Theatrical Blood Effects Part 4 – From MilitaryMoulage.com

medical simulation squib

Part 4 of MilitaryMoulage.com’s article on Theatrical Blood Effects for Realistic Casualty Simulation has been released! Written by Suzanne Patterson, Curriculum Development Specialist / Instructor at Military Moulage, this is the next installment after part 3 covered covered some important elements to keep in mind for maintaining high realism results when selecting and using theatrical bloods in your casualty simulation event or training exercise. In part 4, Suzanne shares a few extra tips, tricks, and techniques we have employed and that you might find useful for your own active bleeding scenario requirements, including how to “release” effects at the right time using Squibs and pumps.

“Active bleeding is arguably central in creating a believable injury simulation psyche, from drips to flows, and there are a number of ways to rig blood loss from small areas all the way to significant hemorrhaging. For instance, blood trickles or drips from the mouth can be easily achieved from pre-filled gelatin-based blood capsules held in the mouth until bitten to give a slow bloody drip effect. We like to rig a small cut piece of cell-like sponge soaked in edible theatrical blood, and when placed in the mouth next to the lips it mixes with the saliva to make a nice dripping consistency. When ready to drip it out the actor simply inserts the sponge and manipulates it a bit with the teeth. For nosebleeds we also use specially made reticulated sponges prepared with edible blood that, when inserted in the nostrils, will “bleed” automatically upon the actor breathing through the nose. If you need a semi-drying dripped blood look from the ears, mouth corners, or nose that needs to be more stationary, we use blood colored gelatin to which some blood paste or additional glycerin has been added for a slightly wet effect. Our favorite trick is to use a scar making material mixed with some theatrical blood product. This method gives very high realism for film and TV use, and the best part is it’s durable and waterproof in wear.



Squibs and pump assemblies are great to use when you need a more significant amount of blood flow, such as from gunshots, impalement (stabbing), amputations, etc. Blood squibs are small sealed bags of liquid blood that are hidden under clothing, and that can be pyrotechnically rigged to explode, mechanically operated to flow by pneumatic liquid means, or simply break open upon surface impact. Pyrotechnic blood squibs involve electrical charges that trigger a ballistic action to spatter the blood bag, and that can be very dangerous or fatal if not done by a professionally trained and licensed technician. We prefer to use mechanically rigged squibs and pump assemblies because most often on a training exercise these have to be operated directly by the role player portraying the injury. One type of safe squib we make is from a dissolvable plasticized material containing blood powder, and rigged with a fast acting dissolving fluid that creates a gravity blood flow. This works great under clothing for gunshots or impalements. You can make your own blood squib bags to size from many kinds of pneumatic capable or collapsible containments, such as litre bottles, plastic zip close food bags, and even small cut off fingers of disposable gloves. They can be custom rigged to flow or release theatrical blood in a variety of ways and in the manner you need them to flow.”

Read the full 4-part series on MilitaryMoulage.com!


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Paint and Powder Cosmetics Provides Quick Application TraumaSkin FX Sculpt Model Gel

medical simulation moulage gel

Looking for quick ways to apply trauma moulage in the field or simulation lab without clunky unrealistic rubber wounds?  Suzanne Patterson from MilitaryMoualge.com fame recently sent me some of her TraumaSkin FX™ Silicone Sculpt and Model Gel. Within 5 minutes I had a realistic wound even with my minimal moulage training experience! Suzanne told me she created these gels so that mass casualty or military training exercise medical training educators could quickly create realistic moulage presence “without expensive, bulky or unrealistic prosthetics”.  With heavy use by the DoD’s MSTC simulation training programs through the U.S. Army, the TraumaSkin FX product has been very much appreciated.  Suzanne also has extensive experience in the movie business, and focuses her more civilian businesses through paintandpowderstore.com.

fast trauma moulage

More about the TraumaFX Product:

This Silicone Sculpt and Model Gel is a simple two part (A and B) platinum silicone paste system that is mixed together in equal amounts by weight or volume to create a thick textured gel. No more messy liquids and dripping containers as this paste-like silicone has the texture of a firm yet soft scar wax that is easily pliable. Once mixed it’s ready to use to sculpt or model into all kinds of 3-D wound effects, scars, or any kind of disfigurements for ultra realistic looking results!

This product is so easy to use that even a beginner artist can create fantastic real-to-the-eye results for all kinds of casualty simulation effects. You don’t need any special tools or equipment to mix and apply this product, and you mix up only what you need so there is no wasting of material. Simply blend equal amounts of Part A and Part B together thoroughly (for about 45 seconds) on a non-porous palette-like surface, and then it’s ready to freehand sculpt on the palette or mold directly on skin into durable wear appliances that bend and flex, and look just like real skin!

trauma moulage gel

PaintandPowderstore.com was created in 2006 by Emmy Award Winning Makeup Artist, Suzanne Patterson, to directly serve the demand for high performing makeup and skin care products for makeup artists and actors working in the film and High Definition Television industry. Having worked heavily in HDTV for the past 8 years she is considered one of the country’s top High Definition Makeup experts, and the professional products offered through the store have been directly tested and performance approved to be HD compatible. The novice artist will find helpful product descriptions and details that are designed to be informative in furthering their product knowledge, decision buying, and application.

(The first person to comment on this post in the HealthySim LinkedIn group will receive by mail the remaining Trauma FX Moulage product sample I received!)

Learn more about the Silicone Trauma Gel at PaintandPowderstore.com and more about Suzanne at CreativeArtistryFX.com!

HealthySim’s Top 10 Most-Read Medical Simulation Articles Of All Time!

What are the 10 most popular medical simulation articles out of our 500 posts written? Today I updated the “Top 10 Most Read Articles” category on the right column of HealthySimulation.com, and thought we should bring it to your attention here!

top healthcare simulation articles

10. How to Produce a Sim Lab Video Orientation – Learn how to produce sim lab orientation and sim lab promotional videos with this tutorial set. Be sure to read part 1 where I talk about the numerous benefits and reasons behind producing your own videos and where to get help. In part 2, I cover how to start your production with camera, lighting, and sound tips from my fifteen years of production experience!

9. Top 50 Best Of Medical Simulation Articles of 2013 – A newer article, this post provides a giant recap of all the best content from HealthySimulation.com shared in 2013. If you are looking to get caught up with all the latest – this is the best place to start!

8. CAE Healthcare Topics – A general breakdown of all CAE Healthcare related articles we have ever published on the website.

7. Laerdal Topics – A general breakdown of all the Laerdal related articles we have ever published on the website.

6. What to Really Look For When Hiring A Sim Tech – One of the first articles I ever wrote for HealthySimulation.com talks about the benefits to hiring a Simulation Technician with technical experience over healthcare experience. Must – read for all simulation champions!

5. Top 50 Best Of Medical Simulation Articles of 2012 – Having been available longer, this list of “best of” material from 2012 ranks high on our list of most read content! Get caught up to speed quickly with this great breakdown list of must read articles!

4. Simulab Video Series – Learn all about Simulab and their TraumaMan & CentraLineMan products with this post. A comprehensive video collection of interviews and in-situ footage captured around the United States by our team. If you only have time for one, check out the LSU Surgical OR Team TraumaMan Training Mini-Documentary!

3. Moulage : Bridging the Gap in Simulation – Written by guest author Bobbie Merica, get introduced to moulage tools, books, recipes, courses and uses! When you are ready for more, check out our general moulage section, or the most read moulage recipe: Emesis Vomit Moulage!

2. Medical Simulation Jobs Listing Page – Looking for a new simulation job, or would you like to get your position posted? Check out this regularly updated list for all the latest jobs we know about!

1. Three articles on where to get some free medical simulation scenarios:

A) “And, Scene!” – Some Great Places to get Simulation Scenarios (even FREE)

B) More Free Nursing Simulation Scenarios

C) Additional Free Nursing Simulation Scenarios

There you have it! Be sure to subscribe to our free monthly email newsletter to get all the best of HealthySimulation.com!


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Luna Innovations Provides TrueClot Blood Simulant

trueclot

Luna Innovations reached out to HealthySim recently to let our community know about their awesome simulated blood moulage products:

TrueClot is currently for sale and in use by military combat medical trainers, medical and Police, Fire and EMSprofessionals across the country. We’ve also started selling internationally as well. Our TrueClot Blood Simulant Concentrate can be reconstituted in water by the end user and our Task Trainer Kits are designed to be used in wound packing and advanced hemostatic gauze (such as QuikClot) training and simulation scenarios. Our Simulated Hemostatic Gauze is made using the same gauze material Z-medica uses to manufacture QuikClot and CombatGauze. Additionally, TrueClot launders from clothing and washes from skin with soap and water. As you can see in the video, you can also make instant simulated blood clots for moulage as well. One of our Fire Department customers uses the clots to simulate avulsed tissue as well simply by squeezing the water from the clots and applying it to a manikin. We also expect TrueClot to be approved for use on several advanced manikin simulators and the product is currently being tested by several advanced trauma manikin manufacturers with excellent results.”

 Check out this video below to see TrueClot in action:

Purchasable now are blood simulants (sold by the gallon), clotting agents, and Hemostatic Gauze. You can event get a sample kit for only $25!

LUNA’s TrueClot Blood Simulant is a highly realistic simulated clotting blood for use in realistic trauma and hemorrhage control training.  Realistic clotting for combat wound packing and hemorrhage control training can be achieved using our Simulated Hemostatic Gauze in a task trainer or hemorrhage simulator.  Simulated clots for moulage or surgical training can be created using TrueClotTM Blood Simulant and our liquid Clotting Solution.

 

TrueClot Blood Simulant is safe and non-hazardous, washes from skin and clothing with soap and water and can be disposed of in regular trash.  The simulated blood will not clot unless it comes in contact with our Simulated Hemostatic Gauze or Clotting Solution and is stable for 6-12 months if stored at room temperature.

Note: I have a question out to their representatives regarding tested use of this simulant with manikin products. I will update this article with the response when received.

 

For now, you can learn all about Trueclot at Luna’s Website!

Post-IMSH Smooth-On Moulage Training Course

Just a quick note today about Smooth-On’s Janurary Moulage Training course taking place in San Francisco the day AFTER IMSH 2014!

smooth-on training moulage course for medical simulation

 Be sure to tell them HealthySim sent you!


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Simubleed by Spectra Takes Moulage Blood to a HyperRealistic Level

Wow! Check out the next level of moulage bleeding with this new blood product “Simubleed” from Spectra!

simubleed

From the Simubleed website: “With Simubleed 1000, Spectra Group has developed an advanced blood simulant that possesses the color and viscosity of human blood and also clots in the presence of a specialty laminate similar to those used by the military personnel in the field. The gauze laminate has been especially designed to work with SimuBleed 1000 and induce clotting upon coming into contact with the gauze. Simubleed 1000 is a completely synthetic blood simulant, with NO animal or biological content. it is bio-hazard FREE, stable (unlimited shelf life), and does not require special transport or storage, which also makes it cost-efficient. “

Simubleed Properties:

  • Dark red color, which is an excellent color match for venous blood
  • Rheology and flow profile close to human blood (more viscous than water)
  • Clots quickly in the presence of the special gauze laminate (although slower, clots in presence of air as well)
  • Can flow through narrow and wide passages (as those found in Laerdal Manikins)
  • Once it dries, it becomes “flaky”, just like dried blood
  • Unlimited shelf life. No special storage or transportation required Safe and easy to clean.
  • No biological or hazardous components
  • Inexpensive “Metallic” smell (optional)
  • Brighter color to simulate arterial blood can be accommodated upon request

realistic blood moulage

What about use with Medical Simulation Manikins?

From the website: “SimuBleed 1000 has been tested on Laerdal Mannequins embedded with a bleeding simulator containing narrow and wider passages to simulate, realistically, venous and oozing bleeding. Since personnel needs to be trained to stop bleeding and conduct hemorrhage control as quickly as possible, the coagulation properties of SimuBleed 1000 allows trainees to have a real feel as to how quickly one must respond and how long it takes for a given wound to stop bleeding. Once the laminate gauze is applied to the wound, coagulation of the blood simulant begins until the bleeding stops.”

simulated blood

Have you used Simubleed? I would want to confirm that the blood does not clot WITHIN the manikin, making it tricky to restart tubes within the high fidelity systems. I have an email out to learn more about the use of the product within mankins — but kudos to Spectra for already experimenting the blood within medical simulation technology!

12/26/13 *UPDATE* A Spectra representative got back to me regarding my question: “My question is about clotting of the blood WITHIN the manikin tubes – how is this prevented, or “restarted” ? We have heard nightmares of internal arm tubes becoming useless after other blood products were left inside and coagulated — so I am just curious how far the tests went with Simubleed and the Laerdal manikin?”

“Regarding your question about the clotting within the manikin. Our simulant can exhibiting clotting in only 2 ways: One is when it comes in contact with the specialty gauze. The second one way that can induce clotting of SimuBleed is if the simulant is left on the manikin with air exposure for several days. We have left SimuBleed on our Laerdal manikin, with all the lines close, and have not observed any clotting or clogging of the lines. ”

Learn more at the Simubleed webpage!

Military Trauma Moulage Report From the Fields

Just connected with Will Enfinger, Simulation Operator/Associate at ICF International after noticing his amazing moulage work posted online last week. He gave me permission to share his email that reflects on his long week of medical simulation!

skin tite smooth on

“Hey Lance,

This week I have had my hands FULL!   

Beginning Monday, our office was involved with a 72-hr medical exercise here at Joint Base Elmendorf-Richardson, Alaska. We were tasked with providing simulation and moulage support for the EMEDS (Expeditionary MEDical Support), or field hospital, training. 

 
Thursday, I presented a full-day moulage training course for the 38th Alaska EMS Symposium. 
neck moulage injury
 
For the EMEDS exercise, our primary focus is the creation and deployment of the “wounded and dead” for the various units across the base.  As the simulated attacks take place (complete with launches of F-22 Raptors, C-17 and C-130 aircraft, deployments of EOD teams and Security Forces) members of the Exercise Evaluation Team come and collect “bodies” to take to the areas affected by the attacks.  Once they are treated locally and triaged, the patients are routed to the EMEDS for care.  In the course of a typical exercise, it is not unusual to create around 150 patients, ranging from the sniffles and watery eyes due to a chemical exposure to amputations, penetrating injuries, lacerations, burns, and more.  Some of these patients are created to be triaged and then replaced with a manikin for the further treatment of their injuries once they arrive at the field hospital:  blast wounds/bruising on the ribs = TraumaMan for a chest tube.  Severe lacerations and hemorrhage become SimMan 3G in hypovolemic shock leading to cardiac arrest. 
 
We even deploy the TOMM and MATT manikins for hemorrhage control, shock-n-awe, and total team reaction assessments. Nothing makes me smile more than the blood trail these two create.  Granted, it does not make me smile when it takes responders too long to adequately tourniquet a femoral bleed . . . and that’s why we train.  To test our medical teams and expose them to the type of real-world combat injuries they will invariably see.  To prepare them.  
simulated frost bite
 
At the EMS Symposium I had the pleasure of sharing the benefits and simplicity of moulage in simulation and medical training to some of the areas up-and-coming trainers, including members of the world-famous “Dragon Slayers” from Aniak, AK (if you don’t know much about them, please search for them and be amazed and what they do).  I shared a brief history of moulage, the current use of the word and how it impacts our training, and then coined a beautiful phrase that I hope everyone uses, “You can’t have moulage without simulation. You CAN have simulation without moulage.  But that’s boring”.  Granted, if you have moulage without simulation it’s just a Halloween party.  I showed them how we can create visual and tactile triggers, ways to combat our worst enemy in simulation:  a poor imagination.  We discussed ideas in an open forum, creating ideas and solutions from folks who had never done this before.  It was long and I was tired of talking (yes, me) but at the end of the day, I made new friends and compatriots in this burgeoning world of medical education and opened the eyes of folks ready to shake a few cages with realistic training.
moulage gunshot
 
Either way you look at it, the importance of moulage in our daily activities is unquestionable. Whether we create simple bruises, the diabetic toe, inflammation of an IV site, or impaled objects and eviscerated bowels we have the ability to change training.  To expand training.  And to keep simulation always interesting!
 
Friday, I took a nap.
 
Simfully yours,
 
Will Enfinger (@ManikinRunner)
(on Linkedin)
.
Picture notes:
Hand = Skin Tite by Smooth-on and Skin Illustrator paints
Neck = Skin Tite, Skin Illustrator, Simulaids blood
Chest = Ben Nye burn wheel and scar wax, simulaids blood”
.
Want to share your moulage work? Email us and let us know what you are up to!

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Happy Halloween Moulage!

laerdal halloween

Happy Halloween everyone! Above is a “manikin” costume from the Simulation Staff at the University of New England! Today we want to point out that you can stay connected with ALL the best moulage news from the healthcare simulation community by clicking on the moulage tab above, or by simply book-marking:

http://healthysimulation.com/moulage/

That location will summarize all the moulage articles that get posted on HealthySimulation.com. Everything from blood makeup tutorials, to new Pocket Nurse products, to moulage books and more! So if you are into treating yourself with some new moulage tricks – that is the best place to be!

Hope you all have a safe and fun night out there!

Pocket Nurse Adds Moulage Category To Catalog

pocket nurse

This week I received word from Pocket Nurse that they have added an entire new section in their sales catalog specifically geared towards Moulage! Take a look at some of these great new items:

bald moulage kit

geriatric moulage kit

magic blood powder

moulage kit

pressure ulcer simulation kit

One of these news products is Bobbie Merica’s Medical Moulage Recipe Book, of which you can read my favorable review here!

To see more products, download the new Moulage Category of the Pocket Nurse Catalog today!

Trauma Moulage Blood Effects: Part 3

Part 3 of MilitaryMoulage.com’s article on Theatrical Blood Effects for Realistic Casualty Simulation has been released! Written by Suzanne Patterson, Curriculum Development Specialist / Instructor at MilitaryMoulage.com, this is the next installment after part 1 and part 2, of a 4-part series!

blood splatter moulage

 

The MilitaryMoulage.com (or MMCIS™) website suggests they provide “the highest quality moulage training workshops for military and civilian casualty simulation personnel, regardless of their skill level, which helps companies or individuals achieve the greatest value for training investment dollars.”

Here’s an excerpt from the article on the types of products necessary to create blood for your trauma scenarios:

“In the two previous blog posts in this series on theatrical blood effects we’ve discussed important facts and characteristics of human blood (and how it bleeds from the body) that you need to know in order to portray blood loss accurately in a simulation.  We also covered some important requirements and what to look for in choosing theatrical blood products for realistic portrayal.  Real time field training, clinical laboratory exercises and visual effects for film and TV production demand products with high fidelity elements for diverse types of real-to-the-eye end results.  Above all, they must contain the three prerequisites essential to high realism portrayals and that is opacity, texture, and color.  For film and TV use, this is vitally important as theatrical bloods can have different visual reactions in a range of light sources, especially in variable sunlight and stage/set lights.  To this end, you must be very careful in making sure the blood has the correct undertone in its color, so that it doesn’t render too orange or pink, or too purple or blue in camera.  If you ignore the undertone color then your simulation will have a visual skew in the overall performance fidelity, regardless if you have the right opacity, texture and redness in color.  In addition, it also must have a believable behavior/mobility on human skin or artificial appliances, meaning it must flow or dry realistically to the eye.

Theatrical blood products are available in 5 textures: thin liquids, thick syrups, semi-solid gels, solid pastes and dried/powders. Each has differing degrees of viscosity, along with a range of reds that you should always test first for color/undertone, texture and opacity before implementing them into your particular needs.  Always be aware of their classification as either cosmetic/external use only or food grade safe, especially if you are going to use it near the eyes, nose or in the mouth.”

blood moulage product

Learn about the 5-texture types for blood products and read the rest of this great article at Militarymoulage.com!