RUMFORD – “Stan” speaks and breathes, blinks and has reactive pupils, has a heartbeat and a pulse. “Who doesn’t?,” some ask. But “Stan” is built of plastic and wire, tubing and metal. “He’ is a Human Patient Simulator (HPS) that replicates complex medical and traumatic problems over and over again.

Stan gives critical care medical personnel a chance to test and practice their reactions and skills, leading to familiarity and confidence when they are confronted with a real patient.

“It’s analogous to a flight simulator,” said Rumford Hospital Emergency Department Chief Al Riel, M.D. “Just as flight simulators put pilots in situations they wouldn’t want to dive into in real life without some experience, the HPS does that for us.”

Critical care medicine relies on a “chain of survival,” with the weakest link often determining the final patient outcome, no matter how expert and practiced the tertiary care providers.

Often the greatest need for sophistication in managing complex, time-critical trauma patients is in Maine’s rural communities. That’s why Stan has traveled the state since June 2006 to allow critical care physicians, nurses and allied medical personnel to encounter a “patient” multiple times with focused feedback in a managed stress environment.

“Stan allowed us to perform work in a critical area without fear of harm,” said Karen Cole, clinical supervisor of the Rumford Hospital Emergency Department. “We could stop right in the middle to discuss, to ask questions or offer suggestions. That’s how you learn.”

By June 2007 every hospital in Maine will have had access to the simulator for at least a week. Enough funding remains for another year of operation and revisits to all the hospitals. Sources of funding to keep Stan on the road beyond 2008 are being explored.

The brainchild of the Maine Health Access Foundation, the simulator was funded by a state transportation bond to improve Maine’s air medical infrastructure.

At the urging of LifeFlight of Maine, the state’s only critical care air transport service, the legislature approved a $3 million bond that included monies for construction of hospital helipads, aviation safety improvements at rural municipal airports and $400,000 to fund the simulator for trauma training.

Stan cost more than $200,000, as he is computer-driven, high fidelity mannequin – the type used to train anesthesiologists in medical schools. Stan travels in a converted motor home that is set up like an emergency room. The mobile trainer is staffed by LifeFlight nurses, paramedics and, as available, physicians.

The scenarios are videotaped. The tape and the simulator expert clinical facilitator provide feedback, a debriefing that covers what was strong and what needs work in the team’s performance.

“It’s a good education program, a good service from LifeFlight,”said Gus Carlson, Rumford Hospital pharmacist, who is often called in on critical care cases to manage drugs. “The training gives critical care staff exposure to scenarios they may never have seen and makes them think about them, to be better prepared for what they may encounter in their work.”

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