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Cool training tool: a mannequin in the labour room

Noelle, a new robot birth simulator from the U.S., is now gaining in popularity in medical schools and hospital maternity wards

ARTIFICIAL LABOUR: Medical students with a robot "giving birth" at Kaiser Permanente in Vallejo, California. PHOTO: AP

VALLEJO: Noelle has given birth in Afghanistan, California and dozens of points in between. She is a lifelike, pregnant robot used in increasing numbers of medical schools and hospital maternity wards.

The full-sized, blond mannequin is in demand because medicine is rapidly abandoning centuries-old training methods that use patients as guinea pigs, turning instead to high-tech simulations. It is better to make a mistake on a $20,000 robot than a live patient.

The Institute of Medicine, an arm of the National Academy of Sciences, estimates that as many as 98,000 patients die in the United States alone annually from preventable medical errors. "We're trying to engineer out some of the errors," said Dr. Paul Preston, an anaesthesiologist at Kaiser Permanente and architect of the hospital chain's four-year-old pregnancy-care training programme, in which Noelle plays a starring role. Noelle is used in most of Kaiser's 30 hospitals nationwide, and other hospitals are putting in orders. An insurance company is sponsoring training programmes in 22 hospitals, rolling out Noelle initially at five of them.

Other companies make lifelike mannequins to train paramedics in emergencies, but Noelle appears to be the only high-tech, pregnant model available. Models range from a $3,200 basic version to a $20,000 computerised Noelle that best approximates a live birth.

She can be programmed for a variety of complications and for cervix dilation. She can labour for hours and produce a breach baby or unexpectedly give birth in a matter of minutes. She delivers a plastic doll that can change colours, from a healthy pink glow to the deadly blue of oxygen deficiency. The baby mannequin is wired to flash vital signs when hooked up to monitors.

The computerised mannequins emit realistic pulse rates and can urinate and breathe. "If she is bleeding, there will be ample blood in evidence everywhere,"

Dr. Preston said one rainy day recently as he put Noelle through her paces at Kaiser Permanente's Vallejo hospital.

About 50 doctors, nurses and others involved in caring for pregnant women attended the training session, which started with Noelle hooked up to standard delivery monitoring machines.

David Isaza, an engineer, sat in a corner with a laptop, sending wireless signals to Noelle. With a keystroke, he can inflict complications.

As Noelle's heart rate increased, a nurse examined her under the sheets. An umbilical chord was visible — not a good thing. Immediately, the nurse called a Code 777.

More medical personnel burst into the room and wheeled Noelle off to the operating room where she gave regular birth to twins after a frenzied 20-minute operation.

Then it was time for the debriefing. "We wheeled her through the hallway with her gown open," complained one nurse. "It was too loud," another said of the chaotic scene.

And so it went for another 30 minutes until it was a second group's turn with Noelle.

"The mannequins are cool," Dr. Preston said. "But it is only one training tool." — AP

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