Development of an Innovative Nonanimal Training Model for Infant Pleural Effusion Drainage via Pigtail Catheter Placement

Background: Chest tube placement is an important skill for providers and bedside nurses caring for critically ill infants, allowing for the evacuation of pleural fluid and pneumothoraces. No realistic simulation models are commercially available for trainees to practice and learn this skill on infants. Purpose: Our objective was to develop an inexpensive and reproducible model for percutaneous pleural pigtail placement for pleural fluid removal via the Seldinger technique. Methods: The model was developed using hardware material and a discarded infant resuscitation manikin. The rib cage was constructed using electrical cable wires. Discarded and expired 250-mL bags of intravenous fluids were placed inside the chest cavity to simulate pleural fluid. Shelf liner was wrapped around the chest and abdomen of the infant model to simulate the skin layer. Pediatric critical care faculty performed the procedure on the final model and scored it for realism and utility for teaching. Without including the discarded manikin and fluid bags, the cost of the materials for the model was less than $20. Results: Eight pediatric critical care faculty tested the pleural pigtail placement model. All faculty agreed the model provides a realistic simulated reproduction of placing a pleural pigtail, felt the model was simple to use, and indicated they would use it as a teaching tool in the future. Implications for Practice: An effective model for pleural pigtail placement can be inexpensively constructed using discarded bags of intravenous fluid and easy-to-find hardware materials. Implications for Research: Future studies are needed to assess whether this model helps providers and nurses develop and maintain the clinical skills for successful percutaneous pleural pigtail catheter placement. Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=35&autoPlay=true.