Simulating capnography in software on the METI emergency care simulator.

INTRODUCTION We attempted to adapt a METI Emergency Care Simulator to support anesthesia scenarios but faced two challenges: the CO2 gas exhaled by the mannequin does not represent the simulated patient's physical status, and the METI Waveform Display software does not support capnography monitoring. METHODS We developed a software application that simulates a CO2 trace that corresponds to the mannequin's ventilation. The software generated a range of CO2 waveform shapes whereas the mannequin was either spontaneously breathing or being mechanically ventilated. We tested the software in three environments: (1) a full-scale simulator research study of advanced anesthesia monitoring displays, (2) simulator-based training courses at the Royal Adelaide Hospital, and (3) at the Sydney Medical Simulation Centre. RESULTS The research study participants successfully used the simulated monitor to confirm correct intubation and detect airway events. Instructors at the Royal Adelaide Hospital reported improvement in the fidelity of simulations for anesthesia trainees. Simulation coordinators at the Sydney Medical Simulation Centre were able to use their Emergency Care Simulator for anesthesia training scenarios, which they were previously unable to run. CONCLUSION We were able to substantially increase the realism of our anesthetic scenarios for research studies and training participants with only a small increase in the fidelity of our capnography monitoring.