September 11, 2007
Pediatric specialist Betsy Hunt, M.D., and "Hugh" help train young doctors to respond rapidly in emergencies.
Pediatric critical care specialist Betsy Hunt has earned wide recognition for pinpointing mundane lapses that can occur amid desperate situations in the hospital, such as the rare times when a child’s heart stops beating. She’s found, for example, that the first part of standard CPR – getting air into the lungs – is done immediately, while checking for a pulse and starting chest compressions may be afterthoughts.
“Instead of using basic life support, people go for the defibrillator,” explains Hunt. “But the hook-up takes time, and if no one’s doing compressions, oxygen isn’t getting into the blood. At six minutes, you’re approaching irreversible brain damage.”
To help residents and nurses keep sharp and avoid such pitfalls, Hunt has been staging monthly pediatric “codes” at Hopkins Children’s. That’s not so unusual – but her assistant is. He’s Hugh, a multi-talented fellow who spurts blood, duplicates abnormal heart rhythms or breath sounds, undergoes intubations, and even flatlines. How does he do all this? Easily. He’s a computerized medical mannequin. And while some physicians may view such simulation training as time stolen from real patients, for pediatric residents and fellows like Nicole Shilkofski, Hugh builds confidence.
“When I was an intern at real pediatric codes, I’d think, ‘How are you supposed to learn to deal with emergencies like this?’” says Shilkofski. “But Hugh is so lifelike he can actually retch if your ventilations put air into his stomach instead of his lungs. You don’t forget that.”