set of U.Va.’s ER for medical students
Photo by Andrew Shurtleff
|Dr. Marcus Martin (center),
chief of emergency medicine, monitors the condition of
the ‘patient’ while
directing a team of rising fourth-year medical students in
a life-saving exercise.
By Dan Heuchert
Blood was everywhere in Room 66 of the U.Va. Medical
department. The team worked feverishly to save Stan, a 35-year-old welder, blown
some 30 feet off a scaffold in a workplace explosion.
Under the watchful eye and calm guidance of Dr. Marcus
Martin, chief of emergency
medicine, the team
worked to assess the moaning patient, restore
stem the bleeding, and stabilize him for delivery to the operating room.
When it was all over, the half-dozen medical students
stood back as Martin praised them. “Good job, team. Outstanding.”
Neither the blood nor the patient were real. The exercise
came on the last day of the third-year medical
students’ surgical rotation, and focused on emergency
diagnostic procedures and managing airways. It was made realistic by “Stan
the Man” (short for “standard man”), a $60,000 computerized
patient simulator obtained in December. (Plans are in the works to buy an even
more expensive adult model, plus a pediatric model.) Stan bleeds fake blood,
may be given a voice by a remote operator, can be hooked up to all manner of
monitors, and offers realistic body structure for incisions, injections and other
In short, he offers very realistic training in a consequence-free
environment, enabling medical students to test
their knowledge and skills in a crisis. “The
[students’] pulse rate rises in there, even with the simulator,” Martin
said. Students have the opportunity to perform a number of procedures that they
are months, or maybe years, away from doing on a real patient, he added.
The students’ day started in Jordan Hall, where they were given a morning-long
overview of disaster medicine and life-saving measures. The real fun — or
simulated fun? — started later, in an ambulance bay outside the emergency
Martin briefed groups of six students on what was known
about their “patient.” They
donned yellow paper gowns and booties; as the accident scenario involved possible
chemical exposures, the patient would have to be decontaminated before treatment
began. The students were assigned roles, which were identified by stickers on
their gowns — “team leader,” “airway,” “left
side of patient.”
Soon, they were led into room 66, where they met Stan,
bleeding from a couple of places, moaning with
pain and complaining about
A student ordered an IV and queried the patient on any
medications he might be taking. They checked
his pulse and put pressure on
else?” Martin asked the students.
blood pressure is low,” one responded.
“Right,” Martin said. “How are his breath sounds?”
There was a brief confusion as the students realized
that none of them had a stethoscope.
have one,” Martin said. “I have one — here.”
Soon, Stan’s tongue was swelling, obstructing his airway. The student leader
ordered a tracheotomy, an emergency incision into the windpipe to allow air into
don’t worry about sterile technique?” asked one student standing
near Stan’s feet.
“You’ve gotta get it done,” Martin said. “A little Betadine
would be fine.”
The student mimed spraying some antiseptic
toward Stan’s neck.
Later, a portable x-ray machine was wheeled
in to take an image of Stan’s
chest (although the images delivered came from a real patient).
another point, a student wielding a rather large needle
sought to place it in just the right
spot in Stan’s abdomen — a procedure called a “diagnostic peritoneal
lavage,” which seeks to determine if there is internal bleeding and where
it is coming from.
“I’m depending on you, Mark,” Martin said encouragingly. “You’re
There indeed was blood in the abdomen,
meaning a trip to the operating
room was necessary.
the students exchanged high-fives then
retired to a conference
view and discuss
biggest fun for me is to take students
who have no experience in this and
push them along and make them make decisions,” Martin said. “They