Low-cost simulator for teaching neuraxial techniques

Abstract

Introduction: Neuraxial techniques (epidural and spinal) are commonly performed in Anesthesiology. Its application carries potentially serious risks if they are not performed properly; therefore, learning these techniques prior to practicing on a patient, can substantially improve patient safety. We present a low-fidelity simulator but useful for teaching neuraxial techniques or lumbar puncture.

Methods: The simulation model is composed of 4 main elements: expanded polystyrene sheet with midline holes, EVA (Ethylene-Vinyl Acetate) foam sheet, lemons/oranges and nitrile gloves. The front of the polystyrene sheet is covered with EVA foam sheet. The lemons are positioned on the back of the polystyrene, at the level of the holes, and fixed with toothpicks. Subsequently, nitrile gloves filled with water, are placed above the lemons and held with wide tape.

Results: Free flowing fluid through the spinal needle can be observed in simulation of spinal punctures. In epidurals, a loss of resistance, typical of an epidural puncture, will be noticed when the needle has gone through the orange/lemon shell and is positioned in the space between the shell and the needle-filled glove. This area allows catheter insertion without difficulty.

Conclusion: This model is easy to assemble, low cost and able to provide similar sensations to real life, which makes it an excellent tool for teaching neuraxial techniques.