Mannequin bleeds for operation war ready

Cameron Johnson, a University of Minnesota biology graduate with plans to go to medical school, admitted it's a "little creepy" to sit face to face with his synthetic doppleganger, the lifelike mannequin for which his face, skull, nostrils and even his trachea served as models. "It's like me, but a lifeless me," Johnson said. "But then I think about all the medics who will learn to save lives, using this mannequin, and it feels pretty good."

An interdisciplinary team of engineers, doctors, graduate students, industry partners and even a Hollywood makeup artist have developed a lifelike mannequin for the military to train combat medics on how to safely insert a breathing tube in the heat of even the most chaotic battles. Officials at the University of Minnesota's Simulation PeriOperative Resources for Training and Learning (SimPORTAL) lab hope it's the first in a line of increasingly complex simulated human models it will develop to more effectively train military medics, civilian EMTs and other first-responders on a litany of human trauma.

"We want to give them the most lifelike experience possible before we give them experience in real life," said Dr. Robert Sweet, associate professor of urology and director of SimPORTAL. Ten other projects are in the SimPORTAL pipeline, he said.

Lifelike? The upper-torso mannequin's skin has pores. Its tongue is coated with moisture. Its teeth click like real teeth. Its jaw moves like a real jaw. A synthetic spine allows the neck to move as a real patient's would. Sensors embedded in the trachea register if a medic trainee exerts too much force when inserting a breathing tube. Real MRI scans of body parts and thousands of tissue sample properties stored in a massive database were used to provide engineers with the right size, scale, elasticity and "feel."

Designers can even make the mannequin "bleed," if necessary.

"If you are going to simulate something, you need to define it in real life," said Jack Stubbs, associate director of SimPORTAL.

Compared with the simple rubber dummy simulators now used by the military, this mannequin is like something from Blade Runner, the futuristic sci-fi movie about androids that seem human. That's not an accident. Crist Ballas, a Hollywood makeup and visual effects artist who has worked on movies such as Star Trek and Batman and Robin, has lent his talents to give the mannequin a dose of reality. Besides his work in show business, Ballas of St. Paul has helped develop facial prosthetics for cancer patients and others.

"When these guys approached me, I thought 'This is a perfect opportunity to make a difference,'" said Ballas, now the creative director of the U's Center for Research in Education and Simulation Technology's (CREST) Anaplastology Laboratory.

Ballas' lab at the university's Mayo building looks like something from a Hollywood effects shop, with mock-ups of skulls and a handful of props from movies. But he takes his job very seriously. He made a mold of Johnson's head, then sculpted finer, finishing touches in clay. His work made it look real. But it took a team of many people with different sets of knowledge and skills to come together and make it feel real, Sweet said.

It all started on the virtual reality side. Earlier, Sweet had hired a graphic artist from EA Sports, which makes video games, to help develop training models.

At the same time Ballas was doing his work, Stubbs and Troy Reihsen, SimPORTAL director of operations, made computer-assisted 3-D models from MRI scans to ensure the parts were anatomically correct. Parts were then created with 3-D printers. It has all come together in a training mannequin with very human characteristics — a head that moves on a simulated neck in the same way a real patient's would. An airway of the correct size and shape and in the same place as a real patient's.

In all, a team of up to 50 people have worked on the mannequin — commissioned by the Army Research Laboratory — including staffers from the university's Medical Devices Center and the Interactive Visualization Lab. The project tapped university resources in 3-D modeling and interactive visualization, as well as such industry partners as 7-SIGMA, Stratasys, Bose ElectroForce and Vital Images.

SimPORTAL launched the project in October 2012, responding to the military's call for better training equipment. The project comprises three phases: Phase One was to see if it could be done. Check. Phase Two will be to make the mannequin robust enough for the mountains of Afghanistan or the deserts of Iraq, while determining which elements are absolutely necessary. Phase Three, which will soon begin planning, will be to decide how to mass produce the mannequins on budget so the trainers can be sent around the world. If all goes well, Phase Three would be ready at the end of 2015.

The plan is to make the mannequin available for civilians, as well. Phase One and Phase Two each cost $250,000. The cost of Phase Three has yet to be determined. Funding is provided by the military. The team, Sweet said, must sustain itself with grants and contracts.

The hope is that medics trained on this mannequin will avoid three common mistakes made on injured soldiers: Chipped teeth, damaging the airway and putting the breathing tube into the stomach rather than the lungs.

In the future, the team hopes to develop a whole body mannequin with separate, yet interrelated systems, just like in a real patient — something that a trauma team in the emergency room or in a battlefield hospital might encounter, with injuries to multiple areas. Future mannequins could be made to replicate elderly patients, obese patients and children. "Basically, you take the original and replicate a human," Stubbs said.

James Walsh • 612-673-7428