Moulage: Nuts & Bolts
Krista Kipper BSN, RN
HealthPartners Clinical Program Manager
Moulage
 Moulage
– The artistic technique of incorporating realistic
cues, such as wounds, perspiration, blood, or
therapeutic devices, to increase the “psychological
fidelity” of a simulation.
Clinical education that measurably improves care.
Considerations
 Alignment with objectives
 Participant considerations
– Level of experience
– Environment
– Inter-professional education
 Subject
– Human
– Mannequin
 Knowledge
– Physiology of the situation
– Mechanism of injury
Clinical education that measurably improves care.
What do you need?
Clinical education that measurably improves care.
Moulage Supplies
 Wigs
– Halloween purchase
 Wounds & Incisions
– Halloween purchase
 Eye Shadows & Blushes
– Many colors
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Make-up brushes
Water Color markers
Finger paints
Distilled water
Clinical education that measurably improves care.
 Dish detergents
– Blue
– White
– Pink/red
 White shaving cream
 Red bubble wrap
 Red plastic food wrap
– Winter holiday purchase
 Food coloring
Moulage Supplies cont…
 Artificial blood
 Spray bottle
– Distilled water to spray
diaphoresis
– Scented concentrate
 Liquor/alcohol
 Fruity for DKA breath
 Adhesives
– Tapes
– Tegaderm
Clinical education that measurably improves care.
 “White” eraser
 Powder
Body Fluids Magic
Clinical education that measurably improves care.
Moulage Supplies cont…
 Mixing Basics
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Secure locking containers
Spoons
Leur-lock syringe
Cath tip syringe
Drainage bags for IV fluids
Funnels
Measuring cups
Clinical education that measurably improves care.
Food Products?
 Avoid
– Mold Growth
Clinical education that measurably improves care.
Food products?
 Possible Exceptions:
– No direct contact with mannequin
 Edema: Cream of wheat/oatmeal in secured bags
covered with nylons
 Coffee grounds added to a fluid presented in a basin
– Cornstarch for thickness
– Rice crispies/broken chips in a baggie for crepitus
– Plain gelatin with red food coloring for clots
Clinical education that measurably improves care.
Human Subjects
 Benefits
– Blending make-up for bruises is easier
– Adhesives stick better
– Individual can assist with device or moulage
– Individual can assist with clean up
– Realistic facial expressions and movement
Clinical education that measurably improves care.
Human Subjects
 Limitations:
– Need breaks
– May have allergies to moulage/device materials
– Inability to perform all “critical actions” when
simulating a medical emergencies (ie. Intubate)
– Limitations to the application of devices (ie. Foley)
– Limitations related to exposure
Clinical education that measurably improves care.
Mannequin Subjects
 Benefits
– More realistic device application (ie. Intubation)
– Easy exposure
– Ability to alter physiological findings
– No allergic concerns
– No timing issues related to breaks
Clinical education that measurably improves care.
Mannequin Subject
 Limitations:
– Lack of movement & facial expressions
– Devices do not fit realistically
– Surface staining
– Realistic blending of make-up is challenging
– Variances' to the adhesive qualities of materials
Clinical education that measurably improves care.
Example of Bruises
Human
Clinical education that measurably improves care.
Mannequin
Example of Bruises
Clinical education that measurably improves care.
Example of Wounds
Clinical education that measurably improves care.
Example of Wounds
Clinical education that measurably improves care.
Example of Burns
Clinical education that measurably improves care.
Example of Burns
Clinical education that measurably improves care.
Moulage Supplies cont….
 Basic device needs
– Dressings
– Basins
– Drainage collection devices
 IV infusion over flow
 Foley
 Stool collection device
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Medications
Intravenous supplies
Chux
Armbands
Oxygen flowmeter
Oxygen Adjuncts
Clinical education that measurably improves care.
Medical Supplies cont…
Additional medical device
considerations:
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Bag valve mask
Splints
C-collar
Backboard
Traction
Chest tubes
JP bulbs
IV pumps
Feeding pumps
Feeding tubes
Suction Canister
Yankeur
Clinical education that measurably improves care.
THE LIST IS ENDLESS!!!
Show me the money!!!
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Use expired materials (ie. Medications, defib pads)
Repackage materials (ie. Cath kits, central line kits)
Predetermined disposal site
Make friends with ancillary departments (ie.
Pharmacy, Biomed, Materials)
 Refill & Reuse… Reuse… Reuse
Clinical education that measurably improves care.
Sample Recipe
 Meconium
– Green finger paint
– Yellow finger paint
– Blue dish detergent
Mix finger paints, adding until desired color. Add
dish detergent for color and consistency.
Clinical education that measurably improves care.
Sample Recipe
 Liquid C-diff Stool
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½ cup Corn starch
2 tsp Shaving cream
Black finger paint
Green finger paint
Red finger paint
2 drops green food
coloring
– 1 drop red food coloring
– Blue dish detergent
Clinical education that measurably improves care.
Pour distilled water into a
bowl for the approximate
amount of stool, add
green and red finger
paints to make a brown
color, add a tiny amount
of black finger paint and
food coloring. Mix corn
starch, shaving cream,
and blue dish detergent
for realistic consistency.
Sample Recipe
 Blood Clots
– 1 box Gelatin
– Food coloring
– Water
Clinical education that measurably improves care.
 Mix according to box
directions but use half
as the amount of water.
Add food color until
desired color obtained.
Pour into a cake pan
(9x13). Place in
refrigerator overnight to
settle.
Assignment
 Bruise
– New
– Older
 Oozing blood
 Make the moulage needed for your simulation
Clinical education that measurably improves care.