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(July 26, 2001, Gazette)

Breathing easier

Drs. Siu O'Young and Vernon Curran inspect one of the mannequins that will be implanted with electronics to assist in teaching neonatal resuscitation. (L-R) Xiaoqian Kong, Alain O'Dea, Dr. O'Young, Rose Wilson, and Dr. Curran.





By Susen Johnson and Sharon Gray

First it was a doll that could crawl, then one that would cry, and, inevitably, a doll that could wet itself.

Now, the Faculty of Engineering and Applied Science is working towards even more lifelike specimens — dolls that mimic sick newborns and their responses to resuscitation.

This is the Anakin Project — Memorial University's attempt to make it easier for health professionals in remote locations to update their skills in neonatal resuscitation methods through mechatronics — the science of integrating electronic devices into mechanical ones.

Named after the child protagonist of the Star Wars saga, Anakin is a group effort of Engineering, the Faculty of Medicine, and the Janeway Children's Health and Rehabilitation Centre to develop computer software instrumentation packages that will render neonatal mannequins more lifelike and improve their utility for distance education.

As Engineering professor Dr. Siu O'Young explained, the idea is that health care professionals who typically travel to regional centres like St. John's to participate in neonatal resuscitation courses would, instead, access a mannequin at a local health site. Then, utilizing a combination of the Internet and videoconferencing, these trainees would update their skills — at a distance.

"Normally, they have to come to St John's and go through a set of maneuvers depending on different simulated conditions," Dr. O'Young said. "The newborn might not breathing on its own due to meconium in the airway, or because they're extremely undersized. The healthcare provider must be able to react to these different scenarios, by properly evaluating the baby's condition and performing the proper steps of resuscitation. Clearly the health care provider has only minutes following the birth of a child before irreparable damage may occur."

Pediatrician Dr. Khalid Aziz of the Faculty of Medicine explained that the doll will mimic the signs of a sick baby and then respond positively to appropriate resuscitative efforts. "We don't certify people in resuscitation," he said, "but we register them as having attended and completed an educational course or update using a simulation."
Dr. Aziz said this project will assist neonatal resuscitation instructors in the province to maintain their skill levels, and, by extension, provide skill updating to the healthcare providers they serve. "In centres with only 100 deliveries per year, less than 10 infants might require resuscitation," Dr. Aziz said. "So that means the nurses and physicians who attend deliveries may only use their skills once a year. The Anakin Project will provide these people with a level of self-efficacy."

On the engineering side, the INCA Centre is developing a package of computerized sensors, actuators, and microcontrollers to render the mannequins more lifelike. The mannequin will display vital signs corresponding to a predefined scenario set by the instructor via the Internet. In addition, it will respond appropriately to the trainee's attempts at resuscitation.

Wired to an ordinary computer in the trainee's work setting, the mannequins will send data to a St. John's-based ‘puppeteer' about how the resuscitation is proceeding. If the proper steps of resuscitation (including providing warmth, clearing the airway, supporting breathing through ventilation, and supporting circulation with chest compressions) are performed in a timely manner, the mannequin will display the vital signs of a healthy newborn.

The mannequin simulators will appear to have lungs which rise and fall, stomachs that distend, and bodies that turn from blue to pink. They will also provide a heart beat and make crying or choking noises.
A randomized controlled trial is planned for this autumn to compare skill retention using the new, instrumented mannequin versus a training videotape.

Sponsors of the program include the Newfoundland and Labrador Provincial Perinatal Program, the Janeway Children's Health and Rehabilitation Centre, the Janeway Foundation, the Newfoundland and Labrador Centre for Applied Health Research, the Heart and Stroke Foundation of Newfoundland and Labrador, and Cahill Instrumentation.

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