To understand how the use of moulage and props add to the realism of simulation

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1 Roxanne Stelmaschuk

2 Workshop objectives To understand how the use of moulage and props add to the realism of simulation Participants will be able to identify ways to add realism to their scenarios

3 Is it really fake?

4 What about this?

5 What is Moulage? Moulage (French: casting/moulding) Art of applying mock injuries for the purpose of training Moulage may be simple or complex Practice dates back to at least the Renaissance, when wax figures were used for this purpose

6 Why use moulage? Crafting an authentic and credible looking victim creates a sense of realism for mass casualty and individual training sessions and evaluations Responders don t have to remember which limb was broken or where there was an injury

7 Moulage and realism in simulation Increase realism to human patient simulators Simulate injury and disease Places the learner in a realistic patient care environment Suspension of disbelief

8 From Simple to Complex

9 Some earlier (1950 s) techniques: Card tied to the victim s ankle or neck identifying wounds or the number assigned to the victim with master sheet given to command post Placards beside the victim Water mixed with food colouring for blood Very often at the scene of the accident but no discernable wreckage Military began to use simple methods In the 1970 s - adding: Clothing to match circumstance Manikins were more available for use Cuts in clothing with pieces of masking tape to identify wound

10 1980 s and on Felt with taped-on injuries Strap on injuries Simple makeup used cosmetic makeup Ben Nye makeup is the best Simulated blood gel and fluid Increased use with live victims Further research done on realistic looking wounds

11 Simulating injuries for the transport of the critically ill patient Deep bruising Deep cuts with debris 3 rd Degree Burns

12 Manikins with strap-on injuries

13 Bruising - fresh

14 Bruising - older

15 The strap-on kit

16 A little about blood Halloween blood from dollar store Homemade recipes - Google it Blood concentrate to be diluted Wound blood vs Stage Blood

17 The addition of actors/models Invite particular actors/models to match scenario Suggest models to wear modest underclothing (bathing suits work for female models) and no jewellery Coach models to act appropriate to the injuries

18 Addition of clothing Clothing to match the scenario Thrift stores and donated clothing keep cost low One use only is ok tear, cut, soil and burn as necessary Burning adds the dimension of scent

19 Getting Started Questions to ask: What is the purpose? Training vs Emergency Planning Practice What is the scope? Number of casualties, location and incident What is my budget? What resources are readily available? Location, kits purchased already, free actors How many artists are coming to help? How big of an area do you have to set up? How much time do you have to set up? Do you have lead time to make injuries prior to the exercise?

20 MCI - Putting it all together Scenario written out with details about each victim Allow enough time between injury creation and moulage artists Identify clothing for each victim Burn clothing (if necessary) ahead of time

21 Putting it all together. Make cards for each victim Use table to guide moulage session on training day for MCIs

22 Example of MCI Moulage Template

23 Some other techniques Active bleeds Creating vomitus Broken teeth A&B blood Embedded objects Oral bleeding Coffee ground emesis Sucking chest wound Subcutaneous Emphysema Eviscerated bowel

24 Smallpox

25 Electrical burn - entry

26 Heat burn

27

28 2 nd and 3 rd Degree Burn

29 Avulsion

30 Poison Ivy

31 Extruded eyeball ready to be applied

32 Ring avulsion

33 Eviscerated bowel ready to be applied

34 Amputation ready to be applied

35 Finished product in the field

36 Open fracture ready to be applied

37 Gunshot wound

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