Development and Evaluation of a Three-Dimensional-Printed Pediatric Intraosseous Infusion Simulator To Enhance Medical Training.

Ryan E Wade,Adam Dubrowski,Brent Mccullum,Chris Patey

doi:10.7759/cureus.21080

Abstract

Vascular access is an essential and rate-limiting step during pediatric resuscitation efforts. Intraosseous (IO) access, an effective resuscitative strategy, remains underutilized in emergency departments. Many medical graduates report never performing the procedure before graduation, and it has been recommended that continuing education and in-servicing programs be implemented to increase the use and familiarity of IO access. The goal of this technical report is to describe the development and evaluation of a three-dimensional (3D)-printed Pediatric IO Infusion Model for simulation-based medical education. The simulator was designed by combining open-source models of a human skeleton and a lower leg surface scan in Blender (Blender Foundation, Amsterdam, Netherlands; www.blender.org), scaled to a pediatric size, and manipulated further using a JavaScript program. Polylactic acid was used to simulate bone while silicone molds were used as skin and soft tissue. Two trainers were produced and evaluated by seven emergency medicine physicians, two family medicine residents, and three medical students.Overall, the simulator was positively received with all participants indicating they would recommend it to assist in the training of others. Suggestions focused on enhancing the anatomical representations of both the skin and bones to enhance the learner experience. The content and outcomes of this report support the use of this simulator as part of simulation-based medical education.

Highlights

Vascular access in trauma is both a critical and essential component of emergency medicine and can considerably influence patient outcomes [1,2]
Suggestions focused on enhancing the anatomical representations of both the skin and bones to enhance the learner experience
This has long been recognized as the rate-limiting step in pediatric resuscitation efforts due to anatomic and physiologic differences during development into an adult [1]

Summary

Introduction

Vascular access in trauma is both a critical and essential component of emergency medicine and can considerably influence patient outcomes [1,2]. This has long been recognized as the rate-limiting step in pediatric resuscitation efforts due to anatomic and physiologic differences during development into an adult [1]. In emergencies involving cardiac arrest and shock, peripheral access in pediatric patients is difficult due to extensive peripheral vasoconstriction [3]. This is a considerable concern, given that any delay in establishing vascular access may delay medical interventions, possibly compromising the outcomes of the patient [4]

Objectives

Findings

Discussion

Conclusion