Roxanne Stelmaschuk
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
Is it really fake?
What about this?
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
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
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
From Simple to Complex
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
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
Simulating injuries for the transport of the critically ill patient Deep bruising Deep cuts with debris 3 rd Degree Burns
Manikins with strap-on injuries
Bruising - fresh
Bruising - older
The strap-on kit
A little about blood Halloween blood from dollar store Homemade recipes - Google it Blood concentrate to be diluted Wound blood vs Stage Blood
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
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
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?
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
Putting it all together. Make cards for each victim Use table to guide moulage session on training day for MCIs
Example of MCI Moulage Template
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
Smallpox
Electrical burn - entry
Heat burn
2 nd and 3 rd Degree Burn
Avulsion
Poison Ivy
Extruded eyeball ready to be applied
Ring avulsion
Eviscerated bowel ready to be applied
Amputation ready to be applied
Finished product in the field
Open fracture ready to be applied
Gunshot wound