60230

Chest Drain & Needle Decompression Trainer with Augmented Reality

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Limbs & Things' Chest Drain & Needle Decompression Trainer has been designed to meet the specific requirements of healthcare professionals, this product is the ideal simulator to deliver training in both surgical and guidewire assisted thoracostomy and thoracentesis, chest drain and needle decompression techniques.

Chest tube insertion is possible on both types of pads, with the Advanced model’s echolucent material allowing practice of the Seldinger’s ultrasound technique.

A more realistic experience for trainees

Needle Decompression Pads

Located on the midclavicular lines, Needle Decompression Pads are used for the management of tension pneumothorax. Positive feedback of a realistic “hiss” of air releasing, or observable bubbles in a saline filled syringe upon successful decompression of the chest cavity.

Chest tube insertion is possible on both types of pads, with the Advanced model’s echolucent material allowing practice of the Seldinger’s ultrasound technique.

A more realistic experience for trainees

Needle Decompression Pads

Standard Pads

Two Standard Pads are included in this trainer. Each comes backed with a “pleural layer” that offers a realistic “pop” on insertion of finger or forceps into the pleural space. These foam pads are suitable for use with adhesive dressings, and sutures can be applied to secure the chest tube.

Advanced Pads

Suitable for use with mock fluids to simulate pleural effusions or haemothorax when using ultrasound guided techniques. With the supplied Respiratory Swing pump, it is possible to simulate movement within the chest cavity for increased realism under ultrasound.

Augmented Reality is now an integral part of Chest Drain training

The Augmented Reality Training Mats and App combine real world MRI and CT scan data, with the skills of talented medical artists and digital creators, to bring the internal anatomy of our trainers to life.

Within the FREE L&T AR app’s digital environment, you can move around your task trainer and view various overlays, including: the musculature, organs and vessels, and skeletal structure. The interface allows you to move seamlessly between the layers, as well as view their cross sections.

Students are also able to view digital procedures in the AR environment to see how the procedure is done, and its impact on the patient’s anatomy.

Overview

FREE Augmented Reality Training app and mat compatible with this Chest Drain trainer
Approved for use in ATLS courses
Supports realistic insertion of needles, guidewires, dilators and drain tubes

Realism

Anatomically accurate torso, representative of an adult male
Needle decompression sites give positive feedback following correct technique (hiss of air on needle insertion)
Needle decompression possible at the 2nd, 4th and 5th intercostal spaces
Suitable for use with mock fluids as well as water
Air bulbs replicate breathing under ultrasound (Advanced Pads only)
Standard Pads have a pleural layer with realistic give, and “pop” when punctured with forceps or finger

Versatility

Standard & Advanced Pads allow support multiple techniques, including, skin incision, suturing, and ultrasound (Seldinger technique)
Chest drain simulator can be used in the sitting or supine position

Cleaning

Drain fluids from trainer after use
Rinse with clean water after use of simulated fluids
Clean skin with a damp soft cloth, warm water and mild detergent
Allow product to completely dry before storing, inside of water chambers can be dried with a soft damn cloth

Safety

All components are latex free
Use caution when moving product, packed weight ~16kg
Due to the increased weight and movement of the fluid when the chambers are filled, we would advise filling/emptying the simulator in place with a jug or having two people move it into position. Filled weight can be up to ~21kg
Fluid use is only possible with the Advanced Pads
Ensure the securing knobs around the pads are properly sealed to avoid fluid leakage

Anatomy

Adult male upper torso
Arms in raises position
Represented internal anatomy landmarks: ribs, lungs and diaphragm

References

Paramedic

National Association of State EMS Officials: National Model EMS Clinical Guidelines (2016, page 185): Trauma: If absent or diminished breath sounds in a hypotensive patient, consider tension pneumothorax, perform needle decompression

Undergraduate Medicine

AAMC Recommendations For Clinical Skills Curricula For Undergraduate Medical Education (2005) (2005, p. 27): Chest tube insertion

Postgraduate Nursing

Advanced Practice Nursing Procedures (2015, Section six, pages 488 - 491) Margaret R. Colyar : Respiratory procedures: Chest Tubes for Emergency Transport

Postgraduate Junior Doctors

RACS Essential Surgical Skills (page 17, Jan 2015): Chest Trauma perform insertion of Chest Tubes and Chest Drains

Physician Associate

NHS National Practitioner Program: Matrix Specification for the Physician Associate (2016). p.68: Breathlessness: Perform chest aspiration and chest drain insertion

CMT

Specialty Training Curriculum for Core Medical Training, 2013 (p.56): Perform chest aspiration and chest drain insertion

General Surgery Training

GMC General Surgery Curriculum 2018 (p.67): Technical Skills and Procedures - Chest drain insertion Trauma & Orthopaedics Curriculum 2015 (updated 2018) (p.205): Technical Skills and Procedures, Module 6, Simulation - Chest Drain insertion Cardiothoracic Surgery Curriculum 2014 Module 6, Simulation Techniques - Chest Drain insertion (p. 43)

Paramedics

College of Paramedics, Paramedic Post Graduate Curriculum Guidance (2017, page) Section 3: Advanced Paramedic ...urgent & emergency care, and includes the development and attainment of the following skills, competencies and clinical expertise; ....Chest Drain

Intensive Care Medicine

ICM Curriculum: Supporting Excellence for a CCT in Intensive Care Medicine, The Faculty of Intensive Care Medicine, 2021.

Trauma & Orthopaedics

Trauma & Orthopaedic Surgery Curriculum, Intercollegiate Surgical Curriculum Programme, 2021

UK CCT in Anaethetics

RCoG 2021 Curriculum. Stage 2 Practical Procedures – Supervision Levels From “Stage 2 practical procedures (with supervision levels)” section: Needle thoracocentesis (simulation) — supervision level 3. Chest drain insertion (simulation) — supervision level 3

Can medical students practice ultrasound techniques during training with the chest drain trainer?

Yes. The Advanced Chest Drain Pads are made of an echolucent material that helps support a wide range of ultrasound simulations. These pads are ideal for practicing the Seldinger technique of placing a tube in the pleural cavity via a guidewire.

Why does the chest tube trainer come with two different types of chest drain pads?

To ensure ongoing cost efficiency for courses, Limbs & Things create the Standard & Advanced Pads to support different training requirements:

Standard Pads – these foam pads are designed for skin incision and suturing as part of a blunt dissection, and include a pleural layer on the back that has realistic give, and a “pop” on puncture. They also support the use of adhesive bandages
Advanced Pads – these silicone pads are designed for ultrasound practice. The echolucent material is partially self-healing, allowing for a greater number of guidewire insertions. The pads also support blunt dissection, however, incisions from this procedure will not self-seal

Replacements are available in packs of 2 or 10 (frequency of replacement depends on procedures and efficiency).

Can we use existing supplies with the chest tube simulator and needle decompression simulator, or does it require specific equipment?

This trainer supports a full range of equipment, though there are some recommended items that the trainers have been tested on:

Advanced Chest Drain Pads – optimal catheter, 12 FG
Needle Decompression Pads – optimal needle, 21g

Other sized catheters or needles can be used, but the above recommendations will help prolong the life of the chest pads.

Troubleshooting

Our chest drain simulator is leaking fluids

Water leakage is the most common query related to the chest trainer, and usually solved with one of the following:

Wrong pad – water leaking from around the edge or through the pad - the chest model is supplied with two different types of pad for chest drain procedures, the Standard foam pad, and the Advanced silicone pad. Only the Advanced pad is designed for use with fluids
Pad end of life – water leaking through previous needle sticks or incisions – Advanced pads support multiple procedures, after prolonged use, the self-healing material will become less effective and will require replacement
Not fitted properly – the Advanced pad needs to have a good seal to keep the internal water chamber contained. Below are some tips on ensuring there’s a strong seal

Tips:

Ensure ribs are fitted into the pads to ensure rigidity
Check you are using the correct rib frame, and it is oriented the correct way (Rib Frames are marked with Left or Right, and an arrow to indicate the top)
Fit the pad into the frame, the silicone edges should be flush with the inside of the frame
Place the frame onto the correct side of the chest, the screws should be centred along the notches along its edge
Place a slotted retaining knob on each screw and hand tighten them (Helpful hint: tighten each knob halfway, then hand tighten them again, so the frame is flush against the torso)
Using the key supplied, tighten each knob to create a tight seal

Uncommon leakage issues: