Figure 5 ("Model in use") from Malik and Chhapra 2021 (CC BY 3.0): participants train hemorrhage control on the goat-leg simulator with pulsatile red-dyed saline bleeding.
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.[1] 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.
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
<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.
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.
The whole partially-defrosted leg, tagged under the interaction-defined Limb class (how the trainee handles the part) rather than a single histological layer; the Tissues/Limb page's own materials table lists this simulator (Malik & Chhapra 2021).
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.
References
↑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.
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