The man was in the emergency trauma room with second- and third-degree burns he received in a house fire. He was semiconscious and having trouble breathing.
Respiratory therapists were called and after evaluating his vital signs, oxygen level, and rate of breathing they intubated him, inserting a tube in his mouth and down his airway so he could be placed on a ventilator.
In this case, the patient was a lifelike, advanced-technology mannequin. The emergency room was a simulated environment. And the respiratory therapists were students.
The realistic exercise took place recently at Northern Essex Community College’s new $27.4 million El-Hefni Allied Health & Technology Center in Lawrence, which opened in January and houses the college’s 20 or so health care programs.
“An important part of the college’s mission is providing local residents with the skills and credentials that will lead to jobs, and that is just what this new facility is helping us do,” said college president Lane Glenn at the ribbon-cutting in March.
“Our health care students are preparing for high-demand jobs, and the great majority of them plan to live and work locally,” he said. “When they graduate they are going to be taking care of all of us, working at area hospitals and health care facilities.”
The building and equipping of the facility were supported by $24 million from a Massachusetts higher education bond; $1 million from the Technical Training Foundation, founded by the late Ibrahim El-Hefni, for whom the building is named; $100,000 from Trinity EMS, which also donated an ambulance; and contributions from other individuals, foundations, and local companies.
“To see this level of both the facility and the mannequins in a community college is shocking,” said Nancy Harnois, simulation center coordinator.
The simulated environments in the 44,000-square-foot facility include a hospital intensive care unit, a trauma unit, an acute-care hospital room, a hospital ward, a doctor’s office, a sleep technology lab, and an ambulance.
“It’s amazing,” said Jennifer Jackson-Stevens, coordinator of the college’s respiratory care program. “It really brings a sense of realism that the students didn’t have before. I think they feel more comfortable going into a hospital setting because of that.”
Students learn basic skills, such as inserting a feeding tube, on static mannequins. As their training advances, they move on to the more high-tech versions.
Harnois, who worked as an emergency medical technician for 10 years, dresses and makes up the mannequins to reflect injuries and accidents. For the burn victim, for instance, she used a special gelatin to create the burns. Sometimes she also recreates smells, such as vomit or fecal matter.
From a control room, Harnois uses a computer to operate the mannequins, controlling everything from vital signs and respiration rate to sudden bleeding and bodily functions.
Some of the mannequins have recorded speech and Harnois can also talk through them. The most advanced mannequin the college has actually breathes, exchanges gases, and can be given medications that can be measured for accuracy. And there is a mannequin that simulates birth to an infant mannequin.
Harnois said the college has a library of prewritten scenarios, “everything from anaphylactic shock from a bee sting to a chemical or biological poisoning incident, like anthrax.”
Faculty members can also design their own scenarios. And Harnois often throws in a surprise or two.
“The students roll with it,” Harnois said. “They are so engaged they forget they are working with mannequins. To them, it feels real.”
The students are sometimes videotaped so they can critique the care they gave.
Another unusual feature is the ambulance in the building (the room was built around it) for paramedic training.
“It’s a huge step in the right direction for us,” said Rory Putnam, clinical coordinator of the paramedic program. “It’s a wonderful teaching tool. Emergency medical services education as a whole is moving toward simulation to prepare [students] for the real world.”
The simulated environments also allow students from different disciplines to work together, such as nurses with emergency medical technicians, and X-ray and respiratory technicians.
“The communication piece is huge,” Harnois said.
For the respiratory students working with the “burn victim,” the simulation was a glimpse into the future, when the patients — and their injuries — will be real.
“It was overall new to us,” said Jessica Malatzky of Malden, who as a student works at Lowell General Hospital and will continue after graduating this month and taking her board exams. “When listening to the breath sounds I didn’t know if you could put the stethoscope on the burn.”
Heather Bompane of Lynn, who also works at Lowell General and plans to continue after her boards, said, “I have never seen a burn patient, so I was cautious of touching him.”
“It was a wonderful learning experience,” said Andrea Middleton of Newburyport, who works at Lawrence General Hospital and plans to return. She also had never encountered a burn patient.
“It’s a different thinking process,” she said. “It’s good to have hands-on experience.”