Abstract:

Simulators are an integral element in nursing education. Two of these simulators to train nursing students in the College of Nursing (CON) at The University of Alabama in Huntsville are:
1) the central venous catheterization trainer and
2) the chest tube and needle decompression trainer.

The central line trainer is a central venous catheterization trainer for teaching internal jugular and subclavian vascular access methods. The chest tube and needle decompression trainer is used for training surgical and guide-wire assisted thoracostomy (chest tube placement) and thoracentesis (removal of fluid or air from the lungs). The torsos of these trainers are covered with a synthetic skin made of silicone rubber. After student usage during a term the trainers have a large number of needle holes and tears which are generally in only one area. One repair solution is to replace the area with the needle holes with a new replacement pad from the manufacturer which can be expensive. This paper presents an alternative solution by fabricating silicon rubber patches that can be placed (layed) directly over the torn area. Smooth-on Dragon Skin FX-Pro was used to fabricate the patches. Smooth-on Slacker tactile mutator was added to change the feel of the silicone rubber to a softer and more flesh-like. After experimentation the selected mixture ratio for the replacement skin was 1PartA (Dragon Skin), 1PartB (Dragon Skin) and 1PartS (Slacker). After additional experimentation in pouring, the mixture was allowed to freely flow on a waxed paper plate. The finished patch thickness was approximately 1-2mm. By allowing the mixture to flow freely, the thickness tapered off toward the outside of the patch. The diameters of the patches varied from 9-18cm. The larger diameter patches were preferred for the central venous catheterization trainer because of a greater adherence to the trainer. An alternative technique was used to make the patches for the chest tube and needle decompression trainer. These trainers also have replaceable needle decompression pads that are available from the manufacturer. Much smaller 6-7.4cm diameter patches were made in plastic molds. These pads were preferred because of the uniform thickness over the entire decompression pad and the tight fit in the trainer. Various quantities of flesh and blood color pigments were mixed to match the color of the trainers. An experiment was conducted to determine the life of the patches. 16gage and 22gage needles were repeatedly injected into a small 3x6cm area. The patches showed no tears and little wear after a hundred jabs. Hand rubbing the area of the jabs appeared to conceal and close the holes. The holes in the patches could still be seen if the patch was stretch and held to a light source. After extended use of the trainers the students could easily locate the correct location for a needle insertion. However, the patches could be easily relocated since the patches were large thus preventing the students from using the previous jabs as a guide. Because of the low cost, the patches can be replaced at the end of each term or sooner as the patches show wear. The material cost of an 18cm diameter and 1.5mm thick pad for the central venous catheterization trainer was approximately $2. The material cost of two 7.6cm diameter and 2.2mm thick pads for the chest tube and needle decompression trainer was $2.

Keywords:

Central Venous Catheterization Trainer, chest tube and needle decompression trainer, correct location of needle insertion, nursing training environment.