Central venous access simulator designed by CSSALT to deploy for first time through U.S. Navy

A simulator built by engineers with the Center for Safety, Simulation & Advanced Learning Technologies (CSSALT) to teach clinicians how to safely perform central venous access (CVA) has traveled to resource-limited environments around the world. Now, after two deployments to Iraq through the Department of Defense, it will soon be deployed for the first time through the U.S. Navy to Camp Lemonnier in Djibouti in the Horn of Africa, the location of the U.S. Africa Command.

Resident practicing on a C-V-A simulator

Using the mixed-reality simulator, clinicians can practice, learn, teach, and debrief on CVA by the internal jugular, infraclavicular, supraclavicular, and axillary approaches with and without ultrasound guidance. The turnkey simulator was built to allow learners to study and debrief independently. It can be used for remote procedural training with the instructor at UF and the trainee in Africa.

With a portable design (all components are stored in a designated box), the simulator can be safely and easily transported, making it a valuable tool in austere environments such as warzones. Configuring the device is simple and quick, even for those unfamiliar with the device.

U.S. Navy Cmdr. Meghann Nelles, MD, a vascular surgeon, will spearhead the simulator’s use in Africa. The simulator was originally referred to Col. Craig Taylor, command surgeon for the U.S. Africa Command, by Darrin Frye, MD, U.S. Army Futures Command. Dr. Frye knew about the CSSALT simulators from the Department of Defense Congressionally Directed Medical Research Programs (CDMRP) JPC-1 grant that he helps administer.

Through that grant, CSSALT designed, built, and verified five mixed-reality procedural and guided intervention simulators. As part of that work, CSSALT designed an open architecture development platform called SMMARTS (System of Modular, Mixed and Augmented Reality Tracking Simulators) to streamline the process. SMMARTS was used to develop nine different simulators, and its creation was described in an article published in September in Simulation in Healthcare.

The CVA simulator has also been put to use closer to home with trainees at UF Health Jacksonville. In mid-January, CSSALT coordinated a loan of the simulator with Adrienne Warrick, MD, a Clinical Assistant Professor in the Department of Anesthesiology at UF Health Jacksonville. Dr. Warrick had used the simulator while completing her anesthesiology residency in our department. The initial results there have been encouraging.

Samsun Lampotang, PhD, FSSH, FAIMBE, the Joachim S. Gravenstein Professorship of Anesthesiology and Director of CSSALT, hopes the grassroots initiative can be extended by sharing the simulator with other nearby institutions and beyond.

“This simulator allows learners to independently study and debrief on a challenging technique, while being simple to operate and efficient,” he said. “I hope it continues to travel across the world to benefit many more trainees, and, ultimately, save lives.”