Posted 12 p.m. Oct. 17, 2013

Baby Hal

First impressions:

Baby Hal receives post-birth care in LCCC's nursing lab.

Photo by Kyle Herzfeld

Birthing simulator 'delivers' education

Nursing students experience miracle of birth in a new way.

By Kyle Herzfeld
Features Editor

Observing the delivery of babies has usually been part of the coursework for Laramie County Community College nursing students in the past.

However, because only eight of 48 students last spring were actually able to view a live birth, so Christina Warren, nursing instructor at LCCC, began researching potential simulators and found NOELLE.

NOELLE is comprised of three mannequins: a pregnant mother, the fetus ready to be delivered and the newborn (called HAL). Two computer monitors track the life signs of the mother and the baby within as well. A tablet is used by the instructor to throw real-life problems at the student. For example, the instructor might make the baby experience shoulder dystocia, a condition in which the shoulders refuse to come out.

After looking at different birthing simulations, Warren chose NOELLE because on one simulator the mannequin looked like a male and on another the mannequin included only the lower torso, so it would have had to been placed on a student.

The second choice was a mannequin named SimMom, whose parent company has supplied the LCCC nursing department with other mannequins. SimMom was rejected as the No. 1 choice because it did not look as real as NOELLE. Students would have had to push the baby out of the mother, which the mother would handle herself in an real-world scenario, whereas NOELLE included a motor that pushes the baby out.

Another deciding factor in choosing NOELLE was this simulator was also used in several hospitals and colleges including Cheyenne Regional Medical Center and the University of Wyoming.

NOELLE features pupil dilation when the mannequins are introduced to a bright light (just like a real person), a heartbeat that can be felt and heard (and sounds less mechanical and more like a human heart), and students can hold the wrists and feel a pulse. The legs are fully jointed, which allows students to treat for shock or simulate holding the mother’s leg as they would during a real birth. Students can even hear the fetus heartbeat through the mother’s abdomen.

NOELLE speaks to students during the birth, saying, “I used cocaine today,” “My water broke,” “I’m having contractions.” NOELLE can also speak in Spanish.

In addition, NOELLE comes with different abdomens, allowing the student to perform different operations including an almost flesh-like abdomen that allows students to perform a Leopold maneuver (when doctors locate the position of the fetus) and an abdomen that permits students to perform C-sections.

Like his “mother,” HAL also has a multitude of features that include the ability to cry, breathing with visible respirations and interchangeable infant genders. It evens comes with different heads allowing the student to demonstrate how to care for head injuries.

The instructor is also able to manipulate the newborn's APGAR score, a number doctors use to determine the overall health of the newborn consisting of five areas worth two points each.

Nurses will take points off depending on the severity of the issue. The five areas are appearance (color of the baby); pulse rate; grimace response (reflex irritability); activity (movement of newborn), and respiration of the newborn spelling APGAR.

By manipulating the APGAR score, the instructor can make HAL’s cheeks turn blue from lack of oxygen, simulate HAL being born with broken bones, change the tone of HAL’s cries (which Warren demonstrated by simulating what a newborn would sound like if its lungs were wet).

Since implementing NOELLE into the classroom on Sept. 9, Warren has found students prefer NOELLE to the live experience for several reasons: Less stress is involved than in a real-world birth; the students can ask questions and receive answers immediately rather than leaving the delivery room with the instructor. In the past, students had to wait and hope a baby would need delivering while they were in the hospital. Under the old system a group of four students would spend six hours at the hospital and hope a birth would take place.

The simulation is currently only available to third-semester students however a change to a first- or second-semester class is being considered. Currently, fourth-semester students will re-visit the simulator, this time encountering high-risk birthing simulations such as birth from an alcoholic, a drug user or a mother with preeclampsia, a medical condition in which a mother has abnormally high blood pressure that can result in a seizure.

Warren said several students have come to her privately and told her they learned a lot from the simulation.