Summary: Certain medical procedures are rarely performed, confer risk to the health care provider or patient, and are challenging to learn or practice. Attempted tourniquet placement on a non-injured limb, if fully deployed, can be painful or dangerous to the subject. Therefore, simulated tourniquet application would be an ideal way to learn or practice this skill without risking the target limb. We describe a low-fidelity simulation system that a volunteer can wear, allowing for safe tourniquet application to a limb while protecting the subject from any ill effects of the tourniquet. This is accomplished by shielding the limb with a segment of PVC pipe easily obtained from any home improvement store. A 4.5-inch-long PVC tube with a diameter slightly larger than a subject’s arm can be secured with a strap or rope around a volunteer’s torso to hold the PVC in place over the mid-bicep. A Foley catheter can then be taped parallel to the tube lumen outside the PVC ring so it won’t migrate. Using IV tubing, a refillable bag of IV fluid (+/- red dye) can then be attached to the Foley and allowed to flow out into a catch basin or draining tube. A learner can then practice applying a tourniquet to the arm and safely tighten it enough to occlude the flow of fluid through the Foley, simulating occluding a bleeding vessel. A pressure infusion cuff can be applied to the saline bag coupled with the Foley to generate any “blood pressure” that the testers wish, with the PVC eloquently protecting the wearer. Low-fidelity simulation is a cost-effective and easy way for educators to ensure that learners can practice rare or dangerous procedures, such as tourniquet application. Such practice can build procedural competency so that it can be performed correctly when required.
Silverberg et al. (Sun,) studied this question.