A novel mechanism for simulation of partial seizures in an infant.
BACKGROUND
Seizures are a common pediatric emergency, occurring in 4% to 6% of all children by the age of 16 years. Seizures are also present in many patients with critical illness requiring resuscitation. Whereas some high-fidelity simulators have built-in seizure mechanisms, others do not. We report a novel inexpensive mechanism replicating a partial seizure in the SimBaby mannequin and the use of this mechanism in several high-fidelity in situ simulations.


METHODS
A brake lever set and a brake cable/housing for a mountain bike were attached under the skin of the SimBaby mannequin, through the groin, out of the axilla, and around the left arm. The cable was hidden under sheets and taped to the floor. The cable length allowed the controller to be several feet away from the mannequin while controlling the seizures. In our emergency department in situ simulations, this person is the educator who runs the mannequin or a confederate participating in the scenario.


RESULTS
The instructor controlling the seizure mechanism was able to stand unobtrusively in the corner during the in situ simulations and activate the seizure as indicated. Simulation participants clearly recognized that the infant was seizing and reacted appropriately as per the scenario (status epilepticus, head trauma, and tricyclic antidepressant ingestion).


CONCLUSIONS
We report a novel and inexpensive mechanism to accurately simulate partial seizures, using commonly available inexpensive bicycle components.
Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, 6621 Fannin St, Suite A2210, Houston, TX 77030, USA. dslemke@texaschildrens.org
Daniel
D
Lemke
Dan
D
Feux
Cara
C
Doughty
D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning; D003198:Computer Simulation; D006259:Craniocerebral Trauma / Q000150:complications; D004636:Emergency Service, Hospital; D004867:Equipment Design; D006801:Humans; D007223:Infant; D008348:Manikins; D017145:Models, Educational; D010372:Pediatrics / Q000193:education*; D012151:Resuscitation / Q000193:education / Q000379:methods; D012640:Seizures / Q000209:etiology; D013226:Status Epilepticus / Q000150:complications
D000929:Antidepressive Agents, Tricyclic