About Us
Welcome to Trauma Simulation Ltd.
Trauma Simulation Ltd is a Swansea University spin-out created by Professor Ian Pallister specifically to enhance the development of the limb trauma training models produced in prototype form in the course of the MSc Trauma Surgery Programme. The current goals are specifically to enhance the trauma training experience available without resorting to animal or human cadaveric material.
Utilising the novel application of design technology available through the National Centre for Product Design and Development Research (PDR), supported by the development of custom silicone elastomers and special effects techniques with MBI (Wales) Limited, complex and versatile models have been developed under contract with the Defence And Security Accelerator (DASA), Porton Down. The models have been designed with military patterns of injury but can be easily adapted to the civilian setting.
Replaceable inserts through which procedures are performed ensure unpredictability for the participants. All Tactical Combat Casualty Care (TCCC) and a wide range of Damage Control Interventions can be executed.
In addition, we produce basic surgical task trainers, fascia iliaca block training models.
Simulated Procedures
All procedures enable the participant to completely engage with the simulation. Cannulation allows simulated blood samples to be taken and infusion/transfusion to be commenced. Bleeding will continue until the participants execute the correct steps to control it in real-time.
Resuscitation Procedures
- Orotracheal intubation
- Chest decompression
- Surgical airway
- Cannulation (subclavian, antecubital fossa and intraosseous)
- Emergency tourniquet application
- Pelvic binder application
Surgical procedures
- Sternotomy for Junctional haemorrhage control in the neck (female model)
- Junctional haemorrhage control:
- Groin & Shoulder
- Pelvic packing and external fixation
- Tubal Pregnancy
- Upper limb escharotomy
- Lower limb:
- Arterial injury haemorrhage control and shunt insertion
- Open fracture
- Debridement and fasciotomy
- External fixation
Simpler versions of the model have been used for teaching fasciotomy, on both the MSc Trauma Surgery Programme and the Management of Surgical Emergencies Course, supported by International Federation of Surgical Colleges, Association of Surgeons of Great Britain & Ireland, and the College of Surgeons of East, Central and Southern Africa (COSECSA). The development of economical multiple use models for training in tourniquet application, and vascular shunting is underway.
- SAM 1.4 MK VI: Whole-Body Modular Immersive Simulator Carrier Base
- SAM 2.1L: Anatomical Left Lower Limb
- SAM 2.1R: Anatomical Right Lower Limb
- Replaceable Inserts for SAM 1.4 MK VI
- SAM 4 MH: Traumatic Amputation And Wound Packing Task Trainer
- SAM 4P: Pelvic packing sub-carrier base
- SAM 8 : Fascia Iliaca Block (FIB) Model
- SAM 10 ES: Right Escharotomy Arm
- SAM BS3: Basic Surgical Skills Task Training Model
- SAM BS-CD: Cut-Down Task Training Model
- SAM BS-SC: Shunt and Coupler Insertion Task Training Model
The Mk VI male whole-body model includes both upper limbs and non-anatomical “blank inserts” to make the model appear complete. The upper limbs house the left sided SAM 3 Shoulder intra-osseous infusion insert and bilateral SAM 3 Antecubital fossa inserts.
The sub-carrier base to use the SAM 4.1I: groin junctional haemorrhage control insert is also provided.
A customised peristaltic pump, tubing and reservoir bag are included along with a SAM 1.3A Surgical Airway Insert and a pair of SAM 1.2T Finger thoracostomy inserts. Simple non-anatomical lower limbs can also be provided. Should traumatic amputation limbs be required, these can also be prepared, tailored to the specific requirement.
On request, customised very durable carry/storage cases are also available.
This contains the femur, tibia and skeleton of the foot for fasciotomy and tibial fracture procedures. It can be supplied as a standalone task trainer or along with SAM 1.4 MK VI. Replaceable SAM 2: Lower Left Leg Fasciotomy Inserts are required
This contains the femur, tibia and skeleton of the foot for a mid-thigh GSW with arterial injury for control and shunting, an option for femoral fracture and fasciotomies. It can be supplied as a standalone task trainer or along with SAM 1.4 MK VI. Replaceable SAM 2: Lower Right Leg Fasciotomy Inserts and SAM 4.4 Right Thigh Injury inserts are required
SAM 2: Lower Left and Right Leg Fasciotomy Inserts: This package consists of the deep fascia separating the deep and superficial posterior compartments, the anterior soft tissues including the septum between the anterior and lateral compartments along with the deep fascia, together with a silicone stocking the make the limb complete
SAM 3: SC Left Subclavian Cannulation Insert: Land-mark guided cannulation can be performed and rapid simulated transfusion established. This insert is repairable.
SAM 3: AC Antecubital fossa Cannulation Inserts (pair): These inserts are not “sided” and each can be fitted into either arm. Once cannulated, the fluid input will go into the model’s simulated circulation. These inserts can be reused multiple times
SAM 3:.1 Sholder Intra-Osseous Infusion Inserts: A soft tissue insert and simulated humeral head allow for IO needle insertion.
SAM 4.1I: Groin Junctional Control Insert: An infra-inguinal arterial injury lies just proximal to the bifurcation of the common femoral into the superficial and profunda arteries. Supra-inguinal control followed by distal control and shunting can be performed. A task-trainer carrier base is also available.
SAM 4.2I: Shoulder Junctional Control Insert: A penetrating injury inferior to the lateral end of the clavicle can be controlled proximally with a supraclavicular incision, retraction or division of sternocleidomastoid, mobilisation of the subclavian vein and then division of scalenus anterior while preserving the phrenic nerve. Distal control can then be achieved. This is a particularly demanding simulation. A task-trainer carrier base is also available.
SAM 4.4: Right Antero-medial Thigh Wound: This insert comes in 2 versions. The first is a penetrating, cavitated injury from a projectile entering the thigh anteriorly and leaving medially, with an associated injury to the superficial femoral artery in Hunter’s canal. A femoral fracture can be included in the scenario. Exploration, proximal and distal surgical control along with shunting can be performed, and fasciotomy in the lower leg if the scope of the simulation permits. A modified version is also available in which the wound is tangential in the thigh, looks dramatic but with no active bleeding point. In this scenario, the decision-making about tourniquet removal/conversion can be explored and then fasciotomy performed as indicated in the right lower leg.
This simple to use model allows real-time practice in the control of catastrophic bleeding from lower limb traumatic amputations and cavitated wounds. Proximal pressure can be applied to initially control the bleeding, followed by improvised or CAT-type tourniquet application. Systematic wound packing can also be performed.
This subcarrier base includes representation of the peritoneal sac, bowel, bladder and the aorta, IVC and pelvic vessels. Used together with the replaceable SAM 4.3 Abdo Wall Pelvic packing insert, extra-peritoneal packing can be performed. Further development and inclusion of additional abdominal visceral and structures is underway.
SAM 4.3 Abdo Wall Pelvic packing insert
This task training model was originally produced for the RAPID Trial. It allows training in the landmark technique for the insertion of a fascia iliac block. It is not ultrasound compatible, however this is an area of active development
The escharotomy arm can be used as a task trainer or attached to the SAM 1.4 MK VI: Whole-Body Modular Immersive Simulator Carrier Base. Developed with support from the Blond McIndoe Foundation, escharotomy of the right upper limb can be performed, with soft tissue swelling into the wound and return of index finger pulp blanching after successful decompression.
This simple model allows participants to learn the fundamental skills of skin incision and closure, along with excision of a suspicious naevus and removal of a lipoma.
Although venous cut-down is uncommonly required in current clinical settings, it is a multi-step procedure which provides an excellent vehicle for learning skin incision, soft tissue dissection and ligation of a vein. The model is designed to allow the participant to repeat the steps several times, capitalising on the concept of purposeful practice.
Arterial shunt insertion and use of venous couplers are a standard part in certain vascular and plastic surgical procedures. This model allows both procedures to be practiced, retoring flow through the model.
