Sula Marie

03/30/2026

💡Would Integrating Simulation Scenarios with the 3-in-1 Dialysis Simulator strengthen realism?

🩺 Simulation Scenario
Air Embolism Due to Improper Venous Line Placement

🎯 Scenario Focus
Air embolism caused by:
Visible air in venous chamber
Venous tubing NOT fully seated in air detector
This introduces a preventable error + equipment misuse, which is exactly what high-level dialysis training should target.

👤 Patient Profile
Name: R.J.
Age: 64
Access: Left forearm AV Graft
Dialysis Session: 2 hours into treatment
Condition: Stable at start of scenario

⚙️ Simulation Setup (Critical Modifications)
3-in-1 Dialysis Simulator
Dialysis Machine (Dedicated for Simulation Training ONLY)
Simulated vital signs and patient response (software or roleplay)
Venous chamber contains visible air (microbubbles progressing to larger air pocket)
Venous tubing is partially dislodged from air detector sensor
Machine does NOT alarm appropriately
Blood pump remains running

📊 Baseline Vitals
BP: 136/82
HR: 84 bpm
RR: 16
SpO₂: 98%
Patient alert, talking

⏱️ Scenario Progression with Vital Trends
🟢 Phase 1: Subtle Onset (0–3 min)
Visual Cue:
Small air bubbles visible in venous chamber/tubing
Tubing visibly misaligned from detector
Patient Complaints:
“I feel a little lightheaded…”
“Something doesn’t feel right…”
Vitals:
BP: 130/80
HR: 92
RR: 18
SpO₂: 95%

🟡 Phase 2: Early Air Embolism (3–6 min)
Symptoms escalate:
Shortness of breath
Anxiety/restlessness
Mild chest discomfort
Patient says:
“I can’t catch my breath…”
“My chest feels tight…”
Vitals:
BP: 118/72
HR: 105
RR: 22
SpO₂: 91%

🔴 Phase 3: Acute Deterioration (6–10 min)
If no intervention:
Symptoms:
Severe dyspnea
Confusion
Cyanosis (if simulated)
Possible loss of consciousness
Vitals:
BP: 88/58
HR: 120–130
RR: 28 (labored)
SpO₂: 84% → dropping

🚨 Critical Action Pathway (Expected Learner Response)
Recognize abnormality
Air in venous chamber
Tubing not in detector
STOP dialysis immediately
Stop blood pump
Clamp arterial & venous lines
Prevent further air entry
Correct tubing placement
Secure connections
Position patient
Left lateral Trendelenburg (Durant maneuver)
Administer high-flow oxygen
Activate emergency response
Monitor & prepare for CPR

❓ Critical Thinking Questions (Ask During or After Scenario)
1. What is the patient experiencing?
2. What assessment findings led you to that conclusion?
3. What immediate interventions are required?
4. What caused this event?
5. How could this have been prevented?

🧠 Debrief Emphasis
This scenario is about:
Human error + system failure
The gap between technology and clinical judgment

03/21/2026

03/21/2026

When you are retired, yet you wake up early planning how you can get home life duties out of the way so you can work on your project uninterrupted.

When you push pass lunch and now it's late and you're losing energy and are forced to pause and eat!

When your husband says "Are you still working" and it is now 2000.

When you finally sign off at 2100 because it's time to watch on CNN.

When you finally retire and lay there half the night and think about what you can do different to improve your product, promote it, make the stakeholders buy-in!

It's NOT a Hobby
It's My Passion

It became my brain child in 2002 when I started my career as a Dialysis Nurse after 15 years in Surgical Trauma ICU.

I'll never forget how nerve wrecking it was to have to manage the dialysis machine, the access, what looked like all the blood in the body on the outside and the rapidly changing conditions of the patients.

I kept thinking, there has got to be a safer and less stressful way to learn dialysis.

Well after 22 years in Dialysis, my brainchild was born.

3-in-1 Dialysis Simulator

Fresenius Medical Care DaVita Kidney Care USRenal Care

03/20/2026

Level up your Dialysis Training Program by adding the 3-in-1 Dialysis Simulator to your toolkit!

03/17/2026

What problem does the 3-in-1 Dialysis Simulator solve? Where is the evidence of this?

3-in-1 Dialysis Simulator solves the critical gap in hands-on training for high-risk dialysis procedures—preparing hemodialysis/peritoneal catheters, running full sessions, AVG cannulation/securement, and machine troubleshooting—where live practice risks patient harm, complications, and access loss while inadequate training contributes to staff shortages and errors.

Key problems it addresses:

**High complication rates from poor skills**. AVG cannulation errors cause aneurysms (0.04/1000 patient-days), infections (0.11/1000), thrombosis (0.24/1000), and graft failures, often from repeated misses leading to pseudoaneurysms in >50% severe cases.

**Training shortages and steep learning curves**: Dialysis units face recruitment/retention issues due to inadequate structured programs with new staff struggling on setups, alarms, and transitions from lab to bedside.

**Patient safety risks in live training**: Limited deliberate practice on real patients heightens infiltration, hematomas, and access loss; simulators enable risk-free repetition for first-stick success up to 95%.

Evidence of Impact:

Industry studies confirm simulation reduces errors: Simulation-based training cuts AVF puncture complications (e.g., hematomas p=0.001, pain p=0.03) and boosts success rates (RR 1.08, moderate evidence across 866 learners).

Vascular access gaps persist: Dialysis nurses/PCTs show knowledge-to-skill transition failures in assessment/cannulation, needing active sim strategies for bedside confidence.

03/14/2026

Education is the foundation for any successful Dialysis Clinic, Home Program, Long Term Care Facility, Acute Programs or anyone offering Dialysis Services.
It shouldn't be on the job training.
It should be training before you're on the job!

S-World's patented 3-in-1 Dialysis Simulator should be a tool in your education toolkit!

Fully dialyzable
Cannulation skills
Skills validation
Critical scenario management
Standardized training







Fresenius Medical Care DaVita Kidney Care USRenal Care

03/11/2026

Skill up, before you hook up!

02/26/2026

Stop Guessing. Start Assessing. Master the "Pop"!
LOOK 👀 LISTEN🩺 FEEL 🖐

Whether you are a student picking up a needle for the first time, a home dialysis patient learning to self-cannulate, or an educator responsible for the next generation of clinicians, the goal is the same: Save the Lifeline.

Cannulation is more than just a "stick"—it is a high-stakes skill that requires precision, empathy, and tactile mastery. Our AVG Cannulation Simulator Kit is designed to bridge the gap between classroom theory and clinical reality.

Why Simulation Matters:

For Students & Clinics: Build muscle memory and confidence before ever touching a patient’s access.

For Home Dialysis: Practice in a low-stress environment to master the "pop" of the vessel wall.

For Nurse Educators: Standardize training with a tool that provides real-time feedback, including bruit, thrill, and flashback confirmation.

Key Training Benefits:

Precision: Master the 20° – 30° angle to avoid the "Danger Zone."
Tactile Feedback: Experience the distinct "pop" of a successful entry.
Safety: Reduce infiltrations—the #1 enemy of a patient's access.
Don’t just learn it—feel it. Elevate your training program and protect your patients.

Ready to bring this to your lab or home? Order your kit here: 👉 (Link available in the first comment!)

Questions? 📧 Email: simlab@kidneymatters-inc.org 📱 Text: 832-982-2926

12/04/2025

Thank you VoyageHouston for shining the Spot Light on how my 3-in-1 Dialysis Simulator invention is bridging the gap between knowledge and practice in Dialysis Education!

Today we’d like to introduce you to Sula Stanfield. Hi Sula, please kick things off for us with an introduction to yourself and your story.As far back as I can remember, I’ve been wired to spot gaps and build the bridge that didn’t exist yet. Entrepreneurship was never a side interest—it was...

10/16/2025

08/16/2025

Coming Soon!
I've been working tirelessly on my new software project developing a curriculum for dialysis simulation high risk low frequency scenarios and core competency skills to complement not only my 3-in-1 Dialysis Simulator but other disciplines as well.
Stay Tuned...