ABSTRACT: Audience: The low cost neonatal umbilical catheterization task trainer is designed to instruct physicians in pediatrics, emergency medicine (EM) and pediatric emergency medicine (PEM).
Introduction: Umbilical catheterization can be a lifesaving technique in the emergent management of a critically ill neonate. Umbilical catheterization remains a common procedure in the neonatal intensive care unit (NICU) setting but is performed less frequently in the emergency department (ED). Given its infrequent nature in the ED, procedural simulation in umbilical catheterization is a necessary component of medical training to gain proficiency and competency in this important technique. Commercially available umbilical catheterization models are available but often represent an expensive investment upwards of a thousand dollars for a single trainer. The expense of these high-fidelity models may be unfortunately cost prohibitive for many departments seeking to offer this simulation training for their physicians. In an effort to diminish the cost associated with these models, a “home built” model was trialed. It was easily constructed with readily available items found in the hospital, the household setting, and the local home improvement and toy store. Each task trainer allows for identification of the umbilical arteries and vein with the ability to catheterize either vessel.
Objectives: By the end of this instructional session learners should: 1) Discuss the indications, contraindications, and complications associated with umbilical catheterization. 2) Competently perform umbilical catheterization on the task trainer. 3) Demonstrate proper securement of the catheter.
Methods: An umbilical cord was constructed using suction catheters to represent the umbilical arteries and nasal canula oxygen tubing was used to represent the umbilical vein. These tubes were suspended in a silicone base and rolled into a log form to simulate the umbilical cord. A small circular hole was cut into the hollow abdomen of a commercially available plastic toy doll and a section of the umbilical cord was inserted. Once assembled, the task trainer can be used in an instructional procedure session to teach umbilical vessel catheterization. The cord can be tied off and cut, allowing for identification of the umbilical vessels. The vessels (either artery or vein) can be cannulated using a variety of catheter sizes, and ultimately the catheter can be sutured or taped in place. The task trainers can be reused multiple times.
Topics: Neonatal resuscitation, umbilical catheter, umbilical catheterization, umbilical cannulation, instruction, simulation, emergency medicine, pediatrics, neonatal.
