Vascular access is such an important component of the treatment of ED patients. Our nurses, paramedics and techs do an amazing job placing IV’s, but sometimes there’s that “difficult stick”. I’ve found ultrasound to be immensely beneficial in situations in which vascular access is unable to be obtained by standard methods. I’ve used it on numerous occasions when placing central lines, and over the past few years, I’ve found myself placing more and more US-guided peripheral IV’s.
One of the physicians at my shop (Jacob Hennings) went to the ACEP teaching fellowship a few weeks back and emailed me about this product called “Clear Ballistics.” He stated that one of the other people there had been using it to make a DIY ultrasound-guided vascular access simulator. As soon as I heard about this, I ordered a block of this ballistics gel, and started experimenting. Here’s how I made it:
Items you’ll need to get started:
1. Ballistics gel
2. Small bread loaf pan
3. Drill bits
4. Countersink bit
5. Latex tubing
6. 2 flask funnels
9. Safety goggles
10. Crock Pot
(this video has been updated as of 12/23/15)
If you don’t feel like watching this video, here are the steps:
- Get your ballistics gel
- Cut your gel into small cubes
- Place them into a recepticle
- Place gel cubes in crockpot. Put the heat setting on high
- Mark the depth you want the “vessel” to be on either side
- Drill holes on either side
- Use countersink bit to smoothen edges
- Be sure to get inside and out
- File the edges
- Measure out the tubing. Give yourself about 6 inches on each side
- Cut it
- Tie one end off
- Fill your syringe from your Thomas cup.
- Fill the tube
- Tie off the other end
- Pull it through the holes
- Cut the end of funnels off, get your dowels.
- Tie the tube to the dowel, place flask between dowel and pan
- Do it on the other side as well.
- Check on your gel. It should be syrupy.
- Begin pouring
- Pour to your hearts content
- After its hardened, take out the dowels and funnels
- Use your hands and a spatula to take the phantom out of pan
- Et voilà!
The beauty of using this instead of a gelatin (the one with food) US-guided vascular access simulator is that this one is much more durable, and when you’re done, you can just take the tubing out, melt it down, and start over. Of course, if you want your gel mold to be opaque (although we haven’t tried it) you can add sugar free Metamucil ( 1TBS/250mL gel)1 or dark food coloring. Let me know how it works for you.
- Kendall JL, Faragher JP. Ultrasound-guided central venous access: a homemade phantom for simulation. CJEM. 2007;9:(5)371-3. [pubmed]