Mark Communale: Today anesthesiologists train in a simulator before they even take care of any patients. At the training program here, our first year residents come down and spend a number of days training performing procedures, performing anesthesia on the manikin before they go to the operating room. This is a patient care simulator, a human patient simulator and he is a manikin and he is anatomically correct and in addition to that he breathes, he is eyes open and his pupils dilate, he has bodily functions, you can give him intravenous fluids, he makes urine, you can listen to his heart rate, you can take his blood pressure, you can even start IVs right here.
He has contacts here so that we can practice CPR and defibrillation. In this particular setting for anesthesia, we are able to intubate him. His mouth will swell if he has an allergic reaction. We have to treat that and the way we train down here is we run through certain exercises. We perform anesthesia just as we would upstairs in the operating room and certain events are programmed to happen and then the person who is here, performing the anesthesia is observed to see whether they appropriately respond to those events.
And in that way, we get practice. So, we can practice treating an allergic reaction for example 50 or 100 times without ever having to worry about a lot of patients. We can practice, what to do in a cardiac arrest during anesthesia many, many times. We can stop in the middle of it and we can even record ourselves and watch ourselves and how we performed and critique ourselves. So, that's the beauty of simulated having a simulator.
So, what you see here is a typical set up in an operating room. This room is essentially no different than the rooms that we have upstairs in the regular operating room. They are set up exactly the same, with the exactly the same anesthesia machine and monitors, the same operating table and the same anesthesia cart which contains all of the same supplies that we would use in the operating room upstairs. So, this is room is really an exact duplicate of any one of our operating rooms upstairs.
There are a number of bodily functions that the anesthesiologist is responsible for monitoring during the surgery in anesthesia. We have over here, the ventilator. Many patients who undergo anesthesia are put to sleep and then once they are asleep they are intubated as you saw earlier with an endotracheal tube and they are placed on a ventilator. And by placing them on a ventilator, I am able to free my hands up to take care of other issues during the surgery.
So, we have a ventilator and we have the controls for the ventilator. we can give the patient deep breaths, we can give them shallow breaths, we can control the number of breaths that the patient gets each minute, then we can also control the amount of oxygen that the patient is getting by using these flow meters on the anesthesia machine, this one happens to be oxygen. We can also dial in air if we don't want to give a lot of oxygen. So, we are able to control the, not only the amount of breaths and the depth of breathing but also what the patient is breathing.
This is a vaporizer that delivers the anesthetic agents, in this case this is called Isoflurane. This is a non-flammable, fairly inert anesthesia agent. It doesn't harm the patients and it is not flammable. But, we dial in the amount of anesthesia that we need by turning this knob on the top of the vaporizer to a setting here that indicates the percent of anesthetic agent that's flowing into the anesthesia machine and into the patient.
We are also constantly monitoring the amount of oxygen that we are giving the patient on this meter right here. We never want to give low concentrations of oxygen because, a patient can't tell you if they are not getting enough oxygen when they are asleep again. So, again it all comes down to the problem with, when the patient is asleep, they can't tell us that there is a problem. So, we have to have all of this technology available and being used on the patient to detect any problems should they occur.
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