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Wounded Willy and Damaged Debbie

  • 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 evaltuation of trainee performance
  • Teaching/training for civilain hosptial ER's
The concept of grouping a large number of casualties in two teaching/training phantoms was originated by the Fleet Hospital & Operations Training Center, Camp Pendleton, California. WOUNDED WILLY and DAMAGED DEBBIE were designed and constructed by Radiology Support Devices, Inc. of Long Beach, California.



It is a universally-accepted fact of life that people cannot be subjected to diagnostic radiography for other than medically-necessary purposes. Observance of this principle rules out the use of patients for basic training in these procedures (but permitting the use of patients for advanced, supervised training).

The re-creation of the human body, in all of its immense complexity, represents overkill for radiographic training. One example of a widely-accepted divergence from precise reproduction of the human is the use of transparent phantoms to combine the teaching of radiography with that of anatomy.

Whichever philosophy is pursued, the basic qualifiers of human substitutes are phantoms that yield radiographs resembling those of the human, taken with human technical factors, articulated to enable basic views to be presented, and with an appropriate level of human anatomy.

A phantom is a "trade-off" between acceptable anatomic detail and unacceptable impact of artifacts on the image. WILLY and DEBBIE are based on several decades of experience with "trade-offs", variously driven toward one extreme or another. They yield human-like images, with human technical factors and with limited artifacts, (which are presented clearly as artifacts, not as anatomic detail). They are well-balanced patient substitutes for basic training of radiologic technologists, particularly in military or emergency room environments.


They 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.

WILLY AND DEBBIE DIFFERENCES:
The most obvious difference between them is in the complement of traumas and pathologies assigned to each.

Another difference is that 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.


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 judgments of the realism of trauma and pathologies are those based on long radiographic experience across the spectrum of casualties.

Patrick Hale, Senior Radiologic Technologist at the UCLA Emergency Room and an RSD consultant, made those judgments with respect to WILLY AND DEBBIE.

DIMENSIONS
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).

ANATOMY
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
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.

SOFT TISSUES
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.

SKELETONS
RSD-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.

RSD skeletons are not to be confused with plastic skeletons for teaching anatomy. RSD 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.


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).


 
Number WILLY/DEBBIE Description Side External Marking
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
8 DEBBIE Mandibular fractures R S,B
9 DEBBIE Cloudy maxillary sinus L N
10 DEBBIE Fracture of nasal bones with mild displacement N/A H

Note: 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


 
Number WILLY/DEBBIE Description Side External Marking
11,12 WILLY Displacement fracture of mandibular condyle L&R S



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).


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.

Number WILLY/DEBBIE Description Side External Marking
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


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).


Number WILLY/DEBBIE Description Side External Marking
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



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).
 

Number WILLY/DEBBIE Description Side External Marking
27 DEBBIE Widened mediastinum and pleural effusion N/A N
28 DEBBIE Chest tube, lung inflated L Tube
29 DEBBIE Infiltrate N/A N



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).


Number WILLY/DEBBIE Description Side External Marking
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




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).

Number WILLY/DEBBIE Description Side External Marking
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



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).

Number WILLY/DEBBIE Description Side External Marking
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




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).

Number WILLY/DEBBIE Description Side External Marking
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




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).







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).

Number WILLY/DEBBIE Description Side External Marking
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    



Number WILLY/DEBBIE Description Side External Marking
59 DEBBIE 3rd and 4th metacarpals shattered L Thickened, back of hand



Includes:

RS-601 WOUNDED WILLY

RS-602 DAMAGED DEBBIE

RS-603 ANATOMIC NECK

RS-604 MECHANICAL NECK WITH FOAM FLESH NECK/1 EA FOR WILLY & DEBBIE

RS-605 TRAUMAS AND PATHOLOGIES (-01 TO -59)


Traumas and pathologies are divided between WILLY and DEBBIE in a way that minimizes interference between them. Some changes can be made in locations of each, or additional traumas and/or pathologies can be added or substituted for others.

Ask about special requirements and pricing of changes.
Changes cannot usually be retrofitted.



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