TissueDB/Simulators/Multipurpose Thoracic Simulator (Carter)
The Multipurpose Thoracic Simulator is a low-cost, bench-top chest-wall trainer built from a porcine rib rack, an intravenous-fluid bag with added air, headliner foam and an antimicrobial drape, for practising two fundamental invasive thoracic procedures: thoracentesis and chest-tube (thoracostomy) insertion.[1] The same module mounts in an upright training manikin for the thoracentesis station and transfers into a separate simulated thorax for the chest-tube station.
| Field | Details |
|---|---|
| Features and Basic Operation | A single chest-wall module serves both stations — mounted in a training manikin for thoracentesis, then transferred into a separate simulated thorax for chest-tube insertion. At each station the trainee first reads paired chest radiographs to choose the indication, then performs the procedure under supervision. |
| Current Development Status | Built and tested with junior trainees, with measured improvement in technical skill on the model; skill transfer to patients was not assessed. |
| Estimated Build Time and Cost | Not stated in source |
| Specialized Tools and Equipment | Upright training manikin (Resusci Anne) as the Station 1 host; a separate simulated thorax (the Carter 2009 model) as the Station 2 host; a clamp for blunt pleural entry; and paired teaching chest radiographs. The module is assembled by hand and the source names no special build tool. |
| Version | Version 1 |
| Development Team Contact Information | Yvonne M. Carter, Brette M. Wilson, Erin Hall and M. Blair Marshall, Division of Thoracic Surgery, Georgetown University Medical Center, Washington, DC. Corresponding author: Yvonne M. Carter (ymc01@gunet.georgetown.edu, per the 2010 publication). |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone (ribs) | 1 rack (4–5 rib segment) | Porcine ribs | — | Provides the rib landmarks and intercostal spaces for needle and chest-tube entry above a rib at both stations. |
| Chest-wall skin | 1 sheet | Headliner foam | — | Provides the covering over the ribs for needle entry at Station 1 and the chest-tube incision at Station 2. |
| Chest-wall skin (outer film layer) | 1 piece | Ioban 2 antimicrobial drape | — | Holds the chest-wall layers together and forms the outer covering for needle entry at Station 1 and the chest-tube incision at Station 2. |
| Pleural effusion | 1 | Intravenous-fluid bag with injected air | — | Provides the fluid drained as a simulated pleural effusion at Station 1. |
Consumables
| Consumable | Quantity | Material | Approximate Cost | Notes |
|---|---|---|---|---|
| Thoracentesis kit | 1 per attempt | Thoracentesis kit (Seldinger technique) | — | The provided kit the trainee uses to drain the simulated pleural effusion at Station 1. |
| Chest tube and suture | 1 per attempt | 28 French chest tube; suture | — | The 28 French chest tube placed at Station 2 and the suture used to secure it. |
Build Instructions
Phase 1: Prepare the chest-wall module materials
- Obtain a 4–5 rib porcine rib segment covering the chest-wall area.
- Obtain a one-litre intravenous-fluid bag from clinical stores.
- Obtain a 1/4 in. (about 6 mm) sheet of headliner foam. The methods call this covering "headliner foam", while Figure 1 calls it "thin felt"; the paper does not explain the difference.
- Obtain Ioban2 antimicrobial drape (3M Health Care, St. Paul, MN).
Phase 2: Assemble the chest-wall module
- Inject about 150 mL of air into the intravenous-fluid bag until it is taut with a visible air–fluid level.
- Place the porcine rib segment on top of the bag containing fluid and added air.
- Cover the rib segment with the headliner foam.
- Wrap the rib–bag–foam assembly together with the Ioban2 drape, enveloping all components so the drape holds the stack together. Figure 1 describes the drape as a sealant.
✓ Verify: the bag is taut with a visible air–fluid level, the rib segment sits over the bag, and the Ioban2 drape fully envelops and holds the stack together.
Phase 3: Install the module for Station 1 — Thoracentesis
- Cut an 8 cm × 8 cm defect in the chest of an upright training manikin (Resusci Anne) and seat the module in the defect. Present the trainee with two chest radiographs (pleural effusion vs. severe atelectasis with lobar collapse), then supply the thoracentesis kit for the trainee to select an intercostal space and drain the simulated effusion (Seldinger technique).
✓ Verify: the module sits in the manikin defect and the chest-wall surface is intact for needle entry.
Phase 4: Install the module for Station 2 — Thoracostomy
- Transfer the same chest-wall module into the separately published Carter 2009 open-lobectomy thorax model (Carter YM, Marshall MB, Ann Thorac Surg 2009;87:1546), where it serves as the chest-wall segment. Present the trainee with two chest radiographs (pneumothorax vs. giant bulla), then supply the standard instruments for the trainee to make the incision, bluntly enter the pleural space with a clamp, place a 28 French chest tube, and secure it with a suture.
✓ Verify: the module seats in the thorax host and the intercostal spaces remain accessible for tube placement.
Build time and cost
The paper describes the model as low cost but does not give a build price or assembly time.
References
- ↑ Carter YM, Wilson BM, Hall E, Marshall MB (2010). "Multipurpose Simulator for Technical Skill Development in Thoracic Surgery." Journal of Surgical Research 163(2):186–191. DOI: 10.1016/j.jss.2010.04.051. PMID: 20691997.
- Related source: Carter YM, Marshall MB (2009). "Open lobectomy simulator is an effective tool for teaching thoracic surgical skills." Annals of Thoracic Surgery 87:1546 — the Station 2 thorax host described in reference 4 of Carter 2010.
| Alternative names | Carter thoracic simulator multipurpose thoracic trainer |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Multipurpose Thoracic Simulator (Carter)". Appropedia. Retrieved October 3, 2026. |