Gastroschisis Simulation Model: Pre-surgical Management Technical Report

Abstract

This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, and nurses, to practice the management of a baby with gastroschisis after birth and prior to surgery. Included is a suggested checklist with which the model can be employed. The details can be modified to suit different learning objectives.

Keywords: abdominal wall defect; delivery room; gastroschisis; newborn; pre-surgical management; resuscitation.

Figure 1. Simulation Model With Occlusive Bag in Place

Babies with gastroschisis are placed in an occlusive bag up to their axilla and the cotton tape is cinched, protecting the baby from evaporative and thermal losses.

Figure 2. Manikin With Hole

A 4-cm hole was made in the abdomen of the manikin.

Figure 3. Materials for Making an Intestine

We used a pastry piping device, sausage casing, and a can of dog food to create the simulated bowel.

Figure 4. Making the Intestine

The piping bag is held together with the sausage casing and the processed dog food is squeezed into the casing, working it manually to the distal knotted end.

Figure 5. Loops of Simulated Intestine

Loops of simulated intestine (25-cm long) were draped over a wooden spoon and then were tied together to make a shape similar to a "bouquet".

Figure 6. Securing Simulated Intestines Affixed to the Back

The string holding together the loops of intestine are pulled through the back and held in place with a tape. The model is placed in prone position in this photograph to demonstrate the method of securement.

Figure 7. Manikin With Simulated Intestine in Place

Simulated intestines in place and secured with the string protruding through the back and held in place with a tape.