Monday, 16 March 2009

Dummy run

Airline pilots train on simulators, one reason why flying is so safe. Surgeons hardly ever train on simulators, one reason why a hospital patient has a 1 in 300 chance of dying or being seriously harmed.

No wonder I'd have to be dragged kicking and screaming into a hospital if the need arose. That statistic is seriously scary. I'd probably have a higher chance of survival in crocodile creek.

Britain's Chief Medical Officer says that if all surgeons trained on simulators, or plastic dummies, there would be a big drop in the number of mistakes and mishaps, and surgical expertise would be greatly improved.

It would avoid cases like Elaine Bromley, who suffered irreversible brain damage during a minor operation because doctors weren't sure how to do a tracheotomy (an incision in the windpipe).

Airline pilots do regular simulator training to help them deal with emergencies. That's why a plane can be successfully landed on New York's Hudson River by an ice-cool pilot who knows exactly what he's doing.

Apparently Israel leads the world in training surgeons and health workers on simulators. They use sophisticated dummies that can bleed, breathe, be anaesthetised, be resuscitated, and show tell-tale medical signs.

If they're so beneficial and they could reduce the shocking toll of medical cock-ups, why on earth aren't Britain's surgeons making more use of them? Perhaps when people go into hospital, they should ask if their surgeon's been trained on a simulator. If not - find one who has.
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The abysmal standard of patient care at Stafford Hospital in England, which has caused up to 1200 unnecessary deaths, is quite shocking. It seems the hospital management was more interested in meeting performance targets than in looking after its patients. Thirsty patients were drinking out of flower vases and others were screaming in agony for lack of pain relief. Unbelievable.

16 comments:

conortje said...

1 in 300? Really? Good grief... mind you the one experience I've had with an operation turned out to be a disaster which had me being wheeled back in an hour later for emergency repairs as I was bleeding internally...

Nick said...

Conor, sorry to hear what happened to you. But doesn't that just prove my point? At least they spotted the internal bleeding, sometimes they don't even notice.

Caro said...

Ouch. At that rate you'd nearly be better off watching the entire twelve series of ER again and carrying out any necessary surgery yourself in front of the mirror.

Seriously though, it seems a no-brainer to practise on dummies rather than real live humans...

Nick said...

Caro - Good idea, if I need any surgery, I'll ask Jenny to have a go. At least she would care deeply about the patient. Indeed, isn't it a no-brainer to try on a few dummies first?

Wisewebwoman said...

I'll add to the horror story collection, Nick, I had an emergency appendectomy (very, very lucky as peritonitis had set in) and friends were taking me home a week later, got me dressed, I was still very weak and upon standing, my whole abdominal incision burst open and I had to be wheeled once more into emergency and re-stitched.
I must have 9 lives. It was horrible.
Like you, I hate hospitals and have zero confidence.
XO
WWW

Nick said...

www - My God, that stitching must have been incompetent to burst open like that. But very lucky they dealt with the peritonitis. There are far too many horror stories for my liking.

Baino said...

I'd be very surprised if UK doctors don't use dummies . . we do! And cadavers so they get the practice without the risk. It doesn't stop the odd 'accident' though. Let's face it, human error is just that and with the extremely long hours that public hospital doctors and surgeons work it's a wonder they can stand up at the end of a shift. Here's a sample of what Aussie doctors are 'practising' on:
http://www.gizmodo.com.au/2008/07/medical_manikins_freak_us_out-2.html

Nick said...

Baino - This is the Chief Medical Officer talking, so I guess he must be right! I've certainly never seen any of those Aussie-type dummies before. Sure, some human errors are inevitable, but using dummies would reduce them.

Liz said...

1 in 300? Considering the number of ops, that's quite a high likelihood, isn't it? No wonder I've always been scared of hospitals.

My verifier is 'undercar'. I suppose if you had been undercar, there wouldn't be much the surgeons could do to make you worse.

Nick said...

Liz - It's an amazing figure, isn't it? Not sure of the source, the article doesn't quote one. Just try not to end up under a car and having to be rushed to hospital!

Los Angelista said...

I believe the statistics. Sometimes I think our culture believes that doctors are infallible because of all that schooling. But just like anything, if you don't practice doing certain operations frequently, you forget how to do something.

Here's to all of us staying healthy enough to avoid the ER!

Nick said...

LA Liz - All operations are complex, any number of things can go wrong, so the surgeons really need to know what they're doing before they're let loose on the general public.

Grow Up said...

Good suggestion, though we are all very slightly different inside and out, but a tracheotomy should be simple enough, we all have our trachea in the same spot! You have hit on a fundamental issue though, people are being incentivised by abstract targets that can be measured. It's a lot more difficult (effort wise) to measure the level of care being administered, so the staff get caught up in the bureaucracy and not the real job of looking after people.

Nick said...

Grow Up - Quite, you would think a tracheotomy was a fairly basic procedure they would be familiar with! This obsession with targets across all the public services can often do more harm than good, if tangible, physical care is being forgotten about.

Quickroute said...

anything that improves the safety of patients is fine by me - I hate hospitals - really hate them

Nick said...

Quicky - A lot of people do. We all know someone who's had a bad experience in hospital, despite the government's endless praise for the health service.