Thursday, December 21, 2006

Patient Simulator

At the end of the cardiovascular block, we had a session with a patient simulator at San Francisco General Hospital (SFGH). The patient simulator is a "souped-up" CPR dummy. It can breathe, has pulses, has pupils that react, and talks. You can listen to heart and breath sounds and do a fairly comprehensive physical exam. They put us in groups of seven as a team to treat the patient.

I was one of two history takers. It was a little nerve-racking. Something was definitely wrong with the patient. He was very light headed, had a pulse of 120, and a blood pressure of 60/40. It was hard to concentrate on which questions were pertinent - clearly, we would not care about where he lived ("social history"), but we might care about whether he had shortness of breath. My peers did a physical exam, set up an EKG, and got the vitals on the monitor. One first-year was the fake resident who supervised us.

We took a quick time-out to discuss a differential for the patient. We came up with a plan of diagnostics and treatment, and began to administer the plan. Afterwards, we gathered in a conference room where a fourth year explained the pathophysiology of the condition. It was highly educational. In a real situation, would we have been as successful? I don't know. Though we pretended the mannequin was a real person, it's hard to picture what we would do if a real person was dying on us.

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