Gelatin model for training ultrasound-guided puncture

Abstract

BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

Treinamento de anastomoses vasculares de baixo custo: o cirurgião vai à feira

“…During the early stages of acquisition of this skill, use of alternative, non-living, models that can be used to simulate surgical steps should be encouraged, thereby minimizing mistakes in human beings. 1,3,4,8 This study evaluated three vegetable models of vascular anastomoses, hoping to identify a low cost alternative that could be easily reproduced at different training centers. Of the models studied, it was only possible to achieve successful anastomosis in the green beans and yardlong beans; the second of which appears more advantageous because it is less thick and better simulates the morphological characteristics of an arterial vessel.…”

“…1,3,5,8 One of the disadvantages of using yardlong beans is the need to remove the beans from the pods, which could damage them as a training model.…”

“…Nevertheless, these characteristics do not rule out using this model as an initial step in the learning curve of several aspects related to materials, threads and tissues. [1][2][3][4][5]8 The cost of the training described was approximately R$320.00, with the greatest cost related to acquisition of suture threads. We therefore believe that use of vegetables could be adopted for practicing vascular anastomoses and could be incorporated into residency and undergraduate medicine programs.…”

Modelo artesanal de treinamento para acesso vascular ecoguiado em adaptação de gel balístico

“…Para suprir a necessidade de destreza, foram desenvolvidos fantasmas de ultrassom, como o descrito neste artigo. Vários outros modelos já foram relatados como o uso de água e gelatina/ágar 9 , Blue Phantom™ 10 e os moldes que utilizam produtos orgânicos, como modelo animal 6,7 . Por outro lado, para ser considerado ideal, o simulador de ultrassom deve possuir a ecogenicidade comparável a dos tecidos humanos 6,7,9 , estar rapidamente disponível 7 , ter baixo custo 6 , possibilidade de ser utilizado repetidamente 6,7,9,10 , promover um feedback tátil 6,7,9 , manter a agulha estática 6,7,9,10 , não deixar evidente o caminho da agulha e não causar exposição a agentes nocivos à saúde 6,7,9,[10][11][12][13] .…”

“…A relativa incapacidade de reutilização daqueles a base de gelatina/ágar não foi observada no presente modelo 9 , havendo perdas por derretimento apenas diante de temperaturas elevadas. Por outro lado, existe um grau de dificuldade moderada na confecção do molde apresentado, visto que são necessárias certas adaptações manuais com os cortes do busto do manequim a ser utilizado.…”