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Simulated Angiogram Suite

When you have a heart attack and are taken to hospital you are likely to end up in an Angiogram Suite. While you lie on the the table, a large ‘C’ shaped X-ray whizzes around your head taking images of your heart and arteries allowing the cardiologist to find the blockage and insert a stent. In many cases, and for planned procedures, the patient is awake on the table and can hear everything that goes on while the clinical team poke around in their heart.

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This is a daunting environment for a patient, but also for trainee cardiologist as they need to respect the patient’s wakefulness while performing under pressure. Imperial College asked us to create a simulation of the cardiology suite to facilitate clinical training and public engagement.

We recreated a robotic simulation x-ray arm that swings about the patient. We also created a table surface that allows an actor to sit with the head in the patient’s head position, but allows their body to sit underneath the mannequin that is being operated on.

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The stepper motor inside the simulated c-arm that drives the rotation.

The 2-axis robotic motion of the c-arm is linked to a virtual reality computer model of the patients blood flow developed by Imperial College engineers. As the cardiologist moves the c-arm around the simulated patient with a simple keypad, the image of the virtual reality heart is displayed on the screen in front of them. The combination of the VR model, the in-situ actor and the dynamic physical presence of the C-arm creates a compelling and believable simulation.

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A rendering of the angiogram set up including the fold up operating table that allows an actor to sit underneath the ‘patient’s’ body.

Our simulation presents trainee cardiologists with ‘realistic’ patients in a realistic environment while they learn these complex procedures.

The simulation has also been used widely at science festivals to educate members of the public about the heart attack care pathway, exploring issues around heart health. Furthermore the simulation has been used as a test environment to try out new models of delivering the heart attack care pathway, specifically looking at information flow from the paramedics to the cardiology team.

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A simple purpose designed reclining chair with a height adjustable seat that presents the actor’s head in the position of the patient’s whatever height the actor is.

At the heart of all the simulation work we do with Imperial College is the approach that the simulation should be very high impact and realistic, but also portable and low-cost, and therefore accessible to many. We are continuing to work with Imperial College to further develop the simulation.