Moulage Minute: Newborn, with Umbilical Cord

Time: 13–15 minutes

Skill Level: Advanced

Supplies: (Find supplies and more at www.moulageconcepts.com.)

1 cup water

Two infant feeding tubes

Three packets unflavored gelatin

Clear moulage gel

Clear latex

Dark blue spray paint

Heavy fishing line

IV tubing

Penrose drain

Red spray paint

Equipment:

24-gauge needle

Bowl

Candy thermometer

Double-boiler

Funnel

Hot pot

Laminated board

Palette knife

Scissors

Thermometer

Toothpick

Technique:

Using scissors, remove the ends from the feeding tubes. In a well-ventilated area, apply blue spray paint to both tubes, rotating several times to ensure complete coverage. See Figure 1.

Using scissors, remove the ends from the IV tubing. In a well-ventilated area, apply red spray paint to IV tubing, rotating several times to ensure complete coverage. See Figure 2.

Heat the moulage gel to 120°F. On the laminated board, apply a thick bead of moulage gel to the bottom half inch of blue tubes; let the tubes sit at least three minutes or until the moulage gel has set and the tubes are secured firmly together. See Figure 3.

On the laminated board, apply a thick bead of moulage gel to red tubing. Secure red tubing to the top of blue tubes, applying additional moulage gel material as needed to the bases of all three tubes; let the tubes sit approximately five minutes, or until firmly set. See Figure 4.

Holding firmly at the secured end, begin coiling the blue tubes around the red tubing. See Figure 5.

Using clear moulage gel, apply a thick bead along and between the tubes, holding firmly for approximately three minutes or until set. Place a filter needle on the syringe containing the clear moulage gel, and place the needle inside one blue tube. Press lightly on the plunger to disperse heated moulage gel, filling the top half inch of the tube. Repeat this technique on the second blue tube. Hold the tubes upright approximately 30 seconds, or until the moulage gel has fully set. See Figure 6.

Carefully tie off the end of the Penrose drain. Using six to eight inches of heavy fishing line, tightly wind the line around the end of the drain approximately five to six times and tie off in a triple knot. Gently begin threading coiled tubing, sealed end down, inside the Penrose drain, working the tubing down the sheath until the tubing is flush with the end of drain. See Figure 7.

Using a toothpick, create a barrier on the end of the coiled tubing. Gently push the toothpick through the end of the coiled tubing and the moulage gel, approximately half inch from the end, ensuring tubing does not slide down the drain. See Figure 8.

Place water in the top pan of a double boiler, and sprinkle the contents of the box of gelatin over the water. Allow the gelatin to set for three minutes to bloom. Place the pan and candy thermometer over medium heat, and stir lightly until the granules have melted and the candy thermometer reaches 120°F. Remove the pan from heat, and allow the gelatin mixture to cool to 80 degrees. Carefully place a funnel inside the open end of the drain next to the toothpick, and fill the cavity with the gelatin mixture. See Figure 9.

Remove the funnel and toothpick, and tightly seal the end of the drain. Using six to eight inches of heavy fishing line, tightly wind the line around the end of the drain, approximately five to six times, and tie off in a triple knot. See Figure 10.

Place the umbilical cord flat inside the refrigerator for at least four hours, or until the gelatin mixture is fully set. Using a scalpel or sharp scissors, cut off the end of umbilical cord directly below the fishing line. See Figure 11.

Assessment Note:

The umbilical cord should always be examined to verify length, uniform diameter, vessel verifications, knots, adequate amount of Wharton’s jelly, or any abnormalities of the membrane.

Dispatch:

Medic 32 Respond Code 3 woman giving birth in car. Flying J Truck Stop, Hwy 5, nearest cross street, Pomeroy Ave. Chino Fire responding. 0620 hours. Dispatch clear.

On Scene: