Medical Monday; A Synthetic C-Section Trainer

It's been a wee while since the last Medical Monday, but that's more a reflection of the size of the projects I've been working on at the hospital over the Spring and early-summer.

One such project is this- a synthetic model for C-Section training...

So here's the brief; recently, we've had a need to do a few training sessions in the Big Hospital, around C-Sections. The staff have been re-drawing the Standard Operating Procedures, and that's meant some 'surprise' (i.e, surprise for the staff) simulations to test response times and techniques. 

This poses a problem; when we do C-Sections as part of courses, we use bought-in kits to make Meat Models. Essentially, a realistic baby doll in a balloon (we fill it with water), under a sheet of silicone, under some real bowel, then plastic apron, then a big sheet of pork belly. All of we cable-tie to a bespoke base. 

The problem? In the lab, on a tabletop, it works well. We got asked to do it on an insitu back in Jan in the ICU, which involved us taking our awesome Pregnancy Robot, Mama Anne, and a meat model, into one of the isolation rooms (which needed a deep clean afterwards). Feedback identified that it broke the scenario a bit, having to pause the scenario, wheel-in a meat model on a trolley, and cutting that instead of the mannequin.

We were asked, for the re-run of the Insitu, to make it 'a little more realistic' and have the meat model incorporated into the robot. Tricky, without sawing a £120k robot in half with a chain saw, so I improvised with the upper body of a Rescusi Anne, and legs made from towels shoved into PJ bottoms. Not bad, except for the the proportions... maybe she was a pregnant US Female Basketball champion, as she ended up about 7 and a bit feet tall.

We then got asked to do it again, this time in A&E. This was, indeed, a problem, as this time, we could have NO meat. Oh, and they needed to be able to still do CPR on the mannequin. Oh and there'd be a Doc playing the patient outside, who needed to look pregnant (beachball under her jumper being the stupidly low-tech solution). Oh, and the Yorkshire Ambulance Service would be involved. 

Raiding the scrap-pile. Thank goodness the NHS manages to both be piss-poor and incredibly wasteful at the same time eh?

 

Actually, these are at least a decade old, were written off as scrap as they are ker-nackered, but nobody threw them away in case they came in useful one day. And to be fair, they were right, all it needed was a weird Technician (me!) to come along.

Dismantling of one torso chassis underway; this is the crumbling foam stomach. I ended up chopping this to bits...

...because I needed to alter the proportions of the body. To stop her looking like the aforementioned basketball champ, the womb area would need to be placed a little higher up the body. That meant cutting down the size of the plastic plate for the CPR, and putting in a new bulkhead, to which could be attached a new lower half with a womb. Note the baseplate marked ready for cutting...

And using parts from a wiring cable trough to create L-section reinforced brakcets, part of the stomach moulding used to create a new bulkhead to seperate the CPR part from the womb area.

Two important bits; breasts made from another lot of Rescusi Annie skin (with breast examination pads inserted behind), and the womb from a scrap Adam Roully C-Section base and baby that could slide-in to the torso chassis, being seccured with velcro pads.

With the meat model, we use the baby in a balloon (specially put in, in a party shop), then silicone, then real bowel. For this one I used a pair of popped playballs that the Scouts had destroyed in games, and a section of punctured bicycle inner tube scrounged off a fellow technician.

For the skin, vinyl with felt backing, cable-tied on, over a layer of inch-thick foam sheet.

The Doc running the show then said the Babbie needed an umbilical and placenta; I used some transparent pink plastic from another popped inflatable (thank goodness my Scouts like destroying toys during games nights), with a windpipe upcycled from a broken robot skin.

Blood-soaked sponge inside, then two circles of vinyl put together with hot-glue (and more glue used to create veins and lumps).

Put into a vacuum-sealed bag.

And filled, laboriously, with water by puncturing the bag and piping in water. Remember when you used to be able to win goldfish in bags at the fair?

The legs next- blanking plates made from scrap MDF and ply, to attach to the stumps on the womb trainer.

Then flexible plastic tube scavenged from a broken ventilator.

Leg bones; the knee joints are foam, with leg bones made from the slats of a broken roller-shutter door from a cupboard.

This way, the legs would be vaguely flexible. These would be wrapped in towels to soak up the blood and water when the bag was cut- bearing in mind I didn't want to make too much mess in a live Resus bay. The towels would then be hidden inside a pair of PJ bottoms.

For the feet, the end of the pipes were curved around, inserted into bedsocks, then padded out with teddybear stuffing.

Here she is, on the table, ready for the op, with an electronic Sim Pad plugged in to do the obs (and the Doc hidden at the head of the bed to voice her, whilst I hid behind the console to run the obs).

So, the scenario- she's pregnant, has a collapse in the car park, bought in by the YAS crew, and she has a heart attack on the table. Quick, we need to get the baby out, whilst more of the team bang-away at the heart to try and keep it pumping.

Cut...

Baby out, cord clamped... Mom revived, babbie delivered safely. Scenario largely successful, and I can relax after a fairly high-stress build.

And here's the model back home in the education department. To re-use it, all it needs are new towel legs, a new umbilical cord, baby in a new bag, another playball to put the baby in, and the 'skin' re-suturing.

The only real damage? The velcro pads which attach the lower section to the airway chassis needs some work, and re-gluing.

Overall, very, very happy with how this turned out. Considering it was built on no budget from scrap parts, it all turned out as the docs specified, and didn't stuff-up the scenario.

 

Garden Railway Saturday; building the Trenarren Models slab wagons

Something a little out of the ordinary for Garden Railway Saturday today- our esteemed Editor, Phil, passed us these kits to review. These two are slate slab wagons, prototypes from Penrhyn Quarry, and are made by Trenarren Models. 

The wheels are steel, the bodies are resin, the additional parts are mainly cast metal; again, out of the ordinary for us, as the majority of builds we do are laser-cut wood.

Fully assembled...

...and painted. Full details are in the review piece itself, but these are rather nice wagons once built.

The first shoot was on-location in Wales, where we built them, but the light was a bit poor.

So, we re-shot the pics on the actual garden railway when we got home.

And in print; we've a couple of other kits to build up and review, hopefully before too long.

 

This Month in British Railway Modelling; A Seaside Promenade Shelter

The summer of colourful kitsch continues!  Whilst at the Keighley Model Railway show, I spotted that Mumfy's Models had a rather nice concrete seaside pavilion shelter kit, in laser-cut MDF. Available in multiple scales, I thought for a change that I'd model in 0 scale.

The Spring saw us in Wales, so I took the opportunity to photograph some of the shelters on the coast. Tywyn above (the pic rather underselling the gale-force winds and manky weather)...

...though it was rather nicer a few days later in Aberystwyth.

It's quite a nice, simple kit, not too many pieces.

I chose to over-complicate things mindyou. Wanting a bit of texture on it, I used sandpaper, double-sided-taped onto it then the window apertures cut out.

Glazed with transparent plastic from packaging material. A bit of graffiti too, modelled on Aberystwyth.

Seagull poo on the roof. An interesting new modelling challenge...

Because the shelter was identical on each side, I decided to make the most of it for the final photographs, and model it double-sided. Sunny on the one, rainy (typical British day at the coast) on the other.

To which end, the folding base was designed to be too identical scenes. It was made to fit into a plastic storage box, the idea being that I'd be shooting on location.

It would be quite a simple base; only a few details, like the drain gratings from old Hornby 00 scale platform fences.

The ornate railings along the promenade were made from the leftover bits from last years Model Village project- the tops of the dolls-house front garden railings. 

Working streetlamps were installed, though on testing a few of the bulbs were blown (these are old, they've been in the scrap-box for maybe 20 years).

Bins from plasticard square-section and channel.

Here's another modelling challenge. Plastic fence of unknown vintage, chopped down into takeaway boxes.

I've always thought that figures for model railways are the weak link, tending to be blobby and misshapen. In recent years, photo-scanning and 3D-printing have revolutionised this field of modelling though. I've a project in mind using such figures in 1/32nd scale at some point but don't have a lot of experience with them. This project would give me a chance to have a go modelling, modifying, and painting them.

They're a mix, from 'Scale Scenery and Figures' and 'Smart Models'. Sprayed black, then dry-brushed with muted tones, then washed over with Citadel nuln oil to bring out the creases and shadows. 

Using watered-down PVA to do puddles on the rainy side.

Oh yeah, the plan to shoot on location... there were some delays in building which meant it would have been too much of a rush to shoot actually in Wales (and the Spring weather was a bit naff anyway). A couple of large prints of the seaside taken on that holiday though, a board, and a sunny day at home meant I could shoot in rather more comfort.

A lot of my other projects have been quite bright, colourful, and cheerful. There's (deliberately) a slightly scuzzy undercurrent with this one though, reflective a bit more of the British seaside. Graffiti, casually dropped litter, bored kids, junk food, and gulls. 

The lighting has also added a bit of a 'Martin Parr' feel to it, with the borderline over-exposed photographs and candid, slightly-exploitative angles to the shots (there I go, using that University Photography degree). I enjoyed creating cameo scenes on this one, particularly the bored kids stuck here whilst the parents chatted and ate their lunch. All the scenes were based on real things seen (this was something spotted a couple of years ago whilst we were in Wales, the kid using her ball as a footstool whilst her sister whined at her to stop in case the ball popped, their brother spitting on the floor. Charming).

I particularly liked this little cameo, though the angle of the bin shows a problem that came up; the sun was so bright on the day, it warped the plasticard flagstones.

Sunny day...

...and a rather more gloomy, grim day. Ah, how many holidays have I spent huddling out of the wind and rain like this? Rain effects with spray-painted gloss varnish with silver glitter sprinkled in to catch the light a bit.

More cameos. The grumpy oldies, the bored kids whilst the parents chat. The little kid looking sadly at her inflatable punctured and dumped by the bins by her mom (again, all these cameos on both sides based on real things seen at the seaside).

Lets end on something a bit jollier then, and kids innocently playing whilst their mom indulgently watches. There, that's a more cheerful middle-class tone to the project!

And in the mag.

An interesting one, this. Quite a small scene, but lots of detailing, and enjoyable to do. I don't often work in 0, but I might be doing a big project in the scale next year. It was nice then to be able to use this as a bit of a dry-run ready for that build...