AR68 is the enhanced version of the now-discontinued Desperate Debra AR58
Adam,Rouilly has worked with leading clinicians to develop an improved late-stage emergency caesarean simulation model to enable clinical teams to learn and practice what to do when a baby’s head becomes lodged deep in the mother’s pelvis during labour.
Debra Enhanced® – Impacted Foetal Head Simulator has been designed to teach vital skills which can help reduce the risk to mothers and babies during caesarean births.
It has been designed as a multi-disciplinary teaching tool to ensure the whole team is equipped with the skills, knowledge and confidence to release an Impacted Foetal Head (IFH).
Debra Enhanced® – Impacted Foetal Head (IFH) simulator was initially invented 10 years ago in collaboration with Dr Graham Tydeman, Consultant in Obstetrics and Gynaecology – NHS Fife, Professor Andy Shennan OBE – Tommy’s Chair in Maternal and Foetal Health and Dr Annette Briley – Professor of Women’s Health & Midwifery Research, Flinders University and Northern Adelaide Local Health Network, South Australia. The original trainer ignited the topic of IFH to inspire global conversations about training for this emergency, best practice techniques and devices to ensure positive maternal and neonatal outcomes. The model was the first teaching aid of its kind and allowed for the realistic simulation of IFH.
Now, we have collaborated again with the clinical team to enhance the model so that it is compatible with the latest prescribed techniques and foetal head elevation devices whilst providing an even more lifelike training experience.
Skills
- Encourages multi-disciplinary team scenario training (obstetricians, midwives, anaesthetists) in the management of an impacted foetal head at full dilation caesarean section
- Highly realistic vaginal examination in advanced labour
- Identification of foetal head position with palpable fontanelles and suture lines
- Use of manual push up techniques
- Supports the use of foetal head elevation devices, e.g. Tydeman® Tube or balloon inflation devices
- Use of inflatable foetal head elevation type delivery assistance devices
- Enables training in the use of forceps insertion and failed forceps delivery simulation (Vaginal delivery of the head is not possible)
- Successful delivery of an impacted foetal head at caesarean section with adjustable degrees of difficulty
- General introduction to caesarean section and foetal head delivery
Features
- Debra Enhanced® simulates a realistic pregnant abdomen with a pre-cut caesarean incision, uterus and foetal head of a birthing mother with a unique mechanism to replicate foetal head impaction:
- Enhanced, more realistic vaginal examination
- Enhanced, palpable fontanelles and suture lines in foetal head
- Variable degrees of foetal head impaction severity
- Adjustable foetal head flexion and asynclitism
- Enables training in the use of forceps insertion and failed forceps delivery simulation (Vaginal delivery of the head is not possible)
- Compatible with manual push from below delivery methods
- Supports the use of foetal head elevation devices, e.g. Tydeman® Tube or balloon inflation devices
- Available in both dark and light skin tones
- Designed and manufactured in the United Kingdom
Increasing Incidences
- The rate of caesarean (CS) section has increased, with CS at full dilatation almost doubling in the last two decades. ("A comparison of techniques to disimpact the foetal head on a second stage caesarean Simulator" – Anastasia Martin, Diane Nzelu, Annette Briley, Graham Tydeman and Andrew Shennan)
- A 2019 study at one UK hospital found that 17% of births were by delivered emergency CS, with difficulty delivering the head affecting 20% of emergency CS and 63% at full dilatation. ("A comparison of techniques to disimpact the foetal head on a second stage caesarean
Simulator" – Anastasia Martin, Diane Nzelu, Annette Briley, Graham Tydeman and Andrew Shennan)
Improving Outcomes
- Studies have demonstrated that training with a Debra simulator can reduce the force used for successful delivery, potentially improving outcomes for both mother and baby. ("Caesarean section at full dilatation: incidence, impact and current management" – Nicola Vousden MBBS BSc,, Zillah Cargill BSc, Annette Briley MSc, Graham Tydeman MRCOG, Andrew H Shennan MD FRCOG)
Integral Training Simulator
- Impacted Foetal Head now forms key parts of the of Royal College of Obstetricians and Gynaecologists Avoiding Brain Injuries in Childbirth (ABC) programme and RCOG Operative Birth Simulation Training Course (ROBuST)
- 93% of experienced participants and 94% of junior obstetricians deemed the Debra simulator “very useful” as a training device following use in a training group. ("Assessment of a Full Dilatation Caesarean Delivery Simulator" – Nicola Vousden, MBBS, BSc, Zoya Hamakarim, MBBS, BSc, Annette Briley, PhD, MSc, Joanna Girling, FRCOG, Paul T. Seed, Msc, CSTAT, Graham Tydeman, FRCOG, and Andrew H. Shennan, MD, FRCOG)
2 Year Guarantee
- This model, manufactured by Adam,Rouilly, comes with a 2 Year Guarantee
- This guarantee applies to models which have been used correctly and covers durability and functionality
