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Comment on: Daly R, Planas JH, Edens MA. Adapting gel wax into an ultrasound-guided pericardiocentesis model at low cost. West J Emerg Med. 2017;18(1):114-6. We were happy to discover the article by Daly and colleagues describing a low-cost, pericardiocentesis training model (Figure 1).1 We have struggled to find a cost-effective means of demonstrating and practicing ultrasound-guided pericardiocentesis with our emergency medicine residents. We greatly appreciated their ingenuity in building upon and improving previous do-it-yourself models.2,3 We were especially impressed with their addition of a plastic Halloween skeleton thorax and 250 mL normal saline bag to act as the pericardial sac. In that same spirit, we have devised a modification of their model that offers the benefit of morerealistic external landmarks. We followed their instructions with several exceptions. Instead of the square-shaped plastic container that they used for Loma Linda University Medical Center and Children’s Hospital, Department of Emergency Medicine, Loma Linda, California

Modification of Daly’s Do-it-yourself, Ultrasound-guided Pericardiocentesis Model for Added External Realism