IMSH Delivers Sessions - Scroll down to "ADD to your Briefcase"
Simulator C-Section Modification (1090-003768)
CE Hours: 0.25 Cost: $0.00
Description:
Our model combines elements from the Strategic Operations CutSuit, modifications to Gaumard’s Victoria manikin, and our own design to c-section a model that supports a realistic cut, splash, and delivery. To create our model, we first “waterproofed” the Victoria's abdomen by removing her c-section stomach insert, exposing the most vulnerable parts of her motor. We used large tegaderms to seal up all openings in her abdomen, then placed a large piece of plastic sheeting that covered the tegaderms as a second barrier. We then placed the c-section stomach insert back in place, now with two layers of protection underneath. We used a screw driver to remove the metal ring that surrounds the opening of the c-section stomach insert. This ring normally serves as an anchor for the uterine cover and belly cover and is designed for both covers to be secured on the several metal prongs that protrude from the top of the ring. Because we found the uterine cover to be too loose when secured as the manufacturer intended, we removed the ring and assembled it with the uterine cover in a different order. With the ring removed, we used clamps to pull the silicone uterine cover tight and hold it in place over the bottom half of the opening of c-section insert. We lined the silicone uterine cover up with the holes on the bottom half of the c-section insert and made small incisions in the silicone for the screws. We then placed the ring back over the top of the c-section insert, and placed the screws back on the lower half of the c-section insert. This holds the uterine cover in place on the lower half of the opening. With the bottom of the uterine cover secured, we took the c-section baby and umbilical cord that was included with Victoria and liberally lubricated it with a silicone-based lubricant. This allows for a more realistic removal by clinicians. We placed the baby in the fetal position and inserted it in the bottom of the stomach. We filled a round clear balloon with red/yellow tinted water until it was the size of a cantaloupe. We then lubricated the balloon for easier insertion, and wedged the balloon underneath the baby's head. We then ensured that the balloon was in such a position that it would pop instantly once learners cut the bottom of the uterine cover with a scalpel. Once baby and balloon were in place, we closed up the rest of the uterine cover using the same method as before. Using clamps to pull the uterine cover tight and run it under the top of the metal ring, we then secured it with screws until it was back in place. With the uterine cover secured by the metal ring, we then took Victoria’s snap-on belly cover and cut it in half, leaving only the top half. We then snapped the top half onto the metal ring. This gives structure to her belly, while leaving the uterine cover exposed. We placed our modified Strategic Operations Cut Suit on top of Victoria’s C-Section stomach cover, covering both the top half of the snap-on cover and the exposed uterine lining. The Cut Suit modification included cutting the top of the suit off just below the nipples, and removing the male genitals. We then removed the back zipper and replaced with Velcro, cut openings in the leg sleeves and added Velcro. This allows us to easily outfit Victoria. We also added a silicone fascia layer for realistic layering on the inside of the abdominal area of the cutsuit. The modification is now complete. Learners cut through a “previous c-section scar” moulaged onto the cut suit that ensures they will hit the uterine cover in a location that will pop the balloon. The uterine cover is tightly secured underneath the metal ring we threaded the uterine cover through. When the balloon pops upon incision, a realistic splash occurs. The baby can then be removed with normal force without accidentally removing the snap-on stomach cover or uterine cover, because it is secured underneath the modified cut suit. The cut suit can be repaired with silicone for several re-uses.