It takes a good minute to make your way to the newest rising star of the Center for Medical Simulation and Innovative Education at Johns Hopkins All Children’s Hospital.
You have to weave through a back room filled with racks upon racks of very life-like medical mannequins and body parts — some outfitted with fake blood and tissue — designed to train health care staff for medical emergencies. A few of them might appear to be looking at you. … It can be a little hair-raising your first time through.
But here it is…. a medical-grade 3-D printer. Think of your dad’s old Sears tool box — on steroids. And with sleeker lines.
This printer is bigger than most kitchen tables. The top opens up (like a toolbox) to reveal a wide, smooth print slate — upon which a world of potential is ready to be realized.
The Simulation Center team has been working for more than a year to acquire this remarkable technology … designed to take medical training and preparation to the next level.
“We’re excited about the potential of this printer for our hospital,” says Jennifer Arnold, M.D., a neonatologist and medical director of the Simulation Center. “This can truly play a role in advancing knowledge, making our surgeries and procedures even more safe, and saving children’s lives.”
While the SIM program benefits from medical mannequins already in use, the 3-D printer offers something more … the ability to re-create anatomy, including a specific diagnosis or pathology, in minute detail … with models so precise, they feel and respond like the real thing.
While patient scans and imaging are critical, the scope of how they prepare a physician and team for a surgery or procedure can be limited. The ability to hold an identical model of a particular patient’s heart or brain or other anatomy in their hands — the opportunity to cut, to suture, to drill, to patch, to dissect — can be a game-changer in terms of value-added knowledge and preparation.
“We can print in such detail,” says Matthew Lee, the simulation engineer who is leading the Simulation Center’s charge to build the 3-D print program. “Let’s say you want to print a patient’s hand. You could print the fingers with the bone material, the flesh with the tissue material, and you could use the gel matrix to create the arteries and nerves.”
The printer can accommodate up to six different materials. Large canisters are loaded into a second chamber, about the size of a refrigerator, which is connected to the printer.
Patient scans are employed to create the files that “talk” to the printer — telling it precisely how to shape a portion of a spine, for example, or how wide the inner wall of a blood vessel should be.
Think of the inkjet print heads on a typical printer. The medical grade printers are more sophisticated, using ballistics to shoot out thousands of droplets of liquid resin in a line ahead of the print head. Then a UV light passes over it to harden, or “cure,” the material — turning it from liquid to solid.
This precision technology was well-received when it was sampled during the Pediatric Brain Symposium held by the hospital’s Institute for Brain Protection Sciences last fall. Participants were able to drill into the bones of 3-D model skulls and perform spinal fusions.
The hope is that the printer will contribute not only to improved patient outcomes in the future but also provide potential cost-savings. Studies show the enhanced knowledge provided by the 3-D prints can cut down on preparation time, including time in the O.R.
Plans include offering the option of using the 3-D models in full simulation trainings in the O.R. simulation room and elsewhere.
The potential is vast and exciting — but it’s not being fully realized here just yet.
Timing Is Everything
As fortune would have it, the much-anticipated 3-D Printer would arrive about the same time something else did. …The coronavirus pandemic would be the other new arrival.
Plans for this printer, like everything else, would have to wait while health care professionals pivoted to respond to this global — and noble call to action.
The SIM team had a predicament. The launch of the 3-D printer program, as designed, would have to pause. But the printer still needed to be in use and maintained, while keeping costs down.
“We got to thinking, what can we do to support our hospital at this time?” says Lee.
The team had been hearing about some staff needing to protect their ears from the chaffing and rubbing caused by the additional personal protective equipment required.
They pulled files from a national database to create small flexible ear guards. The team fired up the printer, and created sheets and sheets of ear guard variations, many with the word “Hero” printed on them. They delivered them to Incident Command, the leadership team managing the COVID crisis, to be distributed, and they’ve received positive feedback.
The SIM team engineers also began exploring the printing of face shields. They obtained files to create resin-based shields that the hospital could have the option of printing in mass and distributing if they found themselves out of other avenues.
“We’re excited to be able to help out where we can,” Lee says. “We’ve made the effort to be proactive, and to do something relevant.”
To adapt and to overcome is part of being in health care. To find a meaningful way to contribute when other plans are thwarted … that is value-added.