Family Presence in ER’s

From the Union-Tribune (San Diego)

In the April 3 edition of The New Yorker, Dr. Jerome Groopman, the brilliant author of “The Measure of Our Days” and other books about illness and death, examines the evolution of family presence, the catchphrase for allowing family members into the emergency room.

The trend, Groopman reports, has been championed by hospital chaplains and nurses, often in opposition to physicians opposed to adding more stress to an already chaotic situation.

If there is a patron saint of family presence, it is the Rev. Hank Post, a chaplain who persuaded a Michigan hospital to allow families to observe resuscitations of loved ones. Post’s 1985 survey of 70 families revealed that the vast majority believed the experience, though harrowing, helped them move through their grief.

Thirteen years ago, the national Emergency Nurses Association endorsed open access, concluding that family members benefit from the first-hand knowledge that everything that could be done was done. Accompanied by a staff member, family can become part of the rescue team. Family members can provide information, for example. They can help decide when it is time to stop.

Still, families should not expect an automatic pass into the emergency room. That’s typically a judgment call by the emergency team, which can be divided.

Advanced Simulator Lab

From the Philadelphia Inquirer:

You wouldn’t want to be Dee, Fritz or Eric.

Last week, Dee was having a heart attack. Fritz was getting a tube snaked down his throat. And Eric, with no pulse or blood pressure, had been left for dead.

Earlier in the day, it was even worse. They had been treated for injuries caused by a small nuclear explosion.

Strapped to gurneys in a virtual emergency room at Burlington County College’s Mount Laurel campus, Dee, Fritz and Eric are human patient simulators – computerized mannequins that appear to breathe, bleed, blink and urinate.

The mannequins, which cost from $20,000 to $300,000 each, can be programmed to appear to be suffering from any of more than 100 afflictions or injuries.

The college’s Simulation Center has 14 of them, more than any institution outside the military, said Charles Grayson, the center’s manager.

The center is only a small part of the college’s Center for Public Health Preparedness, which is funded by the federal Centers for Disease Control and Prevention and has become a regional draw for hands-on emergency instruction.

Since the center opened in September, more than 2,000 nurses, firefighters, and other emergency personnel have trained there.

The mannequins can be programmed to be drug addicts, burn victims, or casualties of a nerve-gas attack. Their bowels rumble. They can be made to speak. They have a pulse just where you’d expect to find one.

Their faces bear an uncanny resemblance to the old Resusci Annes used for CPR training. But the similarity ends there. Compared with these mannequins, Anne is an old windbag. These fellows – they all resemble middle-age white men – have more in common with the humanoid robot Data from Star Trek: The Next Generation. Inside each is a tangle of wires, computer chips, hydraulics and pneumatics.