Presentation on theme: "Adding Realism to Practical situations: The Use of Moulage Techniques in Athletic Training Shawn Felton, EdD, ATC, LAT Hugh Harling, EdD, ATC, LAT 2014."— Presentation transcript:
Adding Realism to Practical situations: The Use of Moulage Techniques in Athletic Training Shawn Felton, EdD, ATC, LAT Hugh Harling, EdD, ATC, LAT 2014 SEATA Educators Conference Atlanta, GA
Factors Needed to Have Successful Realistic Simulation Plausible Environment Plausible Responses Plausible Interaction Familiar Equipment Realistic Simulator Equipment Seropian, M. Technology, Computing and Simulation (2003) Anesth Analg
Importance of Fidelity 3 Fidelities of Patient Simulation –Equipment Fidelity Simulator versus real equipment –Environment Fidelity Simulation of Motion, visual and other sensory environments –Psychological Fidelity How real one perceives the simulated event? Trying to suspend disbelief
Why Use Simulated Events Control for the Area of Interest, specific learning outcomes Protect patients/clients Ensure skills are instructed for specialized skills –CIPs
Testing Utilizing Moulage and Simulation More Authentic Ensure Knowledge and Clinical Skill Ensure flow of communication Scenarios that are rarely encountered –Take out the chance
Play like you Practice Never more true Learn From FBI – J Edgar Hoover Practicing CPR Need opportunity to perform without interruption Moulage always for more authentic experience
Table Discussion What are some of the self-identified challenges for creating moulage and enhancing realism?
What are your challenges ? Time Funds Space Ideas
Lessons from the field (classrooms) Authentic –Use of gloves Obvious for external injuries –Internal Injuries Add Glycerin & Water to simulate sweating (Elevated Temperature) Blue Watercolors on manikin to cue Hypotension – Mild infection
Table Discussion What are you trying to Achieve with Moulage? What have you done to enhance realism? –What were the successes and failures?
Recipes…Blood Ivory dish soap and red food coloring Darkens as drys just like blood WILL STAIN (Skin, clothes, manikins, …) One cup corn syrup Red food coloring mixed with 1-3 drops of green or blue food coloring Corn starch to thicken
Recipes…More Blood Non-Staining Similar to previous recipes (Dishwashing detergent) with washable poster paint (Red, Black, Blue) and sugar-free chocolate syrup
Recipes…Blister / Furuncle with Pus Vanilla pudding with a drop of red, green, or yellow food coloring Inject into bubble wrap and seal with crazy glue Attach to surface and cover with skin
Recipes…Dilated pupils Place black marker dot on old contact and place in eye of manikin Dots can vary in size to create aniscoria
Recipes…Drainage/Secretions Wound drainage presents itself in a variety of situations; often the drainage is as diverse as the situation. Prior to beginning your moulage, consideration should be given to volume, consistency and odors to assist you in authenticating the scenario you are creating. When crafting your wound drainage, consider the following factors: What type of wound is it? Where is it located? What is the over-all health of the patient?
Recipes…Drainage & Secretions (Cont.) Purulent, odorous drainage moulage for healthcare simulation: 1 tsp. (condensed) cream of mushroom, chicken or split pea soup 2 tsp. Limburger cheese 2 drop Kimchee (Chinese seasoning) 4 drops water Caramel food coloring; thinned In a small bowl combine cream soup, Limburger cheese, Kimchee and 2 drops of water. Stir mixture well for approximately 1 minute or until thoroughly combined. On wax paper, thin 1 drop of caramel food coloring with 2 drops of water, stirring well with small paint brush. Swirl paint brush with caramel coloring through purulent mixture to impart coloring and add depth. Environmental Settings: Using a small paint brush, apply purulent drainage to 4×4 wound dressing, gauze pads, and internal cavities and crevices of dimensional wounds. Use in conjunction with diabetic foot ulcer and wound dressing drainage. See: MoulageConcepts.com for more recipes. Clean Up: Using soft, damp cloth; wipe odorous drainage from skin of simulator. Treated dressings, gauze pads and wounds can be stored in the freezer indefinitely. Allow mixture to come to room temperature before proceeding to scenario. To refresh odor: Add 1 drop of Kimchee to dressing. Time Saving Hint: Odorous drainage can be made ahead, stored, covered, in the freezer or refrigerator. To reconstitute, add 2 drops tap water and stir several times.
Recipe…Simplest Laceration Simplest – slice closed foam surface or suture arm from Life/form ($ 165) Slice manikin face, arm or chest (CPR face – 6 for $ 60) Add color and texture to wound
Recipe…Laceration Buildup skin Slice skin Add color and texture to wound If want reusable, make wound on wax paper and adhere to person or manikin, peel off after use
Recipe…Blister Simplest – Bubble wrap glued to plate (Especially if practicing lancing and skin removal) Bubble wrap injected with Vaseline or fluid (Seal with crazy glue) For either of the above, add skin built- up / over the top
Recipe…Blister Alternate Skin built-up Inject Vaseline under skin Drying time issue
Recipe…Another Blister Alternate (Burn) Cut a piece of red Saran wrap in shape and size of wound Adhere to site Apply line of liquid latex or skin to border of area and into the burn area Peel and roll inside edges Apply red makeup or lipstick fading towards the edge
Recipe…Bursitis Hand warmer inside Pantyhose over area (Elbow)
Recipe…Closed Fracture Tape three straws together with tongue depressor Closed cell foam or small bubble wrap Cover with Coban, Pantyhose, or Skin
Recipe…Open Fracture Tape three straws together with white tape Cover end with dry wall patch material Paint ends for marrow Add skin over the top Add blood and makeup
Current Projects Suture removal Staple removal Oral cavity & Dental injuries Nasal Plug insertion Top of head laceration Corneal abrasion
Items to Consider (Cautions) There is no known issues/problems with homemade moulage Sensitivity to Latex Shave area a day or tow before applying liquid latex to skin Be careful with dishsoap use above the neck on real person Use of Sugar type ingredients (Outdoors attracts bugs in summer) Soaking Clogged spray bottles
Proper Cleaning Techniques for Manikins Mild dishwashing soap Citrus cleaner (plastic container only – metal container too harsh) Nothing with acetone on manikins as will desolve manikin clear coat and paint already on manikin (Eyebrows, …) Wet wipes (without bleach) Isopropyl alcohol wipes or gauze Anything you would use on the inside of your car can usually be used
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