TissueDB/Tissues/Limb
A limb is the arm or leg form a trainee works on — the cylindrical body part that carries the wound, the puncture site or the tourniquet — rather than any one tissue layer within it. It is a class defined by how the learner interacts with the part, not by histology: a rigid half-pipe, a foam pool noodle, a shop-display mannequin leg and an animal hind leg are made of quite different materials and imitate no particular tissue, yet all four do the same job of presenting a limb for the procedure. Distinguish it from skin, which is the surface layer laid over a limb and is listed separately where a build supplies one, and from the bench frame or clamp that merely holds a limb in place, which is a structural part. Several of the builds below give a limb no anatomical name of their own; where that is so, the row says so rather than implying the source called it a limb.
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| PVC pipe (rigid half-pipe) | Tourniquet Simulator, Wound Packing Simulator | Two half-pipes cut lengthwise from one pipe of 4 in nominal diameter (about 10 cm), forming the curved surface the learner applies a tourniquet over or presses on to control bleeding. US$3.00 for the pipe — the unit price in the parts list of both build manuals.[1][2] The Wound Packing manual specifies 20 cm lengths; the Tourniquet manual gives no length. Both manuals price every part, so a builder can cost the whole trainer before starting: US$41.45 and US$51.29 respectively. The validation study for the tourniquet build describes it as a physical training model of a bleeding lower extremity.[3] The two CrashSavers build manuals themselves use no anatomical term for the part at all. | ||
| Pool noodle (EVA foam) | Peripheral Intravenous Catheterization Trainer | One section cut about 30 cm (12 in) long, forming the arm that the cannulation site is built on; the simulated vein and the skin pad are laid over it. About US$3 — the figure carried in the trainer page's own cost cell; the source gives the cut length but states no price, and does not name the part as a forearm.[4] | ||
| Commercial ghost-mannequin leg | Synthetic Tourniquet Training Model (Souza Lima) | A shop-display mannequin leg, which the source describes as functioning as anatomical support: it is filled with upholstery foam, coated with an ethylene-vinyl acetate sheet as the skin, and modified with one anterior wound plus two proximal holes 5 cm and 7 cm from it. Whole build R$49.60 — US$11.50 as the source itself converts it (2019). The paper gives no separate price, size or supplier for the leg.[5] | ||
| Goat or lamb hind leg | Hemorrhage Control Simulator (Malik) | A partially defrosted animal hind leg — the whole substrate of this build. It takes two wounds (the source describes one as a simple stab wound and the other as deeper or larger) and is tunnelled proximal to each, so the tubing that delivers the simulated bleeding can be drawn through and left hidden. It is used for both its skin and its muscle bulk, and it is the one entry here that is an actual limb rather than a stand-in for one. No per-item price is given; the source states the whole model cost less than US$50. The paper lists it only as "1 x goat / lamb hind leg" and names no supplier.[6] | ||
| Putty vinyl polysiloxane impression material | Suturing Simulator (Kumaresan) | One thin layer forming the firm, flexible base of a suturing pad. The source calls it a bony base and the paper is an oral surgery training model, so I group it here by function; that is my editorial classification, not the source's own framing. Layer thickness is not specified in the source — the 2–3 mm the paper does give belongs to the elastomeric layer smeared above this base, not to the base itself. No cost is stated for the putty or for the model; the paper says only that the model costs about one tenth of a commercially available suturing model.[7] |
- Skin — the surface layer a build lays over a limb; listed separately wherever a build supplies one
- Connective tissue — the soft-tissue fill inside a limb, where a build differentiates it
- Muscle — the musculature of a limb, where a build differentiates it from the fat
- Bone — the shaft inside a limb; a bone on a bench clamp is not a limb, because the learner works the bone and not the limb form
References
[edit source]- ↑ CrashSavers Trauma. Building Manual of the Simple Version of the CrashSavers DIY Tourniquet Simulator — English version. Appropedia. PDF.
- ↑ CrashSavers VR. Pressure Simulator — Step by Step Building Guide. Appropedia; uploaded 26 October 2022. PDF.
- ↑ Jhunjhunwala R, et al. A low-cost, DIY tourniquet simulator with built-in self-assessment for prehospital providers in Guatemala city. World Journal of Surgery 2024. DOI 10.1002/wjs.12158. PMID 38526473.
- ↑ Stephanie McKee. "Caboodle Noodle 2.0." NLN SIRC HomeGrown Solutions. National League for Nursing / INACSL. NLN website.
- ↑ Souza Lima D, Almeida YADS, Cid DMC, Cardoso LC, Braga CS, Regis FGL. Low-cost synthetic tourniquet training model. Rev Col Bras Cir 2019;46(6):e20192324. DOI 10.1590/0100-6991e-20192324. PMID 31967244.
- ↑ 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.
- ↑ Kumaresan R, Pendayala S, Srinivasan B, Kondreddy K. A simplified suturing model for preclinical training. Indian J Dent Res 2014;25(4):541–543. DOI 10.4103/0970-9290.142577. PMID 25307925.
Overview
[edit source]What the sources tell a buyer. The five options differ sharply in how much costing information they carry, and it is worth knowing which before choosing one. The two CrashSavers manuals price every part individually, so both the PVC pipe (US$3.00) and the whole trainer (US$41.45 for the tourniquet build, US$51.29 for the wound-packing build) can be costed in advance. The three journal papers give only a whole-model figure — US$11.50 for the Souza Lima model and under US$50 for the Malik model — and Kumaresan gives no figure at all, only that the model costs about a tenth of a commercially available suturing model. None of the three papers names a supplier for its limb, and none gives the limb's dimensions.
Building where materials are hard to get. The animal hind leg is the option the sources themselves put forward for the lowest-resource case. Malik and Chhapra built their model because, as they write, commercially available mannequins are often too expensive for institutes and organisations in lower- and middle-income countries, and they describe the items they used as inexpensive and readily available — so within this page the animal leg stands as the documented substitute for the commercial mannequin leg above it, for the same tourniquet and bleeding-control task. The trade-off is recorded in the literature as well: Kumaresan and colleagues note that animal skin and waste meat can be obtained from butchers, but that acquisition and storage in a tropical climate may be difficult, and that microbial contamination and health risk have to be evaluated. So where refrigeration, hygiene or waste handling is the binding constraint, the synthetic options are the ones that avoid it; where cost and vendor access are the binding constraint, the animal leg is the one the sources recommend. The PVC pipe and the pool noodle sit between the two: both are general-retail items that each build simply cuts to length on site.
Synonyms
[edit source]Common names: limb, extremity, arm, leg, forearm, lower extremity
Forms used in the builds: rigid PVC half-pipe limb surface, foam pool-noodle arm armature, commercial ghost-mannequin leg, animal (goat or lamb) hind leg, firm putty base of a suturing pad
Related terms: limb contact surface, arm armature, forearm structure, anatomical support