Start-Up Moulage: Burn Identification Simulation

10/20/2015
"Blog post by volunteer: Arielle Glenn

Moulage wasn’t something I studied and it wasn’t something that was mandatory as a job requirement. Special effects make up was an element of simulation I was quite nervous about as I never considered myself an artist. Let me tell you, there is NOTHING you can’t learn from YouTube and Google. My first endeavor was to make a four inch laceration across the face for a simulation our ED was requesting. They also wanted a car crash patient with massive glass puncture to the face. After a few hours of perusing Google images and a few YouTube tutorials, I was confident I could deliver at least something that resembled what the educator was looking for…
…oh I had a few unsuccessful attempts in the trial period…

…but I finally got it right.
        
I didn’t have much to work with other than blood, modeling wax and some random tools. YouTube helped me out with this debacle tremendously! I slowly started to accumulate the supplies I needed to feel confident in what I was doing. Even if your center doesn’t have a budget for moulage supplies, these items aren’t pricey individually and can be purchased over time from your own pocket – ten dollars here – twelve dollars there – and soon enough, you’ll have what you need. The best part about purchasing items independently is you get to use them any way you see fit which can be great around Halloween time! Here’s a look into my moulage kit:
    

I don’t use everything in this kit on a regular basis. In fact, I rarely use much of these items but I have them just in case. The most commonly used items are blood, sculpting tools, liquid latex, red/black/brown grease make-up and my bruise wheel.

    

Another important element of moulage to remember is using your resources. If you can’t purchase your special effects supplies independently, and there’s no room in the budget but somehow you’re to magically create advanced wounds – don’t fret. Glue, toilet paper, red marker, food coloring, and dirt from the earth are most likely supplies you can get your hands on free of charge or for a few dollars. Look around your space and see what you can pull together to be creative. Again, YouTube really comes in handy for DIY special effects projects.
 

The Burn Identification Simulation


I was so nervous about this simulation because I had to create accurate burns on a manikin for a team of seasoned nurses to identify BSA and degree. I knew nothing about burns. GOOGLE. Thank you Google. I looked up the type of burns dictated in the lengthy sim synopsis I was given: 2nd degree partial circumferential 9% face and 3rd degree full circumferential 18% chest and arms both full thickness. I also studied BSA for a hot minute. If you are creating simulated burns for identification purposes, this might just give you the kick start you need.

Step 1: Gather supplies
  • Liquid latex (LL), toilet paper (separate plies), red/black grease make up sticks, blood paste, brown make up (any kind will do), Vaseline or any type of lubricant/gel/oil, stipple sponge, make up sponges, small paint brush, sculpting tools (or toothpicks if you don’t have the tools), towels, cups of water, syringe, needle, and photo images for examples
    •  Alternatives: Elmer’s glue, toilet paper, red paint or food coloring – corn starch and food coloring work too, any type of oil (even manikin lubricant), fingers!

Step 2: Start your build out
  • Lay down a layer of liquid latex (or glue) over the surface of your manikin’s skin so that when you’re cleaning off your moulage, it peels right off of the skin. 
  • Once your first layer has dried, start building up your layers of TP and liquid latex by laying down one ply at a time and painting LL over the surface…over and over…and over again – for about 5-7 layers depending on the thickness of the burn.

    
***I chose to do the face first as it was depicted to be a different category of burn.

Step 3: Make your craters and blisters
  • It’s important that while your top layers of LL are drying, you start to make your “craters” – I like to call them. These are the parts of the burn that were previously a blister and now have popped – ouch. 
  • Take your sculpting tools or toothpick and make round circles in the LL and TP until you’ve cleared your crater. 
  • To create blisters, fill a syringe with Vaseline then top it off with your needle. Make sure to pick a spot in the LL that is ALMOST DRY. It needs to be dry enough not to smoosh but wet enough to be moldable. Insert your needle under the “skin” of the LL and fill with just a tiny bit of Vaseline. The Vaseline will create a little bubble under the skin and voila, you’ve got your blister.

Step 4: Color me crazy
  • Third degree burns are going to basically be dead blackened crispy skin. You want this part of your burn to look flakey, like you could peel it off and make sushi with it – what? To get this effect, you want to peel back the layers of LL slowly. You can also roll the LL from the skin so it looks like the skin is peeling off. 
  • Take a make-up sponge and start brushing black and brown all over the LL in various motions and thickness. You may need to perfect this little by little as your masterpiece comes together.
  • Fill your craters in with blood paste and particles of colored TP. You can add some black and red grease make up for different color effects. 
  • Go over the whole burned area and add blood and color where needed.


It wasn’t perfect but the learners were very successful in guessing the degree and BSA of the burns and we all had a great time. The biggest take-away for me was knowing these nurses would be more successful at their job because of something I created. I couldn’t have done it without the help of my supervisor pointing me in the right direction, YouTube, and Google Images.
 

RECAP: Start building your repertoire of moulage supplies, use your resources, and have fun!

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