The HPS is connected to a sophisticated computer, which runs the various patients and scenarios [e.g., diagnoses].  Additionally, the HPS is connected to a Phillips Medical Critical Care Monitoring system, which allows for Electrocardiogram [ECG], Arterial or cuff blood pressure, pulmonary artery pressure [PAP], pulmonary capillary wedge pressure [PCWP], central venous pressure [CVP], end tidal carbon dioxide [ETCO2], temperature, oxygen saturation, and cardiac output measurements.  The HPS may be utilized with the monitoring system or all components can be turned off depending on the clinical situation that is being simulated.  

Additionally the HPS utilizes a drug recognition system, which utilizes a bar code scanner and flow meter control to evaluate which drug, and how much was administered.  The HPS then responds accordingly if the drug and dosage were correct [or incorrect] based upon body weight.  The administration of intravenous [IV] drugs is consistent with normal clinical techniques and movements of the trainee.  There are 3 IV access points and fluids may be administered utilizing common IV pumps or by gravity.

The HPS mannequin is a life-sized durable plastic “doll”.  The HPS may be either a male or female as the external genitalia are interchangeable.  It allows for the demonstration of various clinical signs such as heart and breath sounds, palpable pulses, chest excursion, airway patency, etc.  The HPS mannequin is fully operational in the supine, sitting, lateral, and prone positions.  

The HPS provides an excellent platform for training in airway management and for integrating airway management skills into complex training situations by automatically linking airway management to patient outcome in the overall situation.  The HPS provides an anatomically realistic upper airway of an adult patient.  The HPS may be intubated orally or nasally and provides realistic outcomes of incorrect intubation such as unilateral breath sounds and chest excursion with right or left mainstem endobronchial intubation.

The HPS provides an extremely realistic simulation of respiration, which is tightly integrated with the cardiovascular systems.  The HPS breathes spontaneously and the lungs consume oxygen and produce carbon dioxide.  We have the capability to simulate events such as atelectasis, pneumothorax, asthma, and chronic obstructive pulmonary disease [COPD].  Additionally the respiratory system is capable of triggering a ventilator.  Arterial Blood Gases [ABGs] are physiologically modeled within the system so that the results are made available.

The simulated patient generates heart sounds including a range of pathological ones.  The HPS generates a normal sinus ECG as well as a broad range of abnormalities such as myocardial ischemia, sinus tachycardia or bradycardia, ventricular tachycardia or fibrillation, and asystole.  Hemodynamic response to the arrhythmias is physiologically correct.  Palpable carotid, radial, brachial, femoral, and pedal pulses are provided which are synchronous to the ECG.  Additionally we can control pulses independently to create pulse less extremities due to trauma.  The introduction and progressive insertion of a Swan-Ganz catheter, synchronous with the appropriate waveforms, can be simulated with the results shown on the monitor.  The HPS cardiovascular response to drugs is appropriate and dose dependent.  

The HPS provides for excretion of urine with a flow rate that is controlled by the instructor or automatically by the scenario.

The HPS is a powerful tool for education in Advanced Cardiac Life Support [ACLS], resuscitation, and cardiopulmonary resuscitation [CPR].  Effective chest compression of the patient’s sternum results in artificial circulation, cardiac output, central and peripheral pressures, palpable pulses, and venous cardiac dioxide return.  Both conventional and automatic external defibrillators [AEDs] can be applied to the simulator.  The delivered energy is quantified in real-time to trigger the appropriate patient response.  Transcutaneous pacemakers may also be applied.

The pupils of each eye constrict and dilate automatically in response to changing light stimuli.  Usually this is consensual but we can simulate neurologic trauma by independently altering one or both pupils.  Additionally the eyelids open/close spontaneously or can be fixed in a closed position.  When closed, the learner can manually open the eyelids for clinical inspection.

Needle decompression of tension pneumothorax can be performed.  Proper needle placement results in rapid decompression, a rush of air exiting the proximal end of the needle, and automatic improvement in pulmonary mechanics and gas exchange.  A chest tube can be inserted and using ordinary chest tube suction equipment, air or fluid can be removed from the pleural space.  In a continuous manner, the volume removed automatically influences the patient’s physiology to reflect improvement in pulmonary mechanics and gas exchange.  

The models automatically regulate the simulated patient’s physiology in accordance with the type of patient defined.  For example, we can simulate a healthy thirty year old, an elderly patient with mild cardiovascular disease and in sepsis, a middle-aged male with hypertension and COPD, or a female of child bearing age with complications associated with pregnancy.  Scenarios are used to give sets of instructions that modify discrete physiologic parameters and give commands to the HPS causing the simulator to react or respond in a specific manner.  While the HPS system includes pre-configured patients and scenarios, we also have the capability to create our own to meet specific teaching objectives.

The ultimate capabilities of the HPS allow us to ensure, for the first time in health care education, that each learner [student or practitioner] “practices” care for a given diagnosis or clinical situation.  Prior to the introduction of the HPS in our community this was not possible in that we cannot control hospital or extended care facility census.  Thus it is possible for instance that graduates of our nursing program here at CSCC would graduate without ever having cared for a young trauma patient with a closed head injury.  Since the introduction of the HPS at CSCC, all of our graduates have cared for a simulated patient such as this.