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An inexpensive, reusable umbilical catheterization part task trainer

  Submitted by: Anna Lerant on June 07, 2018
  HomeGrown Solution Number: 298
Identification of the Problem
Umbilical catheterization is a critical, but uncommon, procedure in newborn resuscitation [1]. Trainees may not obtain sufficient clinical experience to become adept. Therefore, it is important that neonatal providers have multiple opportunities to practice and reach mastery with umbilical vessel catheterization in a simulated environment. Often, groups of 4-5 providers have to be trained in one session. There are commercially available newborn manikins, but price prohibits acquisition of multiple manikins for training of larger groups. High fidelity umbilici made of synthetic human tissue are available, but the artificial blood used for flashback stains these umbilici permanently red, which decreases fidelity and prevents re-use.
Unique Idea
We used 4-ounce baby bottles as simulated blood reservoirs. The opening of the nipple was enlarged with scissors to snuggly surround the artificial human tissue umbilicus (Syndaver). The artificial blood was made of tap water stained red using 1% phenolphthalein and 1M sodium hydroxide making the water basic (pH8.5-9) to provide the correct color. We used commercially available neonatal dolls with torso made of polyester fabric and stuffed with polyethylene fiber as body forms. An incision was made on the doll’s back and a circular hole in the front. The fiber stuffing was bluntly separated to transmit the umbilicus. The torso was covered with skin from old arterial line trainer skins (Gaumard). We prepared 5 units.
Objectives
Objectives: 1. Create a part-task trainer that allows participants to practice every step of umbilical catheterization. 2. Create a red simulated blood solution that does not stain the synthetic umbilical cords. Expected learning outcomes: 1. Increased confidence with umbilical vessel catheterization among course participants.
Supplies/Ingredients
1. Blood reservoir: 4-ounce baby bottle, wide mouth with nipple. (We used Philips Avent)
2. Umbilicus (from arteficial human tissue), Syndaver, SKU: 130170
3. Newborn body form: "My sweet love" 13-inch soft baby doll
4. Assorted skin colors (Walmart)
5. Simulated blood: tap water in a water bottle
6. Simulated blood: 1 drop of phenolphtalein 1% solution as pH indicator (we brought it from Amazon)
7. Simulated blood: drops of 1 M (1N) sodium hydroxyde solution until water turns red at pH 8.5-9
8. Covering skin for torso: any scrap skin for vascular access arm trainers, we used Gaumard
Steps to Creating the Solution
1. Prepare simulated blood: add a drop of phenolphthalein to tap water and keep adding sodium hydroxide until the indicator turns red.
2. Enlarge the baby bottle's nipple opening with scissors until it snuggly fits umbilicus.
3. Pull umbilicus through the nipple, make sure one end reaches into the reservoir.
4. Split the cloth on the doll body form's back. Separate the stuffing bluntly. Cut a circular hole in the front of the body form just large enough to transmit the umbilicus.
5. Fill the reservoir with the indicator-stained simulated blood. Close bottle with the umbilicus inserted in the nipple.
6. Pull the umbilicus through the body form. Work most of the reservoir into the body form through the split back.
7. Place body form and reservoir on a tray.
8. Cut a hole on the scrap skin, place over the torso to transmit the umbilicus.
9. After the class collect the simulated blood, discard or re-use. Wash umbilici with tap water. Let body forms dry.