Modular and Reusable Pericardiocentesis Trainer Using Gel Wax (1090-002347)
CE Hours: 0.25 Session Type: SimVentors
We developed a novel task trainer model of pericardial effusion to allow for the training of ultrasound-guided as well as anatomy-based pericardiocentesis. Because this trainer was intended to be used during a procedural training session involving up to 30 learners at a time, each performing multiple attempts, it was critical for the model to remain intact through repeated punctures with a hollow-bore needle. It was also important for the trainer to allow for the use of ultrasound to guide the procedure, while also presenting the realistic challenge of obtaining dynamic ultrasound images through the narrow spaces between ribs. Our model is largely made of gel wax, using a series of molds, with artificial ribs suspended near the surface and a plum contained within a balloon to represent the heart within the pericardium. We first created a large torso mold out of medium density fiberboard (MDF) wrapped in aluminum foil, into which the gel wax can be poured. Using a smaller MDF box, we created a void at the “mediastinum”, into which the smaller cardiac modules could be inserted. Gel wax was poured to a level that covered the mediastinal space and allowed to cool. We then laid the artificial ribs over the top of the first layer of gel wax and poured another layer to cover the ribs. Finally, a layer of silicone skin was poured over the entire torso block and allowed to dry. To create the modular cardiac inserts, we built another MDF and aluminum foil box whose inner dimensions matched the mediastinal void we had previously created in the torso. We put a plum into a balloon, filled the balloon with water, and suspended it into this box using thin wire. We filled the box with gel wax and allowed it to dry. Several of these modules were created in preparation for the procedural training session so that they could be exchanged after repeated needle sticks resulted in excessive artifact on ultrasound.