Anthropomorphic Phantoms for Military Training in Radiography
- 60 traumas and pathologies divided between Willy and Debbie
- Can be positioned realistically
- Human technical factors
- Unlimited repetition of views without human exposure
- Radiographs that permit evaluation of trainee performance
- Teaching/training for civilian hospital ER's
Willy and Debbie Capabilities and Differences
Wounded Willy and Damaged Debbie demonstrate and evaluate positioning and imaging techniques, including kVp, mAs, contrast, optical density, OFD and TFD. Their radiographs are optically equivalent to humans in density and contrast.
The most obvious difference between Willy and Debbie is the complement of traumas and pathologies assigned to each. Also Debbie has female breasts, while willy has natural male chest contours. Debbie is fitted with a wig, while Willy is bald. They are dressed in camos for military training and in jumpsuits for civilian training.
Traumas and Pathologies
There is no single, unique description of any of their traumas and pathologies. Rather, there are limitless variations among a broad range of casualties. The most meaningful judgment of the realism of trauma and pathologies are those based on long radiographic experience across the spectrum of casualties.
The size and weight of PIXY are also used for WILLY and DEBBIE. They are small adults. Since technologists must learn to work with patients of all sizes and weights, a smaller phantom is as valid for training as a larger phantom, and position is facilitated. Each is 5 ft. 1 in. tall (156 cm) and weights 105 lbs (48 kg).
WILLY and DEBBIE are articulated at the neck, shoulders, elbows, hips and knees. Fractures of the left shoulder and left hip are located in DEBBIE. To minimize handling problems, all other traumas of the arms and legs are located in WILLY and on the right side of DEBBIE. The articulations provide a broad range of positioning of capabilities, even the “frog position”.
Lungs are molded of durable materials with radiodensities matched to humans in a median respiratory state. Animal lungs matching the human in size and blood vessels are available, but they are oriented towards research rather than training.
WILLY and DEBBIE have solid soft tissues that are hard and rigid. They cannot be palpated to locate traumas. However, radiological technologists are generally informed by the physician as to the views to be taken. The manual provides this information to instructors.
Manufactured skeletons are used rather than natural human skeletons. The latter are generally unavailable and usually consist of an assortment of bones ranging from children to adults of ages for which osteoporosis becomes a factor. They are not to be confused with plastic skeletons for teaching anatomy. These skeletons are made to fit the soft-tissue molds precisely. They have spongiosa moldings within marrow cavities and outer cortical bone. Both constituents meet the internationally-accepted standards for radiodensity and specific gravity.
Notes: An axial duct is seen above. It is filled by a polycarbonate rod to assemble the head and neck to T1. When assembled, the duct artifact is barely visible. Anatomic and mechanical necks are interchangeable between WILLY and DEBBIE. Heads are interchangeable between WILLY and DEBBIE.
Among the trade-offs required in these phantoms is that between anatomic fidelity and the ability to move the head into a broad range of views is required in radiography. No mechanism can be designed for intervertebral motion without artifacts obliterating the radiographs.
This problem has been solved by the use of two necks. One is a multi-articulated polycarbonate assembly which provides for nearly all commonly used views. There is no attempt at radiographic realism in this neck. An alternate, fully-realistic neck is interchangeable with the mechanical neck. The cervical spine of this neck contains traumas.
Legend: Traumas and pathologies are listed below. External markings are: N (none), O (open wound), S (swelling), H (bullet or foreign body hole), B (bruise), Side (R.L.), E (WILLY or DEBBIE).
|1||Willy||Metallic fragment in orbit||R||N|
|2||Willy||Multiple fragments lower face||N/A||N|
|3||Willy||Step deformity of intraorbital rim||L||B|
|4||Willy||Separated fracture of frontal zygomatic suture||L||S|
|5||Willy||Metallic foreign body over skull||N/A||N|
|6||Willy||Mandible fracture with missing bone||N/A||O|
|7||Debbie||Depressed comminuted fracture of zygomatic arch||L||S|
|9||Debbie||Cloudy maxillary sinus||L||N|
|10||Debbie||Fracture of nasal bones with mild displacement||N/A||H|
|11, 12||Willy||Displacement fracture of mandibular condyle||L,R||S|
|13||E||C4, C5 Compression fracture||N/A||N|
|14||E||C7 Fractured by bullet||N/A||H|
|15||E||C-spine bullet anterior to trachea shadow||N/A||H|
|16||Willy||Fracture of lateral ribs 6 & 7||R||N|
|17||Willy||Mediolateral fracture of ribs 8 & 9||L||N|
|18||Willy||Multiple rib fractures, four metallic fragments visible||R||N|
|19||Willy||12th rib frature||R||N|
|20||Willy||Bullet in hemothorax overlaying 8th rib||L||H|
|21||Willy||Bullet overlying heart shadow||N/A||H|
|22||Willy||2 cm metallic fragment in mid chest||R||N|
|23||Willy||Bullet visible below costal margin under 11th rib||L||H|
|24||Willy||2 bullets in LUQ||L||H|
|25, 26||Willy||Shattered distal scapulae||L,R||H|
|27||Debbie||Widened mediastinum and pleural effusion||N/A||N|
|28||Debbie||Chest tube, lung inflated||L||Tube|
|30||Debbie||Bullet in mid-abdomen||N/A||H|
|31||Willy||Unstable fracture of L1||N/A||N|
|32||Willy||Compression fracture of L5||N/A||N|
|33||Debbie||Metallic foreign body lateral to PSOAS||R||N|
|34||Debbie||Compression fracture of L4||N/A||H|
|35||Debbie||Metallic fragments – 2 mid-abdomen, 1 each in RLQ and LLQ||N/A||H|
|36||Debbie||Bullet in mid-abdomen||N/A||H|
|37||Debbie||Metallic fragments – 2 mid-abdomen, 1 each: RLQ and LLQ||N/A||N|
|38||Willy||ILIAC crest comminuted fracture with metallic fragments||R||B|
|39||Debbie||Displaced fracture of pubic ramus||L||N|
|40||Debbie||Sacroiliac disruption, acetabular fracture||L||N|
|41||Debbie||Foreign body lateral to PSOAS||R||N|
|42||Willy||Non-displaced pubic ramus fracture||N/A||N|
|43||Willy||Superior and inferior pubic ramus fracture||R||N|
|44||Willy||Pelvis fracture with symphysis diastasis and sacroiliac joint disruption||N/A||N|
|45||Willy||Bullet in sacrum||N/A||N|
|46||Willy||Shattered acetabulum||L||Latex "shorts"|
|47||Willy||Shattered femoral head||L||Latex "shorts"|
|48||Willy||Comminuted midshaft fracture||L||S|
|49||Willy||Left femur comminuted fracture 12 cm above knee||L||S|
|50||Debbie||Proximal tibia fracture||L||S|
|51||Willy||Comminuted fracture of tibia and fibula||R||S|
|52||Willy||Displaced ankle fracture||R||S|
|53||Debbie||Minimally displaced distal tibia fracture||R||S|
|54||Debbie||Displaced fracture of calcaneus bone||R||N|
|55||Willy||Displaced fracture of radius and ulna||L|
|56||Debbie||Volar angulated distal radius and ulna fracture||R|
|57||Willy||Angulated comminuted fracture of midshaft radius and ulna||R|
|58||Debbie||Minimally displaced distal radius fracture not involving wrist, offset bone ends|
|59||Debbie||3rd and 4th metacarpals shattered||L||Thickened, back of hand|