- Email: [email protected]
A “threepenny” CPR manikin
Resuscitation 82 (2011) 1470–1471
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor A “threepenny” CPR manikin Sir, Manikins are essential in teaching and practicing CPR. Industry has provided them in different degrees of complexity. Costs are directly proportional to sophistication and in some cases it might be a limiting factor especially among poor people. Training programs in emergencies have been developed for humble populations, and have included the use of a CPR dummy made with simple materials – in comparison with more elaborate commercial equipment, acceptable results have been achieved.1,2 Following this line, we have developed a two-piece training manikin that anybody can make using cheap and easily available elements. The head is made of a disposable 2–3 l plastic bottle with a painted face (hair, eyes, nose and mouth) on its surface. A hole is drilled in the middle of the mouth to enable ventilation. The lung is a 20 cm diameter party balloon tied to the spout of the bottle (Fig. 1A).
The thorax is a disposable 5 l plastic jug with both ends cut off. A spring capable of being compressed 5 cm under a 40–45 kg weight3 is welded to metal plates and secured with nuts and bolts through wooden discs to the jug. The trainee exerts compressions over the wooden disc seen in the middle of the partially transparent thorax. An inferior costal rim is painted on the external surface of the jug, and a xiphoid appendix is depicted in red to avoid being compressed (Fig. 1B). For classic CPR, the head and thorax are used together (Fig. 1C). To perform respiration, one rescuer hand tilts the forehead back and the other rises the posterior part of the neck (opening airway manoeuvre). During insufflations the trainee is instructed to watch to see if the balloon inflates – a surrogate for observing if the victim’s thorax rises during inspiration. The head is not needed to practice “Hands Only CPR”.4 The advantages of this dummy include are that disposable plastic containers are easily available and replaceable, the spring costs less than three US dollars, and the rest of elements are inexpensive.
Fig. 1. (A) Manikin components: (1) spring – metal plates – wooden discs set. (2) Disposable plastic jug. Ends must be removed (dashed lines). (3) Disposable water bottle with painted face and a hole drilled in its mouth (light blue oval). (4) Party balloon. (B) Assembled “thorax”. Both jug ends have been removed and the spring set is fixed to the carcass with nuts and bolts. An “inferior costal rim” is painted in black and the “xiphoid appendix” in red. (C) “Head” and “thorax” set put together. (For interpretation of the references to color in text, the reader is referred to the web version of the article.) 0300-9572/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.resuscitation.2011.07.008
Letter to the Editor / Resuscitation 82 (2011) 1470–1471
Conflict of interest statement The author of this letter has no conflict of interests to declare.
1471
3. Geddes LA, Boland MK, Taleyarkhan PR, Vitter J. Chest compression force of trained and untrained CPR rescuers. Cardiovasc Eng 2007;7:47–50. 4. SOS-KANTO Study Group. Cardiopulmonary resuscitation by bystanders with chest compression only: an observational study. Lancet 2007;369: 920–6.
Acknowledgements To technician Mario Macciocco for assisting in the construction of the mannequin and to Anne Fitzpatrick Hantom for revising the English text.
Saul Drajer ∗ Clinica de la Esperanza, Tres Arroyos 2060, 1416 Buenos Aires, Argentina ∗ Tel.:
References 1. Husum H, Gilbert M, Wisborg T. Training pre-hospital trauma care in low-income countries: the “Village University” experience. Med Teach 2003;25:142–8, 2. 2. Gilbert M. Effect of basic lifesaving surgery by minimally-trained people. In: Conference at the AHA resuscitation science symposium. 2007.
+54 11 584 0200; fax: +54 11 583 4117. E-mail addresses: [email protected], sdrajer@fibertel.com.ar 27 June 2011
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor A “threepenny” CPR manikin Sir, Manikins are essential in teaching and practicing CPR. Industry has provided them in different degrees of complexity. Costs are directly proportional to sophistication and in some cases it might be a limiting factor especially among poor people. Training programs in emergencies have been developed for humble populations, and have included the use of a CPR dummy made with simple materials – in comparison with more elaborate commercial equipment, acceptable results have been achieved.1,2 Following this line, we have developed a two-piece training manikin that anybody can make using cheap and easily available elements. The head is made of a disposable 2–3 l plastic bottle with a painted face (hair, eyes, nose and mouth) on its surface. A hole is drilled in the middle of the mouth to enable ventilation. The lung is a 20 cm diameter party balloon tied to the spout of the bottle (Fig. 1A).
The thorax is a disposable 5 l plastic jug with both ends cut off. A spring capable of being compressed 5 cm under a 40–45 kg weight3 is welded to metal plates and secured with nuts and bolts through wooden discs to the jug. The trainee exerts compressions over the wooden disc seen in the middle of the partially transparent thorax. An inferior costal rim is painted on the external surface of the jug, and a xiphoid appendix is depicted in red to avoid being compressed (Fig. 1B). For classic CPR, the head and thorax are used together (Fig. 1C). To perform respiration, one rescuer hand tilts the forehead back and the other rises the posterior part of the neck (opening airway manoeuvre). During insufflations the trainee is instructed to watch to see if the balloon inflates – a surrogate for observing if the victim’s thorax rises during inspiration. The head is not needed to practice “Hands Only CPR”.4 The advantages of this dummy include are that disposable plastic containers are easily available and replaceable, the spring costs less than three US dollars, and the rest of elements are inexpensive.
Fig. 1. (A) Manikin components: (1) spring – metal plates – wooden discs set. (2) Disposable plastic jug. Ends must be removed (dashed lines). (3) Disposable water bottle with painted face and a hole drilled in its mouth (light blue oval). (4) Party balloon. (B) Assembled “thorax”. Both jug ends have been removed and the spring set is fixed to the carcass with nuts and bolts. An “inferior costal rim” is painted in black and the “xiphoid appendix” in red. (C) “Head” and “thorax” set put together. (For interpretation of the references to color in text, the reader is referred to the web version of the article.) 0300-9572/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.resuscitation.2011.07.008
Letter to the Editor / Resuscitation 82 (2011) 1470–1471
Conflict of interest statement The author of this letter has no conflict of interests to declare.
1471
3. Geddes LA, Boland MK, Taleyarkhan PR, Vitter J. Chest compression force of trained and untrained CPR rescuers. Cardiovasc Eng 2007;7:47–50. 4. SOS-KANTO Study Group. Cardiopulmonary resuscitation by bystanders with chest compression only: an observational study. Lancet 2007;369: 920–6.
Acknowledgements To technician Mario Macciocco for assisting in the construction of the mannequin and to Anne Fitzpatrick Hantom for revising the English text.
Saul Drajer ∗ Clinica de la Esperanza, Tres Arroyos 2060, 1416 Buenos Aires, Argentina ∗ Tel.:
References 1. Husum H, Gilbert M, Wisborg T. Training pre-hospital trauma care in low-income countries: the “Village University” experience. Med Teach 2003;25:142–8, 2. 2. Gilbert M. Effect of basic lifesaving surgery by minimally-trained people. In: Conference at the AHA resuscitation science symposium. 2007.
+54 11 584 0200; fax: +54 11 583 4117. E-mail addresses: [email protected], sdrajer@fibertel.com.ar 27 June 2011