VR FOR THE E.R.

Preparing for emergencies before they happen.

Practice makes perfect, the old adage goes. But how do you train for situations that hardly ever happen? And worse yet, what if the situation you’re training for has life-or-death consequences?

This is a persistent challenge facing emergency pediatric doctors and staff, as some of the most serious pediatric cases that come into an ER are also the ones that occur least frequently. Sometimes referred to as “low frequency, high stakes events,” these cases require a highly skilled, highly experienced doctor, but because of their relative rarity, the expertise needed is difficult to acquire.

Traditionally, new doctors have trained on mannequins. This can be a useful way to learn the mechanics of what to do, but it doesn’t replicate other factors that might come into play in an actual emergency. Real world simulations are known to be an excellent way to learn, but these require extra rooms, equipment and time — all things that many hospitals don’t have.

Two doctors from Children’s Hospital Los Angeles (CHLA) teamed up with AiSolve and Bioflight VR to create a virtual trauma room, complete with nurse, respiratory therapist, pharmacist, and distraught parents. Once inside the headset, doctors are debriefed by an EMT on the patient’s status. They can check vital signs and access medication options. They then have to quickly assess and execute the best course of action.

There is a time element here, too. If, say, a child’s airway is closing, every moment matters. As Dr. Marie Lafortune, one of the first people to try it, says, “In VR, you have the emotional stress. It gets your heart racing, your palms are sweaty. You need to refocus with these elements there, so this mirrors what you are going to feel … in a real life emergency.”

VR creates the opportunity to fail without consequences, to get mistakes out of the way in training so when an emergency situation arises in real life, doctors won’t be facing it for the first time.

After seeing positive training results from the program’s initial phase, CHLA has made the training mandatory for all new residents. The program has also been expanded to 11 other sites, including Johns Hopkins and Stanford University health systems. As the number of procedures that doctors are expected to know continues to increase, VR will continue to be an affordable and effective tool to supplement surgeons’ other training methods.

And according to Dr. Lafortune’s assessment, “that should translate into you being a prepared doctor.”