Anesthesiology: Robot of Life & Death

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Sim One has a heart beat, pulse and blood pressure. His chest moves as if it were breathing, his eyes dilate, his muscles twitch, his mouth opens and closes. Sim (for simulator) One is a fiber-glass-and-steel robot, designed to play the part of a patient for anesthesiologists in training at Los Angeles County General Hospital.

Sim One is particularly good for practice in endotracheal intubation, a technique that involves slipping a tube into the patient's windpipe and administering anesthetic gases through it directly into the lungs. The procedure, used in 90% of all major surgery, requires so much delicacy and speed that student anesthesiologists usually take at least three months to learn it. With Sim One's help, the training time may be cut to two days. Developed under a $272,000 U.S. Office of Education grant by the University of Southern California School of Medicine and Aerojet-General's Von Karman Center, the robot is life-sized (6 ft. 2 in., 195 Ibs.). Its skin feels like skin, and it comes equipped with a tongue, vocal cords, an esophageal opening and bronchial tubes.

Moreover, its electronic organs are computer-programmed to simulate virtually all the symptoms and physiological responses the anesthesiologist may encounter during an actual operation. From a nearby console, which monitors such things as the gas rate and the amount of oxygen in the blood, the instructor can suddenly introduce lifelike problems merely by pushing a button. Sim One can be made to vomit, suffer heart arrest, go into shock, react to drugs.

The muscle relaxant succinylcholine, for example, can be injected into the robot's body, and will cause twitches in the neck area the way it does in humans. The robot's teeth are bedded in such a way that too much pressure on the anesthesiologist's equipment can knock them out. At operation's end, Sim One opens its eyes and blinks—if all goes well. If all goes badly, Sim One "dies."

As its name suggests, Sim One is the first in what is expected to be a long line of medical robots. U.S.C.'s Dr. Stephen Abrahamson, who developed the robot with colleague Dr. J. S. Denson, expects that future generations will bleed and sweat, perhaps even groan.