Re: Moulage techniques for first aid simulations/scenarios

For the benefit of the list members:

Here are some of the standard moulaging techniques we have used for mock
disaster and for our Emergency Response practical exams.
For more on mock disaster and Emergency Management Explorer Post 493, see

http://bcn.boulder.co.us/community/explorer

Others who have ideas and experience are invited to share them on this
thread.

BLOOD

We use two types that are also used by the hollywood folks;

One is liquid sta-flo corn starch. Add two vials of red food coloring and
about a half vial of blue food coloring for optimal coloring. This works
best for "blood pumps" where you want to have spurting blood to simulate
arterial bleeding. We get outdated IV bags and blood pumps (new) from
local hospitals. Fill the bags with the "blood" mixture.
(Bags are sterile and uncontaminated, so pose no risk of infection.
Blood pumps must of course be new to be safely used.)
Conceal the bags inside clothing and run tubing to the blood pump down a
sleeve to the victim's hand so he can pump the blood to his "wounds".
This is a real "show stopper" when the "rescuers" arrive and see a stream
of "arterial bleeding" coming from a a major "wound."

The "other" blood we use is Karo clear syrup with a similar mix of food
coloring. The karo works well for "effect" on open wounds, since it
doesn't "run off" and "pools" nicely on floors. Suggest laying down
plastic sheeting to minimize cleanup after the exercise. All blood items
wash out of clothing by letting it soak in cool water, then laundering.
If a "pink" tinge remains, use a weak bleach solution to get it out of
clothing.

CLOTHING

Use old clothing than can be cut/torn to expose injuries. Burns can be
enhanced by carefully singing the edges of "burned" areas with a lighter
or torch. Pieces of burned cloth can be attached to "burned" skin areas
with liquid latex described below. Be sure to have Scout "victims" wear
gym shorts or swim trunks under clothing in case it is "cut away" by
rescuers.

AMPUTATED EXTREMITIES

Use "baggy" jeans or shorts, especially for simulated amputations. Have
the "victim" place his foot back up the pant leg to simulate a "stump" and
use a store mannequin "leg" to simulate the amputated member. Commercial
moulages can be placed on the knee to enhance the realism or use molding
wax and grease paint to simulate one. Arterial bleeding pumps here are
especially effective.

BURNS

For burns, we use theatrical liquid latex. Paint a thin layer on the skin
and let it dry until "tacky" then pull up selected areas to create
"blisters." Then use a mix of glycerin and water to simulate lymph flow
from the "blisters." Use theatrical grease paint to add black and red
highlights. The latex has a finite life, so keep it capped between uses,
don't let it freeze, and buy it in small bottles. It is a little "pricey"
so small quantities are a good idea.

SHOCK/DIAPHORESIS

Use gray pancake makeup to simulate shock; apply evenly on the face. Use
blue grease paint to simulate cyanosis on the lips, apply lightly.

Use glycerin and water mix in a spray bottle to simulate diaphoresis
(perspiration) around the lips and forehead.

WOUNDS

"wound wax" or theatrical molding wax is great for simulating deformity
such as fractures and swelling. Roll it like modeling clay to make it
pliable then mold it to the shape desired. To simulate a wound, use a
table knife and then color with red grease paint.

Use blue and red pancake makeup mixed to simulate large bruises on the
abdomen and chest, or grease paint thinly applied with some gray pancake
makeup works too.

EMESIS

Vomitus can be simulated with cream of asparagus or pea soup..(major
yucchy) but effective. Good for improving awareness about airway
protection.

OPEN FRACTURES/SWOLLEN JOINTS

Open fractures can be simulated with the wound wax and "chicken bones" or
carved wood fragments painted white.

ATTACHING MOULAGE

Use theatrical spirit gum or duo-derm surgical adhesive to attach moulage
items flush with skin; blend in edges with molding wax and color with
grease paint or pancake makeup. DON'T use adhesives such as rubber cement
or casein glue as this can cause skin reactions in some folks and the
solvents are toxic

COMMERCIAL MOULAGE KITS

If you have access to simulated wounds from a moulage kit, they have some
excellent large lacerations, open fractures, eviscerations (abdominal
wounds with viscera exposed). They also have "arteries" you can plug
blood pumps into and simulate spurting blood from the "wounds." Red Cross
and EMT training schools often have these items and can loan them to you
or to an instructor for you.

If you can't get commercial moulages (they are pricey) you can do a lot
with simulation by paper mache (simulated amputations).

ACTING/SIMULATIONS

The "acting" is another major part of the exercise. Train Scouts on how
to react with symptoms, pain, changes in level of
consciousness/responsiveness, etc. Avoid "over-acting" since this tends
to turn the scenario into a giggling match especially with younger scouts.
Remind them that seriously injured patients are often very quiet or
withdrawn due to shock and should be of greatest concern. Noisy, active
patients are often in fairly good shape unless they have a closed head
injury and are acting inappropriately due to changes in mentation.

Get an EMT Instructor or Red Cross first aid instructor to help you coach
Scouts on simulating signs and symptoms, as well as makeup techniques.

MASS CASUALTY EXERCISES

Organize your "victims" by trauma/medical triage codes:
Red for urgent/life threatening injuries
Yellow for delayed
green for "walking wounded"
blue for "unsalvageable"
black for deceased

Try to set a reasonable "balance" of a few "reds," more "yellows," and
lots of "greens," a few "blues" and a few "blacks." Train your triage
teams to first code all victims, then move the victims when stable, to the
transportation areas. Reds and some yellows will have to go by stretcher
or backboard; greens can usually walk to their area. Blues and Blacks are
left at the scene until the "coroner" arrives to approve their "removal."

Then write up index cards with a description of the nature of injuries for
each victim, what vital signs/symptoms they are to have and where they are
to be located in the exercise. As they come through the makeup line, they
can be fitted/made up for the appropriate injuries, and coached on their
symptoms, then located at their spot in the exercise.

Your local Emergency Management or Emergency Medical Service providers can
get you "triage tags" for the "rescuers" to use in "coding" the victims
when they arrive on scene. this is a great way to teach triage, but be
sure they are taught how to use the tags in small exercises before the
"big event."

Hope this helps..let me know if you need more background.

Best wishes,

Bob Amick, EMT-B, Emergency Response Instructor, American Red Cross
Explorer Advisor,High Adventure Explorer Post 72/Ship 72, Boulder, CO
web page: http://bcn.boulder.co.us/community/explorer72

• Messages sorted by: [ date ][ thread ][ subject ][ author ]
• Next message
• Previous message