By Lucas Dufalla
Portland Press Herald
SANFORD, Maine — As soon as the simulated alarm indicating cardiac arrest blared through LifeFlight of Maine’s new simulation lab, trainee flight medic Casey Fiola jumped into action.
In two CPR sessions over four grueling minutes, Fiola repeatedly pressed on the chest of a hyperrealistic dummy as the monitor flatlined.
Then the practice patient began to revive and the monitor indicated that vitals had returned to normal. The patient had been saved.
Fiola demonstrated emergency medical care as the nonprofit opened the Sanford simulation lab and two others in Bangor and Lewiston. The state’s sole air ambulance service recently finished constructing the labs, with funding from Bangor Savings Bank.
“Having a simulation lab helps us as providers walk into a room and problem-solve,” Fiola said. “It really helps us bridge the gap between the patient and us.”
The purpose of the new labs, which cost $250,000 to build, is to give LifeFlight crews the ability to train for scenarios they might encounter on calls. The labs feature an array of technology meant to give first responders realistic training in real-world scenarios.
They can be used to stage many different medical crises.
“Having these spaces really adds to our capability of what we’re able to do,” said Chuck Hogan, LifeFlight’s director of clinical operations. “We can replicate really any disease pathology we want to.”
A significant expense in creating the labs was buying the training dolls that can simulate a range of different medical scenarios. The dolls — some costing more than $50,000 — are a far cry from their low-tech predecessors. They can simulate a range of injuries, from cardiac arrest to severe head trauma.
Before, said flight paramedic Tommy Gallant, “we had a mannequin that would work 20 percent of the time, if we were lucky. The new simulation lab gives us the opportunity to manage new, complex patient scenarios.”
The three labs also feature technology that can allow them to run a simulation together. An instructor in one lab can view another lab’s simulation remotely and give real-time feedback.
“When we do these simulations, our medical directors, our clinical operations and our base managers that aren’t there to visualize every call can be present,” said flight nurse Kayla Jones. “This is their opportunity to observe where our crew is at and fill in the (training) gaps.”
The flight crews need the practice and the immediate feedback, Jones said. “We can practice until we get it right, and then keep practicing until we can’t get it wrong,” she said.
LifeFlight first-responder teams include both a paramedic and a nurse. Working through simulations, they can hone the way they communicate and move together.
“Having a flight nurse and a flight paramedic together means that we can take both of our combined licenses, experience and skills and put them together. We can take our combined skills — our combined knowledge — and become a powerhouse,” Gallant said.
Some scenarios are harder than others to simulate. The mannequins, for instance, do not have a full range of motion, so they cannot quite mimic the intricacies of the movements of a person having a stroke, for example.
“There is some artificiality, so we incorporate actors, who are usually crew members, to play the part and replicate those lost pieces,” Hogan said.
Still, the hope is the new labs will make LifeFlight stronger.
K.C. Ford, a LifeFlight board member who was rescued by the organization in 2011, believes that the practical training provided by the labs will help LifeFlight save lives, just as it saved hers more than a decade ago. While flying from Matinicus Isle to Owls Head, Ford’s plane crashed, leaving her stranded in the water with a life-threatening injury to her aorta. After 45 minutes in the water, Ford was rescued from the crash site and flown to nearby Pen Bay Medical Center.
“I don’t say it lightly when I say that I think about LifeFlight every day,” Ford said. “To be able to have these simulation labs to practice and get feedback is just amazing. It’s critical for them to be able to continue to be the experts that they are.”
LifeFlight used to use a mobile lab and local hospitals to train its own crews and other community first responders. Now, with simulation labs of its own, it can streamline its training and tailor sessions to specific needs.
LifeFlight can also train many others outside the organization, said Hogan, who said the old mobile lab was “essentially a big Winnebago.”
Emergency care at LifeFlight is different from care at an ER. Small crews have to do a great deal.
“When the crew arrives, they bring the ICU to the patient. That’s what makes the difference,” said Kate O’Halloran, the nonprofit’s executive director. “Helicopters are cool, but the people make the difference.”
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