ELECTRONIC RESOURCES

Intensive Care Resources on the Web: Let’s PlayDoctor!

Barry P. Markovitz, MD

Markovitz BP. Intensive care resources on the web: let’s play realistic and entertaining ‘‘moulages’’ that puts youdoctor! J Intensive Care Med 2001;16:100–101.

in charge of a trauma resuscitation, evaluations ofspinal column injuries, a pediatric scenario, andeven on a trip in a helicopter to be the first to arriveHypothetical patient scenarios, or reliving real ex-

periences, are used throughout health care as an at an accident scene. The moulages are valuableexercises for anyone involved in the care of traumainvaluable teaching tool. Indeed, discussing indi-

vidual case management is an integral part of many patients.The CyperPatient Simulator at MDChoice (http://specialties’ oral board examinations. It is nearly im-

possible to reproduce this experience of a dynamic www.mdchoice.com) has both adult and pediatriccode simulators. Although becoming dated andpatient encounter on paper. Until recently only a

human could react to the student’s actions, resulting with a limited number of scenarios, this is still auseful resource. One problem with these simulatorsin a smooth patient encounter or a stormy path of

complications with an adverse outcome. There is is their limited ability to accept more than one cor-rect response. Certainly in many situations, givennow software that can function in this capacity quite

admirably, and can be accessed from your desktop the choices available, only one strategy is correct.However, in real life and in these simulations thereon the Internet. There are also free-standing soft-

ware programs as well as ‘‘real’’ patient simulators are some gray areas where reasonable variationsin care are not tolerated.that are becoming increasingly useful and popular.

Trauma.org (http://www.trauma.org) has several A number of commercial offerings are available

Fig 1. SimBioSys Clinics 2.0 interface screen shot.

100 Copyright q 2001 Blackwell Science, Inc.

Markovitz: Intensive Care Resources on the Web 101

for purchase and installation on your desktop com- responses to interventions. Trainees, faculty, andpractitioners of many fields from emergency medi-puter. (These are listed for illustrative purposes

only; no recommendation or endorsement is im- cine to intensive care can experience physiologi-cally responsive mannequins with heart tones,plied.) Mad Scientist Software (http://www.madsci-

.com) offers Cardiac Arrest!, Code Team!, Trauma breath sounds, and even pupillary responses, andmust do everything that would be required for aOne!, and more. ResusSim 98 from Sophus Medical

(http://www.sophusmedical.dk/) is an ALS simula- real patient, including the administration of drugsand fluids. Sophisticated software along with antor. Medical Multimedia Systems (http://www.web-

com.com/~medmult/) offers SimBioSys Clinics operator in an adjacent control room provides ex-tremely realistic scenarios. Indeed, particularly forversion 2.0, a PC- or Mac-based program that offers

a dynamic, graphical approach to ICU patient man- rare event recognition and management, healthcare could certainly stand to learn some lessonsagement scenarios (Fig 1).

Of course all web-based simulators pale in com- from the advances made with simulators in the avia-tion industry. We are well on our way now.parison to the ‘‘real’’ simulators available today at

many academic institutions, usually based in anes-Barry P. Markovitz, MDthesiology departments. A listing of programs thatDepartments of Anesthesiology and Pediatricshave simulators (that are often available for useWashington University School of Medicineby community physicians for a fee) is available atSt. Louis Children’s Hospital

http://web.anes.rochester.edu/simulate/simusers One Children’s Place.htm. These are life-size mock patients that can be St. Louis, MO 63110

E-mail: markovitz@kids.wustl.eduprogrammed to exhibit a myriad of conditions and