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Revived Mannequins Breathe New Life Into Training
by U.S. Navy Dawn Grimes, NMRTC Guantanamo Bay
May 4, 2022

Hospital Corpsman Ethan Church departed US Navy Medicine Readiness and Training Command Guantanamo Bay (US NMRTC GB) several weeks ago.

However, the contributions he made during his 18-month tour live on in the life-like mannequins that are helping medical staff keep their life-saving emergency medicine skills honed and ready.

November 8, 2021 - Naval Medical Forces Atlantic (MEDLANT) Rear Adm. Darin K. Via present HN Ethan Church US Navy Medicine Readiness and Training Command with a flag officer coin for his extensive efforts to improve the quality of training at the command. (U.S. Navy photo by Dawn Grimes, NMRTC Guantanamo Bay)
November 8, 2021 - Naval Medical Forces Atlantic (MEDLANT) Rear Adm. Darin K. Via present HN Ethan Church US Navy Medicine Readiness and Training Command with a flag officer coin for his extensive efforts to improve the quality of training at the command. (U.S. Navy photo by Dawn Grimes, NMRTC Guantanamo Bay)

When he arrived in October 2020, the London, Kentucky native was assigned to the Staff Education and Training (SEAT) department. It wasn’t the assignment he expected, but due to an extreme shortage in training staff, Church, right out of “A” school, was not only assigned, but for a short while, served as Lead Petty Officer. Almost immediately, he took an interest in the department’s training mannequins.

“When I got here, these things were useless, just negative space and only one person knew how to use them, Lt. Williams,” Church said. “Of course, her primary job was taking care of patients and she couldn’t come out to SEAT to make them work,” he explained. “It started out with me just trying to figure out on my own all the things they could do I thought it was neat ‘oh they can do this and that.’” His curiosity earned him an opportunity to undergo two-weeks of formal instruction at Navy Yard Portsmouth, Virginia. Two classrooms there simulated a battlefield environment, the other, an Operating Room. “I learned all about them, how they work, how to program, take them apart, clean them."

Returning to Guantanamo Bay, the newly trained technician set out to revive the training department's lifeless mannequins and give them a leading role in a variety of training scenarios including mass casualty drills, the command’s quarterly Round Robin Skills Training and during unannounced emergency drills.

“As the only qualified Enlisted Simulation Technician in the command, he programed and ran the 'SIM-Man' mannequin for the providers in the hospital to practice on.” Cmdr. Kristen Edgar, SEAT Department Head said. “During quarterly training, a mannequin was used to insert NG tubes to aspirate the contents of the stomach and practice feeding and monitoring the vitals while being inpatient," she said, adding,. “His ability to plan and operate training aids has been invaluable and greatly added to the successful and ever improving training for the command.”

Church managed, tracked, and maintained 21 mannequins, each with unique capabilities for complimenting and enhancing medical readiness training like ‘SimMan 3G’, a patient simulator created to simulate Pharyngeal swelling, Laryngospasm, Needle Thoracentesis, and other medical conditions. ‘SimMan 3G Trauma’ provides students the opportunity to practice responding to Arterial and Venous bleeding, Surgical Cricothyrotomy (a procedure that involves placing a tube through an incision in the cricothyroid membrane) as well as practice responding to amputated limbs.

“They’re very life-like, they can hold up to a pint of liquid that simulates blood, they talk and cry out and they have eye-tracking,' Church said, adding that the impact the mannequins make is evident. “Most of the time it’s not what people say when they’re training, it’s what they look like," he said. “During our last Code Purple, you could see they were really being tested they were stressing out - decisions had to be made - after the drill they were like, ‘that was one of the best trainings I’ve ever done.’”

Code Purple simulates an obstetrics emergency. The command’s most recent Code Purple occurred after Church’s rotation and used the mannequin named ‘Victoria.” The advanced simulator has accurate anatomical proportions and allows students to train using the obstetric tools they use in real patient care scenarios and simulates all stages of labor - from antepartum to postpartum.

April 26, 2022 - U.S. Navy Lt. Cmdr. Kristen Elmezzi responds to Code Purple Drill simulating birth with shoulder dystocia, also called birth trauma with “Victoria,” a Simulation Mannequin used during training at US NMRTC Guantanamo Bay. (U.S. Navy photo by Dawn Grimes, NMRTC Guantanamo Bay)
April 26, 2022 - U.S. Navy Lt. Cmdr. Kristen Elmezzi responds to Code Purple Drill simulating birth with shoulder dystocia, also called birth trauma with “Victoria,” a Simulation Mannequin used during training at US NMRTC Guantanamo Bay. (U.S. Navy photo by Dawn Grimes, NMRTC Guantanamo Bay)

For this drill, a code was called for simulating birth with shoulder dystocia, also called birth trauma, that happens when one or both of a baby's shoulders get stuck inside the mother's pelvis during labor and birth. “We just have fewer resources,” said Lt. Cmdr.. Kristen Elmezzi US NMRTC GB OB-GYN. “We have phenomenal and competent physicians, but being in an isolated location without ICUs or a big medical center very close by, these drills are essential to ensuring that we’re all keeping up our skills – from the OBGYN to everybody involved.”

The Code Purple drill also employed, ‘Super Tory’ a newborn simulator so life-like that it startled the responding physician. The infant simulator is designed to recreate the challenges of neonatal care specialist training in real environments and features active movement, true ventilator support and real patient monitoring. “Even though the moms who stay here to deliver are expected to have healthy babies, any labor has the potential to be very dangerous,” Elmezzi said. “That’s why you want to make sure that we’re doing these drills and that they’re as realistic as possible.”

As training leader for the command, Cmdr. Edgar, puts high value on the benefits of training with the mannequins Church revitalized. “Simulation in healthcare creates a safe learning environment in which healthcare practitioners can learn new skills and hone existing individual and team skills.” Edgar said.

Lt Cmdr. Elmezzi, who joined the command after Church, echoed, “I don’t know how it was before I was here, but while I was here, I really feel like he took our simulations to the next level he really ran with this idea,” she said. “I handed him some materials in terms of simulations topics, and he took it and he created phenomenal drills. He really got the mannequins ready to roll and he made it so the rest of the SEAT team are prepared to continue, that was shown in our last drill, the SEAT team were ready and on it and completed the simulation without any hiccups.”

Last November, Church was recognized by Naval Medical Forces Atlantic Commander, Rear Adm. Darin K. Via who presented him with a flag officer coin for his extensive efforts to improve the quality of training at the command. He has now reported for duty with 1st Marine Division, 5th Regiment Camp Pendleton California. “I want to be in the field, that’s where every corpsman should want to be, that’s where corpsmen originated.” About his time and experience in Guantanamo Bay, Church said, “I couldn’t do patient care, so I found my own way. I’ve learned a lot and I feel fortunate that I got to play a role in patient care making a difference for how our doctors and corpsmen are ready.“

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