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Moulage Techniques for Realistic Simulations in Healthcare

Learn about moulage, the artistic technique enhancing simulation fidelity with wounds, blood, and more. Supplies, human vs mannequin subjects, limitations, and sample recipes included.

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Moulage Techniques for Realistic Simulations in Healthcare

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  1. Moulage: Nuts & Bolts Krista Kipper BSN, RN HealthPartners Clinical Program Manager

  2. Moulage • Moulage • The artistic technique of incorporating realistic cues, such as wounds, perspiration, blood, or therapeutic devices, to increase the “psychological fidelity” of a simulation.

  3. Considerations • Alignment with objectives • Participant considerations • Level of experience • Environment • Inter-professional education • Subject • Human • Mannequin • Knowledge • Physiology of the situation • Mechanism of injury

  4. What do you need?

  5. Moulage Supplies • Dish detergents • Blue • White • Pink/red • White shaving cream • Red bubble wrap • Red plastic food wrap • Winter holiday purchase • Food coloring • Wigs • Halloween purchase • Wounds & Incisions • Halloween purchase • Eye Shadows & Blushes • Many colors • Make-up brushes • Water Color markers • Finger paints • Distilled water

  6. Moulage Supplies cont… • Artificial blood • Spray bottle • Distilled water to spray diaphoresis • Scented concentrate • Liquor/alcohol • Fruity for DKA breath • Adhesives • Tapes • Tegaderm • “White” eraser • Powder

  7. Body Fluids Magic

  8. Moulage Supplies cont… • Mixing Basics • Secure locking containers • Spoons • Leur-lock syringe • Cath tip syringe • Drainage bags for IV fluids • Funnels • Measuring cups

  9. Food Products? • Avoid • Mold Growth

  10. Food products? • Possible Exceptions: • No direct contact with mannequin • Edema: Cream of wheat/oatmeal in secured bags covered with nylons • Coffee grounds added to a fluid presented in a basin • Cornstarch for thickness • Rice crispies/broken chips in a baggie for crepitus • Plain gelatin with red food coloring for clots

  11. Human Subjects • Benefits • Blending make-up for bruises is easier • Adhesives stick better • Individual can assist with device or moulage • Individual can assist with clean up • Realistic facial expressions and movement

  12. Human Subjects • Limitations: • Need breaks • May have allergies to moulage/device materials • Inability to perform all “critical actions” when simulating a medical emergencies (ie. Intubate) • Limitations to the application of devices (ie. Foley) • Limitations related to exposure

  13. Mannequin Subjects • Benefits • More realistic device application (ie. Intubation) • Easy exposure • Ability to alter physiological findings • No allergic concerns • No timing issues related to breaks

  14. Mannequin Subject • Limitations: • Lack of movement & facial expressions • Devices do not fit realistically • Surface staining • Realistic blending of make-up is challenging • Variances' to the adhesive qualities of materials

  15. Example of Bruises Human Mannequin

  16. Example of Bruises

  17. Example of Wounds

  18. Example of Wounds

  19. Example of Burns

  20. Example of Burns

  21. Moulage Supplies cont…. • Basic device needs • Dressings • Basins • Drainage collection devices • IV infusion over flow • Foley • Stool collection device • Medications • Intravenous supplies • Chux • Armbands • Oxygen flowmeter • Oxygen Adjuncts

  22. Medical Supplies cont… Additional medical device considerations: THE LIST IS ENDLESS!!! • Bag valve mask • Splints • C-collar • Backboard • Traction • Chest tubes • JP bulbs • IV pumps • Feeding pumps • Feeding tubes • Suction Canister • Yankeur

  23. Show me the money!!! • Use expired materials (ie. Medications, defib pads) • Repackage materials (ie. Cath kits, central line kits) • Predetermined disposal site • Make friends with ancillary departments (ie. Pharmacy, Biomed, Materials) • Refill & Reuse… Reuse… Reuse

  24. Sample Recipe • Meconium • Green finger paint • Yellow finger paint • Blue dish detergent Mix finger paints, adding until desired color. Add dish detergent for color and consistency.

  25. Sample Recipe Pour distilled water into a bowl for the approximate amount of stool, add green and red finger paints to make a brown color, add a tiny amount of black finger paint and food coloring. Mix corn starch, shaving cream, and blue dish detergent for realistic consistency. • Liquid C-diff Stool • ½ cup Corn starch • 2 tsp Shaving cream • Black finger paint • Green finger paint • Red finger paint • 2 drops green food coloring • 1 drop red food coloring • Blue dish detergent

  26. Sample Recipe • Mix according to box directions but use half as the amount of water. Add food color until desired color obtained. Pour into a cake pan (9x13). Place in refrigerator overnight to settle. • Blood Clots • 1 box Gelatin • Food coloring • Water

  27. Assignment • Bruise • New • Older • Oozing blood • Make the moulage needed for your simulation

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