Peter Weinstock: Lifelike simulations that make real-life surgery safer
Peter Weinstock: Realistické simulace, které dělají skutečné operace bezpečnějšími
Dr. Peter Weinstock is an Intensive Care Unit physician and Director of the Pediatric Simulator Program at Boston Children's Hospital/Harvard Medical School. Peter and his team fuse medicine with state of the art special effects, puppeteering and 3D printing technologies to create lifelike simulations of complex surgeries. Full bio
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there was a new technology
že je tu nová technologie,
of doctors and nurses,
doktorů a sester,
and adults, patients of all ages;
pacientů každého věku;
dávkou a odezvou,
where care is delivered.
kdekoli se péče poskytuje.
at Boston Children's Hospital,
Bostonské Dětské Nemocnice,
through medical simulation.
pomocí lékařských simulací.
the challenge ahead,
výzvu před námi,
going to improve health care
nejen že zdravotní péči zlepší,
just born into the world.
zrovna narozená do života.
that she is deteriorating.
že se zhoršuje.
her blood pressure is going down,
její tlak klesá,
is displayed in this chest X-ray.
rentgenu hrudníku.
a little infant's body.
tělíčka dítěte.
are supposed to be.
that's where the abdomen is,
are supposed to be.
there's sort of that translucent area
toho dětského hrudníčku.
of this child's chest.
in the wrong place.
na špatném místě.
for this poor baby to breathe.
to the operating room,
back into the abdomen,
to the operating room,
to the ICU, where I work.
kde pracuji.
on heart-lung bypass.
little incision in the neck,
vessels of the neck --
are about the size of a pen,
drawn from the body,
it gets oxygenated,
diaphragmatic hernia --
allowed these intestines to sneak up --
kterým střeva vyklouzla --
to get the volume --
dostat se k množství --
těchto pacientů --
curve at 100 percent.
that I trained for over 20 years,
v kterém učím přes 20 let,
the apprenticeship model.
a surgery maybe once,
že vidíte operaci možná jednou,
that surgery to the next generation.
that we are delivering care to.
kterým poskytujeme péči.
high-stakes industry
kde je hodně v sázce
approach through medical simulation.
pomocí lékařských simulací.
vydali za obory, kde je hodně v sázce,
to other high-stakes industries
metodologie po desetiletí.
of methodology for decades.
on a regular basis
zkouší scénaře,
what they hope will never occur.
že se nikdy nestane.
the airline industry --
letecký průmysl --
comforted by the idea
s klidným vědomím,
on simulators much like these,
na simulátorech, jako tyto,
se nikdy nestanou,
that we hope will never occur,
as far as to create fuselages
že vytváří celé trupy letadel
of the team coming together.
these rare, rare events,
tyto velmi vzácné případy,
on the drop of a dime.
než dopadne desetník.
in some ways is the sports industry --
v jistých ohledech, sportovní průmysl --
baseball players practice.
baseballových hráčů.
of progressive training.
postupného tréninku.
is go out to spring training.
na jarní trénink.
but they're on a simulated field,
ale na simulovaném
during the season games,
během sezóny.
before they start the game?
and do batting practice for hours,
a odpalují celé hodiny.
being thrown at them,
as they limber their muscles,
až vytrénují svaly
phenomenal part of this,
any sport event,
we're building practice swings like this
cvičné švihy v medicíně.
for the patients that we care about
pro pacienty, o které se staráme
that we recently built.
who had a progressively enlarging head,
zvětšovala hlava
neurologic milestones,
neurologického vývoje.
surrounding the brain.
která ho obklopuje.
between the brain and cranium,
je vyplněn
cerebrospinal fluid or fluid,
just bathing your brains
koupe mozky
and flows through,
a protéká skrz
occurs for all of us.
u nás probíhá podle schématu.
neurologic milestones.
a bit of the cranium off,
stick a drain in place,
this drain internal to the body.
in neurosurgical care
že pokroky v neurochirurgii
minimally invasive approaches
invazivní postup
a camera can be inserted,
that allows all that fluid to drain,
která moku dovolí odtékat,
is no longer under pressure,
through a single-hole incision.
this scope to the right place.
v zavádění sondy na správné místo.
about this, even our own.
docela kreativní, dokonce i naši.
not made in Hollywood;
né ta hollywoodská;
a scope into the pepper,
using a little tweezer.
pomocí malé pinzety.
of doing this surgery.
the apprenticeship model,
učňovskému modelu,
as they present themselves,
reproductions of children
teams to rehearse
mohli nacvičovat,
Division of the Simulator Program.
našeho simulačního programu.
from CT scans and MRIs,
z CT skenů a MRI,
of the child itself,
that have been casted as needed,
které se odlijí podle potřeby,
and be able to output it
three-dimensional printing devices
the child's anatomy will look like.
jak bude vypadat anatomie dítěte.
we performed this surgery.
in Hollywood, California.
pobřeží z Hollywoodu v Kalifornii.
that are incredibly talented
that we are doing cinematography.
že děláme kinematografii.
of our dear friends at Fractured FX
z Fractured FX
special effects firm.
that these individuals do.
kterou tito lidé dělají.
and fused our experience,
a propojujeme zkušenosti
do Bostonské Dětské Nemocnice
to Boston Children's Hospital,
out to Hollywood, California
do Hollywoodu do Kalifornie
these type of simulators.
typy simulátorů.
is a reproduction of this child.
on the child's head is reproduced.
na hlavě dítěte.
that reproduced child --
také vytvořené dítě --
is, on one side, the actual patient,
skutečný pacient
needs to make its way down,
se musí dostat dolů
in this membrane
v membráně
who thinks which side is which,
která strana je která,
training opportunities,
příležitost k nácviku
as many times as they want,
until they feel comfortable.
bring the child into the operating room.
is not just the skill itself,
zvládnutí dovednosti,
who's going to deliver that care.
který poskytuje péči.
of a technician putting on a tire
again on this car.
going to be incorporated
the exchange of tires
vyměňuje pneumatiky
is a simulated operation.
I just described to you,
který jsem popisoval,
at Boston Children's Hospital,
v Bostonské Dětské Nemocnici
these native teams, operative teams --
tyto místní týmy, operační týmy --
You want the head down or head up?
Chcete hlavu dolů nebo nahoru?
the whole table down a little bit?
is behaving like a vessel.
8 to 8 1/2, all right? I'll be right in.
Hned tam budu.
which is critical,
immediately and debrief them.
and Six Sigma in the military,
and talk about what went right,
bavíme se o tom, co fungovalo dobře,
and do it again.
a děláme to znovu.
in the moments when it matters most.
kdy na tom nejvíce záleží.
how we care for this child
jak o něj budeme pečovat
at three o'clock in the morning.
out of scans and images,
to the virtual bedside,
on this child in the hours ahead --
za několik hodin --
that I have with families
at Boston Children's Hospital
v Bostonské Dětské nemocnici
frequently in our ICU,
poruchou na naší JIP,
udělat vašemu dítěti,
to do on your child,
back to the operating room."
na operační sál."
ABOUT THE SPEAKER
Peter Weinstock - Pediatric ICU doctorDr. Peter Weinstock is an Intensive Care Unit physician and Director of the Pediatric Simulator Program at Boston Children's Hospital/Harvard Medical School. Peter and his team fuse medicine with state of the art special effects, puppeteering and 3D printing technologies to create lifelike simulations of complex surgeries.
Why you should listen
Dr. Peter Weinstock has merged his lifelong interest in human nature, medicine, theater and puppetry to develop one of the most advanced rehearsal spaces in medicine. Weinstock is a practicing pediatric intensive care unit physician at Boston Children's Hospital, where he serves as Senior Associate in Critical Care Medicine, Associate Professor of Anesthesia at Harvard Medical School, Chair of Pediatric Simulation and Director of the Boston Children's Hospital Simulator Program (SIMPeds). Weinstock works with his team of educators, psychologists, engineers, animators, special effects designers and 3D printers to immerse doctors, nurses, patients and their families in Hollywood-style "life-like" experiences -- all to optimize performance, clinical outcomes, as well as the entire healthcare journey for children and their families.
Weinstock received his PhD from Rockefeller University in molecular and cell biology, followed by clinical training in plastic and general surgery at the University of Pittsburgh and general pediatrics and critical care medicine at the Boston Children’s Hospital. His passion is in developing methods that link highly realistic practice and preparedness training directly to the delivery of high quality, safe care to improve the lives of infants, children and their families. Due to its inherent emotionality, Weinstock's approach to simulation is keenly connected to emotionality and behavioral psychology as essential elements of relationships and decision-making to understand and optimize human-human and human-technology interactions. Weinstock has rapidly grown SIMPeds to thousands of simulations per year, and the SIMPeds method has been adopted among pediatric teaching centers around the globe.
Weinstock frequently lectures internationally on state of art simulation and experiential learning, and he has published sentinel articles in innovative application and approaches to simulation -- from human factors to engineering and testing of next generation of ultra-realistic training devices. He has chaired meetings worldwide and is Founding President of the International Pediatric Simulation Society.
Peter Weinstock | Speaker | TED.com