Emesis Vomit Moualge is a must-know skill for clinical simulation champions training on sick patients. Emesis is also referred to as vomit and is a byproduct which follows after vomiting. Vomiting is a common sign of gastrointestinal (GI) disorders. Vomiting also occurs with fluid and electrolyte imbalances, infections, metabolic, endocrine, labyrinthine, central nervous system (CNS), and cardiac disorders. This article includes recipes provided by Bobbie Merica at Moulage Concepts and will provide some common emesis or vomit moulage based recipes to be able to incorporate into healthcare simulation moulage and scenarios from this source as well as others.
Emesis Vomit Moulage: Basic
- 2 tbsp. instant oatmeal
- ½ cup water
- 1-3 raisins
- 2 tsp. plain yogurt
- 1-3 frozen corn
- ¼ drop of caramel coloring or dash of cinnamon
- 2 drop of Kimchee
In a small bowl or emesis basin, combine water, yogurt, kimchee and caramel food coloring. Add oatmeal and raisins, stirring well to combine. Add several kernels of corn if desired.
Coffee Ground Emesis Vomit Moulage
- 1 Tbsp. used coffee grounds
- 2 Tbsp. water
- ½ drop caramel coloring
- ¼ tsp. red Kool-Aid powder; sugar free
Combine used coffee grounds and water in the emesis basin. Stir approximately 1 minute or until water becomes tainted with coffee ground mixture. Add additional water as necessary to create “slushy” consistency. Stir in caramel and red Kool-Aid powder.
For smell, swirl rusty nail through coffee ground mixture to create slight “bloody, metallic” smell
Environmental Settings
Using your fingertips or paint brush, apply a light coat of vaseline or “soft” barrier around the mouth, lips and chin of the simulator, creating a moulage surface. Using Q-tip or small paint brush, gently apply small amounts of emesis granules to the outside lips and chin of the simulator. (Do not put inside your mouth, lips or gums). Add a small amount of emesis to towel/wash cloth and front of patient gown (remove towel/gown from simulator, allow mixture to fully dry before replacing) in addition to emesis basin.
Clean Up to Ensure Readiness for the Next Simulation Scenario
Using a soft rag or cloth, gently wipe the emesis and barrier from the lips and chin of the simulator. Treated towel/gown and emesis basin (contents dried at room temperature approximately 48 hours or until all moisture has evaporated) can be stored together in a Moulage box or bag for future use. Mixtures can be reused approx. 20 times.
Time Saving Hints
Mixtures can be made ahead, dried and stored, covered, in the emesis basin. To reconstitute: Add 1-2 Tbsp. of tap water to the emesis basin. Carefully swirl water in basin and allow mixture to rest for at least 10 minutes.
Creating your scene: Add a PO medication to the emesis basin. Place filled emesis basin on bedside table in front of simulator or have family member at bedside carefully holding emesis basin at mouth of patient. Set the simulator to retch and ring the nurses call light for assistance. Or using a funnel; drain bloody emesis mixture through suction tubing and into a suction container. Use in conjunction with abdominal distention.
View the HealthySimulation.com Webinar Innovation & Moulage: Affordable Solutions to Increase Clinical Simulation Realism to learn more!
Other Emesis Recipes, Tips and Resources
Betadine or yellow, green food coloring can add some more color and texture to the emesis/vomit moulage recipes above. The rationale to add betadine to an emesis/vomit recipe is that this will demonstrate a positive hemoccult test. Creamed vegetable soup straight from a can, is a useful base for a vomit/emesis recipe. Other vomit/emesis recipes include a base of crushed saltine crackers, Italian salad dressing, sprite and barfume.
Parmesan cheese, grated mixed in with lemon juice into any vomit/emesis recipe will create the moulage smell of emesis/vomit. Some healthcare simulation participants may react unfavorably to the cheese and lemon juice added to the vomit/emesis mixture as the smell is quite strong. To get the moulage smell effect from the lemon juice and parmesan cheese, some time is required.
Vomit/Emesis Moulage Clean Up
Any food coloring that has been used in a vomit/emesis moulage recipe scenario may have the ability to stain gowns, sheets or manikins. This should be considered and steps taken in order to protect healthcare simulation equipment and resources. The storage of the vomit/emesis moulage recipes should also be considered.
If food products have been used such as in the recipes discussed within this article, the vomit/emesis moulage contents can generally be kept in the refrigerator for a short time. When certain recipe ingredients have been mixed together such as parmesan cheese and lemon juice, this will as per the recipe cause a very strong and overpowering smell. If an attempt is made to store this recipe to reuse, ensure that this vomit/emesis is kept in the refrigerator in an airtight container.
Bilious Vomit Moulage Recipe
Ingredients for this recipe include: fine grain wheat cereal, cream soup, a few drops of yellow or green food coloring or betadine, Diet coke (diluted ½ with water) Corn syrup (dark) and Coffee grounds. (coffee grounds are optional addition for a GI bleed) The maker of the bilious vomit/emesis recipe should experiment with the combination of the liquid recipe ingredients. This experimentation will assist to achieve the right consistency and color of the bilious vomit/emesis for the clinical simulation scenario.
The texture and color of bilious vomit/emesis varies from yellow to dark green. Most are more green in color however. For a healthcare simulation scenario which requires a pH result for a nasogastric tube Diet Coke added into the recipe will have a pH 4.0. This addition can mean that healthcare simulation participants have the ability to be able to test the nasogastric tubes pH level if this level of fidelity will add to the clinical simulation scenario.
This article has explored some basic vomit/emesis recipes provided by Bobbie Merica at Moulage Concepts as well as from other sources within the healthcare simulation moulage industry. Vomit and emesis moulage can be highly effective in order to add realism and to assist healthcare simulation participants buy in. A number of simple food based products found in most households are able to make a number of different textured and colored vomit/emesis moulage recipes easily to enhance realism and clinical simulation participants buy in.
