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ECT Simulator (ACTOR)

ECT Simulator (ACTOR)

The ECT simulator ACTOR (Apparatus for Convulsive Therapy Operator Rehearsal) was developed to create a realistic "hands on" means for rehearsing ECT. Similar in function to a CPR manikin which gives a clinically congruent experience, ACTOR does this for ECT practitioners. Actor has a seizure when electrically stimulated and generates EEG data appropriate to the type of seizure being simulated.

Main benefits:

  • Anatomically realistic & familiar appearance
  • Practice at making clinical machine-patient connections
  • Placement of mouth/teeth guard
  • Practice at unilateral (D'Elia) and unilateral, bilateral and bifrontal stimulation
  • Generates both L & R EEG signals
  • Generates motor seizure to assist with interpretation of EEG information
  • Enables rehearsal of common clinical events
  • Scenario may be repeatedly experienced until a satisfactory outcome is achieved
  • Compatible with most/all ECT machines
  • Take as long as necessary/ as often as necessary

The design concept behind the development of ACTOR was to produce a simulation of convulsive physiology during the period of treatment for a patient undergoing Monitored ECT (MECT). Simply put, Syrinx Technology set out to produce and "artificial patient" which would behave similarly to a real patient when subjected to MECT. In addition, the design required that the ACTOR would be attached to the same equipment to which a normal patient was attached.

To this end all the connections from ACTOR are standard clinical grade connections. For example the patient EEG monitoring leads connect to ACTOR's EEG electrodes (fronto-mastoid positioning). The stimulating electrodes may be placed in any combination of unilateral, bilateral or bifrontal standard positions.

ACTOR consists of a motorised head and thorax covered with a realistic face and skin, looking like a patient lying supine. A unique feature of ACTOR is the level of realism that is achieved with each moving seizure.

In order to enhance the reality with which ACTOR is used, SYRINX have developed an isolated forelimb. This enables the operators to use the Hamilton isolated cuff technique. Called ARTIST (ACTORs Remote Thumb Indicating Seizure Therapy) it is able to replace the jaw movement completely. Additionally if the cuff is not inflated and maintained above systolic blood pressure all forearm movement ceases.

All ACTORs built after 2011 have the hardware to connect ARTIST. Those earlier models can be easily upgraded, the cost of which is included in the upgrade to ARTIST.

ACTOR is being used in Australian, New Zealand and United Kingdom based hospitals for the training and retraining of Physicians, Residents and Psychiatry trainees.



Acquisition of A.C.T.O.R. Electroconvulsive Therapy (ECT) Simulator (Syrinx Technology):

Sydney Local Health District has recently acquired an ECT Simulator for the use at Concord, Bankstown, Liverpool and Campbelltown Hospitals to assist in training psychiatrists to administer Electroconvulsive Therapy (ECT). The development of simulation devices has been a substantial advance in all areas of procedural medicine because it permits new practitioners to learn and enhance skills in the absence of real life pressures such as patient anxiety and time limitations. This is especially relevant when learning to administer ECT where patients receiving the treatment are often already very agitated when they are having the treatment and treatment needs to be administered quickly because of the very short period patients are anaesthetised for. The simulator does require the presence of an experienced instructor but can be used with most types of ECT machine to demonstrate a wide variety of different possibilities that are encountered when administering ECT (induction of a good seizure; prolonged seizure; poorly generalized seizure; threshold seizure good seizure; short seizure and a ‘failed’ or no seizure. In addition to learning what one can expect to see when a patient has an ECT induced seizure the simulator results in the ECT machine generating corresponding electroencephalographs (which also permit teaching about interpretation and application of knowledge concerning EEG morphology) to the practice of ECT.

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