We (Paramedics in the county) use the Simman. It is a full size simulator that can have a heartbeat, resps. and B/P. It can close it's throat mimicking an allergic reaction while intubating it. We use it for chest decompressions, I.V.'s and mega codes. We also use it for command recert every year. It can be used instead of going to the E.D. or O.R. if we are short on tubes in the year but we still perfer humans for high fidility training.