Making simulations more real: experiences from an advanced resuscitation provider course

Methods Eight EMTs participated in the course, which started with self-studies based on the 2005 ALS-algorithm and an instructional DVD that has been produced in-house. This was followed by six hours of skill training workshops. Another six hours of traditional mannequin simulation preceded the more advanced scenarios which also spanned over six hours (six scenarios) on CPR mannequins (Skilltrainer, Skillmaster and Resusci-Anne, Laerdal, Norway). Simulations were made more realistic with the use of alternative clothing on the mannequins, furniture to simulate a realistic location, human actors as next of kin or healthcare professionals and so on. In one particular scenario, esophageal hemorrhage from varicose veins was simulated by intubating the mannequin in both lungs to insert a drip set. Using the drip set, we filled each lung with red-coloured lactated Ringer's solution. Placed horizontally, the oropharynx quickly flooded with "blood". We made a point of using easily obtainable objects to do this, so that anyone who runs simulations can replicate it with low costs.