TissueDB/Simulators/Hemorrhage Control Simulator (Malik)
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The Hemorrhage Control Simulator (Malik) is a low-cost bleeding-leg trainer built from a goat or lamb hind leg and other readily available materials for teaching hemorrhage control in resource-limited settings. Two lengths of IV tubing, tunneled through knife-made wounds, act as bleeding vessels fed by bags of red-dyed saline, so learners can practise controlling steady venous-type and pulsatile arterial-type bleeding from a limb. It is aimed at civilians, new nurses, and operating-room technicians, including as part of "Until Help Arrives"-style courses.[1]
| Field | Details |
|---|---|
| Features and Basic Operation | Bleeding rate is adjustable at the IV roller-clamp, and squeezing the fluid bag by hand produces pulsatile arterial-type bleeding, so one leg can present different bleeding scenarios. The wet animal-tissue substrate can be cut and handled like a wounded limb. Within TissueDB it sits alongside other hemorrhage-control trainers such as the Tourniquet Simulator. |
| Current Development Status | Pilot-tested |
| Estimated Build Time and Cost | Less than US$50 |
| Specialized Tools and Equipment | Tunneler from a tunneled dialysis-catheter set, used to draw the IV tubing through the leg. The source otherwise lists only a knife (to make the two wounds) and a 5 cc syringe (listed among the source's items, though the paper does not state its use); no power tools or other specialized instruments are needed. |
| Version | Version 1 |
| Development Team Contact Information | Patients' Aid Foundation, Jinnah Postgraduate Medical Center, Karachi, Pakistan. Corresponding author: Dr. Omar Abbas Ahmed Malik, MBBS (omar.a.a.malik@gmail.com); co-author Dr. Rijah Chhapra, MBBS. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Skin | 1 | Goat or lamb hind leg | — | Outer skin of the partially defrosted leg; receives the two stab wounds (one simple, one deeper or larger) described in the source. |
| Soft Tissue | 1 | Goat or lamb hind leg | — | Muscle bulk of the same leg; the tunneler is passed through it to seat the IV tubing proximal to each wound. |
| Blood Vessel | 2 | IV Tubing | — | One length per wound, tunneled through the meat so the connection point is hidden inside the tunnel; acts as the bleeding vessel. |
| Blood | 2 bottles or bags | Saline or other IV fluid mixed with red food coloring | — | The source specifies "saline or other fluid" mixed with red food coloring. Flow rate is set by the IV roller-clamp; a squeezable bag (not a rigid bottle) allows the hand-pulsed arterial-type mode. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Cling film (saran wrap) | 1 roll | Plastic film | — | Wraps the leg to contain fluid spread during the session. |
| Clothing (shirt, tights, or pants) | Optional, 1 set | Fabric | — | Optional overlay on the leg to add scenario context for trauma training. |
Build Instructions
Phase 1: Leg preparation
- Defrost the goat or lamb hind leg partially.
- Wrap the leg in cling film (saran wrap).
Phase 2: Wound creation
- Make a simple stab wound on one side of the leg with the knife.
- Make a deeper or larger wound on the other side of the leg.
Phase 3: IV tubing placement
- Detach the plastic connector from one length of IV tubing and connect the open end to the tunneler.
- Puncture the meat with the tunneler a few inches proximal to the first wound, create a tunnel through the meat to the wound site, and pull the IV tubing through the tunnel.
- Detach the tubing from the tunneler when the tunneler exits at the wound, then retract the tubing slightly so the open end is hidden inside the tunnel.
- Repeat the proximal-puncture, tunnel, and retract steps for the second wound on the opposite side of the leg.
Phase 4: Fluid connection
- Attach each IV tubing line to a saline bag or bottle filled with fluid that has been mixed with red food coloring or other red dye.
- Place clothing (shirt, tights, or pants) on the leg if a clothed scenario is desired (optional).
Phase 5: Bleed control
- Control the rate and amount of bleeding using the roller-clamp on each IV tubing line.
- Compress the IV fluid bag manually in a pulsatile manner to simulate arterial bleeding.
Validation
The simulator was shown to five attending-level surgeons and five emergency medicine residents (n = 10) before classroom use. On a 1–5 Likert scale (1 = unrealistic, 5 = life-like) covering realistic bleeding, tactile feel, response to intervention, and applicability to real-life scenarios, the model was consistently rated as "nearly real" to "life like" by all physicians and surgeons.[1]
The simulator was subsequently used in three civilian training sessions and one combined session with new nurses and Operating Room technicians. Participants reported improved confidence in life-threatening hemorrhage control both in and out of the hospital, based on the "Until Help Arrives" Post-Course Survey.[1]
Limitations stated by the authors: the effectiveness evaluation was semi-quantitative and has not been shown to improve real-world outcomes; the number of medically trained reviewers was limited.
References
- ↑ 1.0 1.1 1.2 1.3 Malik OAA, Chhapra R. An Inexpensive model to teach hemorrhage control in resource limited settings. Pak J Med Sci 2021;37(3):916-918. doi:10.12669/pjms.37.3.3517. PMID 34104189. PMC8155406. Open Access CC BY 3.0.
| Alternative names | Bleeding Leg Simulator |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Hemorrhage Control Simulator (Malik)". Appropedia. Retrieved July 14, 2026. |