1. Improving realism of PALS-courses with smart
simulation tools & children
Burkhard J. Wermter1
Jenny Siebdrat1,2
Ina Geisler1
Michael Weldi1,3
Rudolf Janz1,3
Stefan Oppermann4
Ella Scott5
Ruth Lollgen5
Becky Damazo6
Tex Kissoon7
Aaron Donoghue8
Paul Lecat9
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Pediatric Simulation Research Collaborative South Tyrol (ITA)
PICU Medical School Hannover (DEU)
Med-Sta Graz (AUT)
IFN Institute for Emergency Medicine Hamburg (DEU)
Kim Oats Australian Paediatric Simulation Center, Sydney (AUS)
Rural SimCenter CSU Chico (USA)
World Federation of Pediatric Intensive & Critical Care Societies
Children’s Hospital of Philadelphia (USA)
Clinical Pediatrics / Internal Medicine, Northeast Ohio Medical University (USA)
INSPIRE @ IMSH 2014:
San Francisco, California,USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background 1
• With the program “Helping Babies Breathe”,
we have learned that implementation of welldesigned, low-cost training is lowering
newborn mortality.
• What can we learn to improve implementation
of Pediatric Advanced Life Support (PALS)
courses elaborated by EXPRESS-study group
with low budget simulation?
International Network for Simulation-based Pediatric Innovation, Research and Education

3. Background 2
• How imitate clinical reality?
• 1) images of real ill patients (video clip)
• 2) a vital parameter monitor (app for tablet PC)
• 3) registered sound (heart and lung) from real patients. Sequences of
evolution
• 4) more realistic maniquins in key issues: behaviour of ventilation
(NeoNathalie/infant CPR anytime) and weight/temperature
• 5) real children (respiratory and Trauma scenarios)
• 6) change of skin colour
• 7) a cloud of perceptions creates mental processes which lead to decisions
and actions
3

4. Background 3
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5. PICO Question
• P: Children from birth to puberty
• I: Training intervention
• C: Compare standard training with
extended training
• O:Better clinical outcomes post training
International Network for Simulation-based Pediatric Innovation, Research and Education

6. Approach / Design
• Only use of BLS- and ALS mannequins during
PALS courses. Limitate the budget.
• Introduction of tablet patient monitors an all PALS
stations.
• Use of real sound sequences on 2 of 3 practical
stations comparing learning outcomes of students
in differently equipped teaching stations.
• Integration of real children.
• Change of skin colour
International Network for Simulation-based Pediatric Innovation, Research and Education

7. Approach / Design 2
Further information:
1) tablet Patient Monitor: SimMon www.castleandersen.dk
DART sim http://ecg-simulator.com
2) sound sequences: Ventriloscope www.ventriloscope.com
3) RealChildren in Simulation: webinar, poster, video
• webinar: http://ipss.adobeconnect.com/p9ohhths9dx/
• Poster: www.provinz.bz.it/se/west/mup-paednotmed/poster_real_children_in_simulation_SESAMALASIC_Coimbra2009_081109final.pdf
• video:
http://www.provinz.bz.it/se/west/mup-paednotmed/orf.
International Network for Simulation-based Pediatric Innovation, Research and Education

8. Timeline
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ALERT Presentation: IMSH Jan. 2014 – San Francisco (USA)
Grant Proposal (if applicable): after IPSSW Apr. 2014 Vienna (A)
IRB Submission: spring/summer 2014
Recruitment / Data Collection:
– Pilote project: June 2013 – April 2014
– Training of instructors June – October 2013
– First formal PALS courses with extended tools in Dec. 2013 and Jan. 2014 with
participants and instructors from Italy, Switzerland, Austria and Germany at
Brixen/Southtyrol (Italy) www.brixen.org European Alpine space area and EU-Regio Tirol
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Study: summer 2014 – winter 2015
Data Analysis: winter/spring 2015
Abstract Presentation: IPSSW 2015
Manuscript Preparation : spring 2015
International Network for Simulation-based Pediatric Innovation, Research and Education

9. 3 Questions to improve study
1. Search for more trial centers: How
would you like to participate?
2. How can we improve measurement of
educational impact?
3. Can we link educational impact &
patient outcome?
International Network for Simulation-based Pediatric Innovation, Research and Education

10. Contact Information
Burkhard J. Wermter
PSRCS Pediatric Simulation Research
Collaborative Southtyrol
psrc_suedtirol@outlook.com
+39 380 680 6021
www.provinz.bz.it/se/PaedNotmed
International Network for Simulation-based Pediatric Innovation, Research and Education

11. Appendix
• HBB: http://www.helpingbabiesbreathe.org/docs/HBB%20Tanzania.pdf
• EXPRESS: http://www.inspiresim.com/index.php/default.html
• 1st PALS-AHA/AAP-course after official release in Oct. 2011 (page
6): http://www.sesam-web.org/index.cfm?event=downloadfile&famid=294992
• IMPLEMENTATION OF SIMULATION WITH NEW BUISINESS
MODELS
http://www.provinz.bz.it/se/west/mup-paednotmed/Paedsim_ipssw2011mix.pdf
• A PAEDIATRIC SIMULATION BASED COURSE FOR ALL
BUDGETS:
http://www.provinz.bz.it/se/west/mup-paednotmed/Paedsim_sydney_toulouse.pdf
International Network for Simulation-based Pediatric Innovation, Research and Education