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Use of an Embalming Machine to Create a Central Venous Access Model in Human Cadavers
Author(s) -
Wilbur Lee,
Messina Frank,
Cooper Dylan,
Barroso Eric
Publication year - 2009
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2009.00392_19.x
Subject(s) - medicine , cadaver , embalming , cannula , femoral vein , surgery , vein , dissection (medical) , femoral artery , subclavian vein , anatomy , catheter
Background: Human cadavers provide an effective model for procedural training; however, inconsistent blood return during central venous cannulation compromises the overall reliability of this procedure. Objective: To create and quantitatively assess a human cadaver central venous access model using a continuously‐run embalming machine. Curriculum: Emergency medicine (EM) faculty at Indiana University created this model for a procedure lab designed for EM residents. The right femoral artery was identified by superficial dissection and cannulated distally towards the lower leg. This cannula was connected to a Duotronic embalming machine with a solution composed of 16 oz of 24‐index fluid and 3 gallons of tap water at a fixed output of 13 pounds per square inch (psi). Next, the left subclavian vein and artery were identified by dissection and each was cannulated with an 18 gauge angiocath connected to a continuous pressure monitor. Pressures (mmHg) in the subclavian vein and artery were measured continuously while study personnel cannulated the left femoral, right subclavian, right supraclavicular, and right internal jugular veins. This model was assessed for dual sessions lasting two hours each with a two hour break in‐between. Results: During the first session, subclavian pressures were measured at 3 mmHg venous and 22 mmHg arterial, increasing to 11 mmHg venous and 27 mmHg arterial during the second session. Residents were able to withdraw at least 5 milliliters at each central venous site in the embalmed cadaver. Conclusions: We created a reliable and measurable central venous access model in a fresh‐frozen human cadaver using a standard embalming machine.