1. Moulage Magic 101 Carol Okupniak RN, MSN John Cornele RN, BSN, EMT-P Linda Wilson RN, PhD, CPAN, CAPA, BC, CNE Fabien Pampaloni RN, BSN Leland Rockstraw PhD, RN

2. Moulage Moulage (French: casting/moulding) is the art of applying mock injuries for the purpose of training Emergency Response Teams and other medical and military personnel. Moulage may be as simple as applying pre- made rubber or latex "wounds" to a healthy "patient's" limbs, chest, head, etc....

3. Background Moulage will add to the fidelity or realism of the scenario – Overdone moulage can actually detract from the experience Moulage can be used with both Standardized Patients (people) and Human Patient Simulators (plastics) Moulage does not have to be expensive – But with some investment you are more likely to get more consistent results

4. Background Your moulage kit does not have to be expensive or complicated – Many things you can find “around the house” In most of your scenarios you will need to make bruising, redness, sweat (diaphoresis) and vomit As you gain experience or acquire new audiences you will need to add to you skill set

5. Background It is also important to understand the physiology that is going on – What is the age of the wound? – What environment did the wound occur In the field or in the OR? – Do you need to bring in some dirt? – Is the wound infected? – Do we need odors? – Do the bones really bend that way?

6. Background For human victims good quality makeup can really make a difference – Blends better (beware the edges) and smoother – Lasts longer both on the patient and in the box – Looks better – Less chance of allergic reactions

7. Human Techniques Generally it is easier to produce more realistic results on people – Blending is easier and more consistent – Appliances usually stick better – The patient can help take care of the appliance – The patient can be taught to “refresh” the moulage – They can help with cleanup

8. Human Techniques Some drawbacks to people – They move … sometimes a lot – They have to go to the restroom …. sometimes a lot – They may have allergies – They are sometimes fussy – It is sometimes hard to make them lie still for four hours

9. Manikin Techniques Blending is harder in order to make it realistic Some appliances don’t fit well Some make up stains easily – Cream based is generally better that any oil based Be sure that you test on a small place first They don’t move much They don’t go the restroom (unless it is a part of the scenario)

10. Getting to Work Best to start with a good base color – Redness for burns as a base – Some red base for bruises as there will be inflammation – Build the other appropriate colors on top Don’t put too much base as it will be harder to “blend” out later. You will develop an eye to what looks best

11. Getting to Work Spirit gum – Needs a clean surface to start – Needs some drying time Morticians wax and temperature Working up a good sweat

12. Some Sources Best is trial and error or working with a experienced buddy Some secrets online – www.cert-la.com/education/moulage-recipes.pdf – www.whatcomcountyems.com/pdfs/CE%20Instruc tors/BASIC%20MOULAGE.pdf Where to get stuff – www.moulage.net – http://www.stagemakeuponline.com/

13. Some Examples Just some examples of what you can do

14. Questions?