EMS Education on a Shoestring
Everyone is experiencing budget cuts and EMS education is no exception. Just the other day, a student asked me why our CPR manikins had no arms or legs. My reply? “Budget cuts! You’re lucky you don’t have just a sternum and a pair of lips to work with!”
Since my educational budget was downsized, I have been forced to develop some improvised teaching tools. Most of what I have put together is from broken or old equipment and commonplace household items.
An OB Manikin for Under $20
I got this idea during an American Heart Association PALS update. I needed to replace my old OB manikin, but didn’t want to spend what little money I had in my budget for a device I knew that, as an EMS educator, I would not use very often. The most expensive item for the manikin was the newborn-baby doll. I especially had a good time emptying the bucket of ice cream for this project and presenting the receipt to the accounting office for reimbursement.
1. Take one bag of quilt stuffing, a newborn-baby doll, a pair of opaque tights in size small for the “manikin,” clear thread, Velcro, a red piece of craft felt for the placenta, a red bungee cord for the umbilical cord, a blue marker and a bucket of ice cream (flavor optional) for the body. If you wish your students to experience “twins,” double certain recipe ingredients.
2. Remove the handle from the ice cream bucket. Cut up one side of the bucket and cut the bottom out.
3. Tape the bucket back together making sure you are able to push the doll through it.
4. Make a cut in the cotton crotch of the tights the length of the panel. Do not cut through this panel to the tights because you will lose the integrity of the tights.
5. Fill the legs with the quilt stuffing. Tape the top of the stuffing to keep it in place.
6. Make sure the tights fit over the bucket. Glue the “hook” part of the Velcro inside the bucket at a minimum of 12, 3, 6, and 9 o’clock to hold the tights in place.
7. Slide the tights on the bucket and over to the inside to place on the Velcro. The tights will stick without using the “loop” part of the Velcro.
8. Cut the ends of the bungee cord off.
9. Glue the “hook” part of the Velcro to one end of the bungee cord.
10. Glue the “loop” part of the Velcro on the baby at the umbilicus.
11. Sew the red craft felt together to make a pocket. I cut the ends for a less “square” look before I stitched it. Fill the pocket with the quilt stuffing, making sure not to overstuff it. Stitch closed.
12. Glue the end of the bungee cord without the Velcro to the placenta. Use blue marker for believability.
13. I also use the blue marker to color the Velcro at the baby’s umbilicus.
14. Completed OB manikin.
15. Baby “crowning.”
16. Birth.
17. Baby and umbilical cord delivered.
18. Placenta delivered.
Tracheostomy Tot
For teaching a section about children with special needs in PEPP, PALS or other classes, I made a trach baby from one of the old CPR manikins from the 1970s. Besides an old CPR manikin, the items needed for this teaching tool are the appropriate size tracheotomy tube for the manikin you are using and a drill. Carefully drill through the front of the neck, trying not to use such force that you also drill through the back of the neck! Insert the tracheotomy tube. Using a BVM attached to the trach tube, you should be able to see the chest rise with each breath. Depending on which manikin you use, you may be able to incorporate other special needs such as shunts, gastric tubes and central venous access devices.
EMT Medication Administration
For teaching medication administration during an EMT program, I ask each student to bring a small tube of cake frosting gel, a container of Tic-Tacs, a retractable (click) style pen and breath spray to simulate the medication.
Oral glucose: Tube of cake frosting gel. I always advise students to buy a flavor they like and try to avoid dark colors, as it will take some time for the color to disappear from their mouth.
Epinephrine auto-injector (EpiPen): The retractable pen with the click top simulating the needle end to practice activating the mechanism. It only takes one time of holding it wrong to “get the point.”
Nitroglycerin tablet: Tic-Tac. In addition, the Tic-Tac will have the usual “bite” when placed under the tongue!
Metered-dose inhaler administration: Breath spray. It does not take long before the student realizes how to position the spray to avoid missing the mouth.
Umbilical Cord for Cannulation
I came up with this teaching tool the day before our first PALS class, when I found out that the synthetic umbilical cords I had ordered a month before were still on backorder. Since umbilical cord cannulation is part of the core curriculum, I had to think of something. I went into our EMS equipment room and found a box of broken supplies. I grabbed a couple of endotracheal tubes and started putting them together. And since necessity is the mother of invention…
1. I used two 2.5 endotracheal tubes for the arteries, one 4.0 tube for the vein and one 8.0 tube for the umbilical cord. You can use any combination. I also used cloth tape to wrap around the umbilical cord to hide the tubes. I used red and blue markers for believability. Use permanent marker so the colors do not run during cannulation use in the station.
2. Cut the ET tubes at the vocal cord markers.
3. Color the inside and outside of the two 2.5 tubes with red marker just at the ends. If you do the whole tube, it will be too dark to see the colors when finished.
4. Color the one 4.0 tube with blue marker the same way as the 2.5 tubes.
5. Hold all three tubes together and “gently persuade” the tubes into the 8.0. You can use a few drops of water to help this process.
6. To line up the tubes, leave the smaller tubes above the opening of the 8.0 tube and push on a hard, flat surface. This will help align the openings.
7. When the tubes are in place, it should look something like this.
8. Use cloth tape wrapped at an angle to conceal the tubes.
9. Color the tape, leaving white areas. If you are overzealous with color, you will not be able to view the colors of the inside tubes.
10. View the inside to make sure the color of the arteries and vein are visible. If not, disassemble and use less color on the tape and/or more color on the tubes.
11. Angle another layer of tape over the colored tape starting in the opposite direction.
12. This is the first umbilical cord I concocted. It has been through many PALS and EMS programs and has worked well.
