Stories about: Simulation Program

A second chance for Bentley and his encephalocele

Bentley Yoder encephaloceleSierra Yoder was having a normal pregnancy, but the 20-week prenatal ultrasound seemed to tell another story. The Yoders learned that their child — a boy to be named Bentley — had something called an encephalocele. Brain tissue was bulging out of an abnormal opening in his skull, unprotected by bone.

“They said he had zero chance of survival — ‘incompatible with life,’ they told us,” recalls Sierra. “I specifically remember asking is there any chance he could survive? They said no, that in the best-case scenario, he’s going to be a vegetable. They made it out like I was going to lose him at any point.”

With that knowledge, the Yoders decided to end the pregnancy. But at the 11th hour, Sierra changed her mind. It didn’t feel right — Bentley was moving and kicking and had a strong heartbeat.

So they kept going.

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Lessons from a disaster relief simulation

A group of clinicians worked together to stabilize the "patient."

Clinicians working in high-resource settings, like Children’s Hospital Boston, rely on the availability of certain equipment to do their jobs, like ventilators, specially sized needles and tubes and a fully stocked pharmacy. But when they’re forced to perform without their gear—like in Haiti in the immediate aftermath of the January earthquake—many find it bewildering and even paralyzing. “We fall into these patterns of providing care,” says David Mooney, MD, MPH, director of the Trauma Program, who was one of the first medical responders to respond after the disaster. “One of the things I noticed in Haiti was that many doctors really fixated on what they didn’t have.”

That mental block can waste time and be counterproductive, so Children’s is developing a training program to prepare the doctors, surgeons, nurses, pharmacists and other volunteers who are going to Haiti to continue relief efforts in the coming months for the conditions they’re likely to find. Mooney, along with Shannon Manzi, PharmD, and Debra Weiner, MD, PhD, worked with Children’s Simulator Program to create the special training, in which clinicians reenact challenging situations on robotic mannequins. Peter Weinstock, MD, PhD, director of the Simulator program, hopes that by practicing in an environment with limited supplies, clinicians will be encouraged to think outside of the box to find the resources they need, and will be better prepared for a disaster zone.

(Listen to a WBUR story about Children’s new simulation program and read The Boston Globe’s White Coat Notes report of it.)

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