Modifying Laerdal Patient Simulators for Anterior-Posterior Defibrillation using Live Energy with Zoll R Series Defibrillators

Background/Problem: Most high-technology simulation manikins are designed for use with anterolateral defibrillation electrode pad placement. Our Center had a need to train with live electrical energy while maintaining all features and fidelity available with the simulator. When a new defibrillator device was introduced to the organization, existing anterolateral placement was no longer used and there was a need to teach with anterior/posterior electrode pad placement. There were no simulation manikins in the organization’s inventory that would accommodate this function. Solution: Using a recently decommissioned Laerdal Medical Resusci Anne Simulator capable of being defibrillated, cardioverted, and paced, the manikin was redesigned as a prototype to use existing simulator manufacturer parts supplemented by locally produced parts to permit anterior/lateral electrode pad placement and use of live energy from the new defibrillators used in the organization. Discussion: While training electrodes combined with inline rhythm generators work well in many situations and are capable of achieving learning objectives specific to those situations, the need for a higher level of realism (fidelity) using real electrode pads and using the defibrillator as intended were a requirement for many other user groups. The prototype unit was designed to safely interact with the real defibrillator and real electrode pads to provide the highest level of realism in practice. Extensive safety testing was conducted to ensure the manikin still functioned well within all performance specifications. Outcome: After several weeks of consistent use, the redesigned simulator is working well with positive faculty and user feedback. Since them several other manikins, including Laerdal Medical SimJunior Simulators, have been converted to accept anterior/posterior electrode pad placement.