Evaluation of a low cost high fidelity arterial simulation device for ultrasound guided vascular puncture and cannulation.
K. Bull, J. Willers, R. Jeevanathan, C. Long, J. Macallan, N. Duke 
Background
Obtaining Ultrasound guided arterial access is a desirable skill for the modern day anaesthetist. Vascular access phantoms incorporating mechanical pump devices simulating pulsation for arterial puncture and cannulation are available, but costly. We endeavoured to create a low cost, effective, high fidelity simulation device for teaching this skill. We developed a fully functional, high fidelity arterial system compatible with various procedures.
Methodology
An existing variable volume/pressure arterial simulation pump1 was connected to an elastic artery analogue (160Q size modelling balloon). This was connected to a pigmented fluid source at diastolic pressure (Fig 1). The pulsations at 60 per minute, and systolic pressure were provided by manipulating pump settings suiting the compliance of the vessel model. Any fluid aspirated from the system was automatically replaced at diastolic pressure. The arterial analogue was placed between two layers of ADAM gel (Aqueous Dietary fibre Antifreeze Mix gel) an US medium resistant to needle tract damage (Fig 2). The total cost was <£40, of which £30 was for the pump. It was then evaluated as a training tool using an established assessment questionnaire.
Result
The evaluation from 15 Anaesthetists at various stages of training is summarised below (Fig 3).
Conclusion
It is possible to construct a high fidelity arterial access simulation phantom device at a reasonable cost that functions as an effective training tool.
References
1. Improving the fidelity of vascular access and regional block phantoms by integrating arterial pulsations through the use of a novel motorised syringe pump. R. Jeevananthan, J. Willers, D.R. Uncles, L. Goosen, B. Bukunola, L. Bisht Presented at AAGBI WSM 2015