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HomeGrown Solution: Improvised CVP Monitoring Simulator

Title

Improvised CVP Monitoring Simulator

Submitted By

Cara Jaye Francesca Garcia

HomeGrown Solution Number

257

Identification of the Problem

Achieving fidelity with basic task trainers is challenging, especially in the context of teaching hemodynamic (central venous pressure) monitoring to baccalaureate senior students. The skill of CVP monitoring demands dexterity and high regard for patient safety. In developing countries particularly, where costs of high-fidelity manikins remains high, and preparing students for complex critical care situations is imperative, resourceful re-thinking of available medical supplies is key.

Unique Idea

Using readily-available medical supplies, our homegrown low-cost CVP monitoring simulator enables students to deliberately and safely practice their manometer technique given a critical care scenario; and allows instructors to manually control the volume and fluid oscillations to mimic clinical reality. The simulator can be attached to a basic task trainer to provide a comprehensive learning experience.

Supplies/Ingredients

  1. 3-way stopcock
  2. IV Fluid (500 ml or 1 L depending on case)
  3. IV set (macroset)
  4. IV extension set (Luer-lok ends)
  5. Pressure infusor (no gauge required)
  6. Manometer (to test)

Steps to Creating the Solution

  1. Prime the IV macroset using the available fluid or as prescribed by the case scenario.
  2. Connect the macroset to the 1st tubing port of the 3-way stopcock
  3. Connect the extension set to the 2nd tubing port of the 3-way stopcock
  4. Inflate the infusor fully using the squeeze bulb and lock the air in using the air directional valve
  5. Connect the other end of the extension set to the air directional valve to close the system
  6. Attach the set-up to a torso/full-bodied manikin making sure that only a part of the extension set connected to the stopcock is in view
  7. Test the system by loading a manometer onto the last port of the stopcock and opening the valve and IV roller clamp to fill the manometer. As soon as the valve is turned (toward the patient), create fluid oscillations using the squeeze bulb and keep the water from dropping by adjusting the air valve slowly
  8. Drain the system by unscrewing or disconnecting the squeeze bulb and emptying fluid contents.

Images

hung IV fluid with attached primed macroset, pressure infusor, and tray with 3-way stopcock, extensions set, and manometer Hung IV fluid with attached primed macroset. Hand holding the connection of the primed macroset to the extension set to each tubing port of the 3-way stopcock. Hand manually inflating a pressure bag using a squeeze bulb. Air valve is kept in "keep inflated' position. Hung IV fluid attached to a pressure bag attached to a squeeze bulb. Hand holding a manometer attached to a stopcock. Squeeze bulb and pressure bag are on the countertop.

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