MANHASSET, NY –A 44 year-old business man was rushed to the emergency room after collapsing and hitting his head in a restaurant bathroom during lunch. He was rushed to the nearest emergency room and met by a team of doctors, nurses and therapists. The patient was sweating, had high blood pressure and drank a few alcoholic drinks during lunch. He complained of stabbing chest pain, radiating back pain and numbness in his legs. A nurse noticed white powder under his nose. The clinical team quickly sized up the situation, trying to rule out a heart attack and a head injury, and possible cocaine use.

The high-risk scenario, based on real-life events, did not take place in a hospital but recently played out in a mock ER during the North Shore-LIJ ’s Patient Safety Institute’s (PSI) annual SimWars competition, an event in which two clinical teams are presented with a simulated medical emergency and evaluated on their performance. A high-tech, computerized mannequin mimics a real patient that is able to talk and respond to healthcare workers, who take vital signs and perform emergent procedures such as intravenous line insertion, breathing tube insertion and medication administration. An audience of about 100 people watched the scenario, which was projected on three large screens, and vital signs were displayed on two oversized monitors. An expert clinical panel and the audience (using a remote response device) judged the hospital teams on communication, teamwork and clinical decision-making.

Organized by staff of the health system’s PSI and held at the Feinstein Institute for Medical Research , the event’s “play off” was between the Cardiothoracic team at North Shore University Hospital (NSUH) and a team comprised of staff members from different departments of Southside Hospital , known as the “Scrambled Eggs.” For the second year in a row, the Cardiothoracic team won the competition, quickly diagnosing the patient with a life-threatening aortic dissection, or tear in the largest artery in the body. The winning team received a silver trophy for its department and each team member was also recognized with a Lucite award. In the semi-finals there were teams competing from Southside’s Family Medicine Department and Cardiothoracic Unit and Franklin Hospital’s Emergency Department.

Michael Cassara, DO, an emergency medicine physician at NSUH, associate medical director of PSI and one of the judges for the competition, said the scenario was a “challenging case” but many of the same aspects are seen in the ER everyday. “In this scenario, the patient’s life depends on how quickly the patient is diagnosed and that hinges on the entire clinical team working together, connecting the symptoms and communicating effectively.”

“This sophisticated competition simulates the fast pace and complex issues faced by clinicians in a real emergency department.” said Barbara DeVoe, DNP, director of clinical education programs and North Shore-LIJ’s PSI. “SimWars highlights not only our top clinical performers but our commitment to patient safety and the benefits of practicing life-threatening, medical scenarios in a risk-free environment.”