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Emergency personnel learn from mannequins

Local emergency medical personnel engaged in an exercise Tuesday in a mobile training vehicle at Jamestown Regional Medical Center. (John M. Steiner / The Sun)

You could call him a dummy, but Joe might be one of the most advanced dummies around — he blinks, bleeds and breathes, and with the help of his handlers, he can teach.

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On Tuesday, he helped out at Jamestown Regional Medical Center.

Joe is one of many nicknames for one of three advanced human patient simulator mannequins used by Simulation In Motion – North Dakota (SIM-ND) to give hands-on training to emergency care workers throughout the state.

“The purpose is to hit all critical access hospitals in the state, and emergency personnel,” said Melissa Misialek, registered nurse and sim coordinator with Sanford in Fargo. “… the purpose is to practice these low-frequency, high-acuity medical and trauma situations.”

In Jamestown, Joe, who resembles a child of 6 to 8 years old, played a trauma victim, and his adult-sized counterpart (named Einar for the day) also played a trauma victim.

“It gives them the opportunity to practice, review, practice (again) and talk about it,” Misialek said.

About 25 people tried the simulations at JRMC, including hospital staff as well as Jamestown Ambulance and Medina Ambulance workers.

“This is an excellent opportunity for the nursing staff and the ambulance staff,” said Sheila Krapp, manager of JRMC’s emergency department.

Participants in the simulations receive continuing education credits that they need to maintain certification.

“It was fun to be able to practice skills in an actual real-life situation, but not having to worry if you made mistakes,” said Caitlin Diede, a JRMC registered nurse who works in the emergency department.


SIM-ND is a partnership of the North Dakota Department of Health and the University of North Dakota School of Medicine, which administers the program using four massive simulation vehicles.

The vehicles and equipment were paid for by a grant from The Leona M. and Harry B. Helmsley Charitable Trust, and facilities they visit don’t have to pay any fees, Misialek said.

The mobile learning labs each have a different home base — Fargo, Minot, Grand Forks and Bismarck. Together, they have reached about 1,000 learners at 50 different sites.

The one that visited Jamestown Tuesday came from Fargo, and it’s staffed by members of the F-M Ambulance crew, Sanford Health in Fargo and Essentia Health in Fargo.

The back of the vehicle is kitted out like an ambulance, complete with all the features of a real one, and the front of the vehicle has a fully-equipped emergency room, just like a facility in a hospital.

In between lies a control room, where various members of the five-person staff make child-sized Joe and his two mannequin friends as human as possible.

“He had a really bad accident and had chest trauma,” Misialek said, gesturing to Joe, who can be defibrillated, intubated and given IV fluids. The heart monitor shows his rhythms, and his pulse can easily be felt through his slightly-rubbery skin.

And with a little work, his handlers can make Joe sweaty, change the size of the pupils in his blue eyes, make him up so he’s bruised or turning blue and even — using creamed corn and oil — make him throw up.

“The purpose is to assess him like you would the real patient,” Misialek said.

Joe could have been hit by a car, but he could also have a seizure or a respiratory emergency, each with appropriate symptoms.

And from the control room, the SIM-ND staff serve as Joe’s voice, moaning in pain or talking like a child Joe’s apparent age would speak. Sometimes the staff plays a worried or distraught relative instead, asking questions or giving pieces of patient history to try to help.

“It is a little shocking, the realism, but that is the point,” Misialek said.

The mannequins are about as close as it’s possible to get to the real thing, Diede said.

“The focus of today was a lot of teamwork and learning how to do effective communication in a fast-paced trauma situation,” she said, calling it “a great experience.”

About the only thing that made Joe and his counterparts different from a real patient was the skin, which wouldn’t show color and temperature in exactly the same way human skin would, said Barb Schlecht, a registered nurse and house supervisor in the emergency department.

Even so, she said the patients were “very, very humanlike,” and helped the team practice communication, prioritize patients, assess and reassess and provide medications.

“I would love to see them come back in the future,” Schlecht added.

Chris Lunde, a registered nurse who serves as trauma coordinator for the JRMC, said the sim truck was a component of awareness and improvement.

“The mannequins are responsive. You’re able to identify visual injuries and treat the mannequin as a normal person,” Lunde said.

He was one of the trauma coordinators across the state who went to the opening of the sim trucks in Bismarck in June.

JRMC sees about 400 injuries per month — not including illnesses — and about 12 to 20 of those patients usually qualify to be classified as trauma patients, meaning they have severe injuries, multiple injuries or complicating factors, Lunde said.

Many of those patients are hurt in vehicle accidents — car-pedestrian, car-car, ATV or farm accidents, rollovers or higher-speed accidents, he added.

Like many of his real-life counterparts, that’s what happened to patient Joe in the pediatric trauma simulation that JRMC did.

“Joe was in a car accident, but due to the great care by the paramedics and nurses here, he’s going to make it,” Misialek said with a smile.

Sun reporter Kari Lucin can be reached at 701-952-8453 or by email at