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Abstract Number: F 7
Abstract Type: Original Research
Introduction: Skills acquired on a simulator are transferable to the clinical setting. To achieve an 80% success rate for the dexterity intensive skill of epidural placement requires a minimum of 90 attempts1 . A free application is being developed that enables residents to practice epidural or spinal anesthesia on an iPad or iPhone.
Methods: The simulation uses the Apple iPhone SDK and Unity 3D Game Engine. The iPhone’s accelerometers are used to manipulate the direction of the virtual Tuohy needle-syringe assembly .The touch screen is used to advance the needle into the epidural space. When the ligamentum flavum is pierced, the plunger telescopes into the barrel of the syringe. If the dura is punctured, the syringe fills with yellow fluid. Audio cues are given as a grinding sound when bone is encounterd or a ‘pop’ for the flavum.
Discussion: Current plastic- rubber epidural manikins cost on average $2000, haptic (force feedback) virtual reality simulators in excess of $15,000. iPad based video games are a cost effective way of providing realistic training without the expense of maintaining a simulation lab.
Reference: Anesth Analg 1998;86:635-9.