Wound of the Month: Fresh Bruise or Contusion

This month we launch a new column that provides recipes for creating wounds using moulage. The first column looks at fresh bruises (2–6 hours) and contusions (see Figure 1).

Time: 

3-6 minutes

Skill Level:

Beginner

Supplies (available at www.moulageconcepts.com):

Make-up wheel, red

Make-up wheel, medium blue

Make-up wheel, burgundy

Equipment:

Make-up sponge, latex

Tissue

Technique:

Using red make-up, lightly apply a medium-sized, approximately 2 inch × 2 inch circular pattern to the skin of victim. Gently blot the color with a tissue along the outside perimeter of the bruise layer, variegating the color intensity so that the highest level of color concentration remains in the center and fades out along the edges (see Figure 2).

Using a make-up sponge dipped in blue make-up, lightly apply the second layer of color stretching approximately 1/3 around the perimeter of the skin reddening and extending outward approximately 1/4 to 1/2 inch. (This will be the point of impact; most objects do not hit with full force-evenly.)

Alternate the intensity of color placed on the skin by the amount of pressure applied to the applicator. Using a tissue, lightly blot the perimeter of the second layer of bruising, ensuring that the highest concentration of color remains at the point of impact and fades out around the edges (see Figure 3).

Using a make-up sponge dipped in burgundy make-up, create the point of impact by lightly depositing the make-up using a blotting motion along the inside perimeter of the bruise, where the red and blue meet. Using a tissue, lightly blot the color to fade and blend into the existing colors (see Figure 4).

Quick Fix:

Has your bruise advanced past the 2–6 hour timeline? Lighten and set the color by gently blotting the bruise with a large blush brush that has been dipped in baby powder. Tap the edge of the brush on firm surface to shake off the excess powder before applying.

Dispatch:

Medic 61 Respond Code 3 to a woman down, unknown medical/medical alert monitor; 2112 Roe St., nearest cross Bluewillow Ave. Chico Fire responding. 2220 hrs. Dispatch clear.

On Scene:

Place a gray hair wig and reading glasses on victim. Using black tooth wax, age teeth to show slight decay between each tooth, appropriate for an older person. Add 2–6 hour bruise to eye, cheek and jaw of victim. Apply additional bruising in varying sizes and age progression on the arms, legs, and knees of patient. Create a home environment by adding furnishings such as a table, chairs, and sofa to the training area. Overturn a floor lamp and place near victim. Add additional clutter to tables and counters (e.g., wadded-up bloody tissues, empty food cartons, dirty dishes).

Use in Conjunction With:

Abrasions

Ecchymosis of gums

Bloody Nose

Bruise, days 3 to 4

Bruise, days 5 to 10

Helpful Hint:

To create multiple bruises on legs, knees and arms, combine red, burgundy and blue powder makeup in a sealable freezer bag. Using a rolling pin or your fingers, crumble makeup into a fine powder. Dip a firm, short-bristled blush brush into the powder mixture. Deposit color on victim, using a blotting technique or up-and-down motion.

Cleanup and Storage:

Using a soft clean cloth or make-up remover towelette, wipe away the bruising from the skin of the victim. Return reading glasses, wig, bloody tissues and home clutter to your moulage box for future use.

This recipe is referenced from Emergency Moulage—Making your Simulations Come Alive.

Bobbie Merica is the author of Medical Moulage: How to Make Your Simulations Come Alive, Moulage! Bridging the Gap in Simulation and Moulage Magic! Theatrical Tricks to Bring Simulation to Life and owner of Moulage Concepts. All works are based on her popular Moulage Mastery! Bridging the Gap^TM in Simulation workshops. She received her certification in Moulage-The Art of Injury Simulation; Biological/Chemical/Terrorism and WMD terrorism training through TEEX. Upon discovering the absence of moulage specific to a clinical/hospital setting, she designed and implemented the first of a series of 3D clinical wounds, moulage kits and courses that she teaches all over the country. She began her career as a simulation technologist with California State University, Chico, where her collaborative work in the development of the Rural Northern California Simulation Center earned runner-up honors in Advance magazine 2009 Best Nursing Team contest. She is a contributing author for EMS World and HealthySimulations.com, and medical moulage & trauma expert for the Bureau of Public Health Emergency Preparedness, AZ. She will be offering the Medical & Trauma Moulage Workshop for Simulated Clinical Experiences, August 29–31, Cheyenne Regional Mediacl Center, Cheyenne, WY, and Idaho State University, October 3–5. For more information, visit www.moulageconcepts.com.