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HomeGrown Solution: Hybrid Fidelity Manikin for Gastrointestinal Bleed

Title

Hybrid Fidelity Manikin for Gastrointestinal Bleed

Submitted by

Ryan Stambro and Dylan Cooper

HomeGrown Solution Number

367

Identification of the Problem

Gastrointestinal (GI) bleeding is a a symptom of a disorder in the digestive tract. This is a difficult procedure given the lack of visibility caused by the blood and the need to act quickly to avoid significant blood loss. It is not a procedure that lends itself to in situ training. Emergency medicine physicians wanted to train residents on a GI bleed, but did not have a valid trainer to use for simulation.

Unique Idea

We took an old, no longer working adult manikin and replaced its insides with a simulated stomach and tubing that leads to a bucket filled with simulated blood. The tubing is attached to an aquarium pump inside the bucket that pushes the blood through the new GI tract and out of the manikin's mouth. This allowed us to enhance its function to replicate a patient with an upper GI bleed.

Objectives

To create a simulated patient with a GI bleed to train emergency medicine residents.

Supplies/Ingredients

  • 3 gallons of distilled water, blood concentrate, and alcohol
  • Old manikin stripped of electronics, mechanics, and miscellaneous tubing
  • 5 gallon bucket with holes in lid to run tube and power cord
  • Aquarium pump
  • 6-10 feet of flexible silicone tubing that fits the aquarium pump
  • Zip ties
  • Chest tube connector
  • Wireless on/off switch
  • Suction supplies
  • Disposable underpads

Steps to Creating the Solution

  1. Acquire a manikin that is out of warranty and or broken beyond repair. Remove all of the electronics, mechanics, and miscellaneous tubing. If the manikin has a tracheostomy opening, tape the opening closed. Manikin vitals will be run from a virtual monitor.
  2. Create simulated blood using the recipe of your choice. The inventors of this solution used distilled water, blood concentrate, and 91% alcohol.
  3. Fill a bucket with blood. The inventors used approximately 3 gallons.
  4. Create a new GI tract by connecting the flexible tubing from the manikin's esophagus, all the way through the stomach, and down to the aquarium pump that will be submerged inside the bucket of simulated blood. Avoid kinks or twists in the tubing that would inhibit the flow of simulated blood to the esophagus.
  5. Place disposable underpads under the patient to retain the simulated blood that exits the manikin.
  6. Plug in wireless on/off switch. Attach the power cord of the aquarium pump to the wireless on/off switch.
  7. The simulated GI bleeder is ready for use.

Images

manikin with a covered tracheostomy shown from the chest up on a disposable underpad inside manikin chest showing connectors with droplets of simulated blood Manikin on gurney with tubing running from the manikin. The tubing runs into a 5 gallon bucket beside gurney through a hole in the bucket lid. five gallon bucket with attached aquarium pump half filled with simulated blood gloved hand holding a wireless on off switch

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