saturation using your real native oxymeter;
– pulse sites synchronized with BP and heart rate;
– intraosseous access at tibia;
– ECG monitoring using real devices;
– defibrillate, cardiovert and pace using real devices;
– vital signs monitor;
– create and store vocal responses in any language.

Software:
– it includes standard scenarios, but allows trainers to create their own scenarios;
– it includes a recording function in order to allow the assessment of learners, as well as to get feedback on the performed procedures.

Advanced 5 year pediatric simulator, portable, wireless controlled

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Five year pediatric simulator that allows the organization of efficient simulation sessions anywhere: at an accident scene, in an emergency room, in a medical emergency vehicle, in an intensive care unit etc.

It remains fully responsive even when it is carried from one place to another.

Features:
– tongue edema;
– multiple upper airway sounds synchronized with breathing;
– oral and nasal intubation;
– Sellick maneuver;
– perform a tracheotomy;
– control rate and depth of respiration;
– bilateral carotid, brachial and radial pulses operate continuously;

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– normal and phatological independent lung sounds;
– allow assisted ventilation, including mask and balloon mechanical ventilator, ventilation and chest compressions – detected, measured and recorded;
– chest compressions generate palpable blood pressure wave form and ECG artifacts;
– unilateral chest rise and multiple breath sounds;
– view ECGs with physiologic variations generated in real-time;
– pulse strengths with blood pressure and pulses are synchronized with ECG;
– intraosseous access at tibia and arms;
– defibrillate, cardiovert and pace using real devices;
– active eyes;
– body convulses on command;
– realistic rotation of the shoulder and hip joints.

Advanced newborn simulator, portable, wireless controlled

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This Newborn simulator allows you to perform advanced simulation anywhere at an accident scene, in an ER, in a labor and delivery room or in a NICU. “Care in motion” also provides the opportunity to measure how well the pacient transfer takes place, what was done well and what needs to be improved.

Features:
– nasal or oral intubation, right mainstem intubation;
– sensors detect depth of intubation;
– bag-valve-mask ventilation;
– Sellick maneuver brings vocal cords into view;

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– the rate and depth of respiration can be controled;
– bilateral chest rise and fall;
– normal and phatological independent lung sounds;
– chest compressions generate palpable blood pressure wave form and ECG artifacts;
– unilateral chest rise simulates pneumothorax;
– ECG rhythms are generated in real time;
– Korotkoff sounds audible between systolic and diastolic pressures;
– heart sounds synchronized with ECG;
– intraosseous infusion and injection system with realistic tibia bones;
– seizure/convulsions;
– muscle tone: active, right arm only, left arm only, reduced and limp;
– realistic rotation of the shoulder and hip joints;
– central cyanosis;
– color and vital signs respond to hypoxic events and interventions;
– interchangeable genitalia;
– umbilical catheterization.