Kiri Oates, Will Ibbotson
Medical Officers RFDS SE Section
We needed to source a low fidelity, low cost, easily replicable chest wall simulator to train 50 GP Registrars in the critical care procedure of surgical thoracostomy and chest drain insertion. Traditional task trainers for trauma are expensive, fragile and require training to operate. Given these limitations we set out to build a sufficiently robust and cheaper alternative which could be used in our pre-hospital setting.
The model needed to fulfill the following attributes to adequately simulate the task of tube thoracostomy:
- Sensation of tissue dividing as dissected
- Realism of ribs separating
- ‘Pop’ of passing into pleural space
- Impression of finger sweeping over pleura
The chest wall simulator we created was built from layers of cleaning sponge to represent the soft tissues, popsicle sticks as ribs and coloured book cover plastic for skin and pleura. This was mounted to a manikin to increase realism, however we recognised if unavailable, fixing to a container would suffice to demonstrate the procedural steps.
Limitations of this model include a lack of sensation of different tissue types i.e. adipose tissue and muscle, lack of blood occluding visual field and no simulated lung component.
Despite the limitations, feedback from participants was positive and suggested the model provided a good replicant to simulate the process of surgical chest drain insertion.
Future developments of this model include a balloon for collapsed lung replication and investigating other materials which more closely replicate different tissue types.