Moulage of the Month: Heroin Overdose

Objective: Using moulage to create effects of heroin overdose.

Time: 2–3 minutes

Skill Level: Beginner

Supplies: (Shop www.moulageconcepts.com for all your moulage needs)

• Make-up stix, cyanosis blue
• Make-up stix, burgundy
• Blue watercolor marker
• Flesh-colored wax
• Clear latex
• Black powder
• Blood gel

Equipment:

• Make-up sponge
• Stipple sponge or fan brush
• Blush brush
• Small paint brush
• Fan brush
• Toothpick
• Small mixing bowl

Technique:

Using the pointed end of a watercolor marker, trace the line of the fingernail along the sides and cuticle of the finger. Using the broad side of the watercolor marker, fill in the fingernail bed with color and blot lightly with a tissue.

Create bruising and track marks along the veins. Using a make-up sponge that has been lightly dipped in burgundy make-up, create advanced bruising along the inside veins of the arm. Using a gentle blotting motion, deposit color in a linear fashion, following the natural veins of the underarm. Using a fan brush, apply small areas of blue over the burgundy using a gentle blotting motion. In a small bowl, mix together black powder make-up and blood gel. Using a toothpick, create small open sores and track marks over the top of the "bruised" area of the skin. 

Training Scenario:

Dispatch: Medic 12, Respond Code 3 to 1233 Hildale Apt. Complex, Southside, victim non-responsive. Nearest cross street, 5th Ave. Yuba County Fire responding. 2215 hours. Dispatch clear.

On Scene: Using a make-up sponge, apply white make-up to the face of victim, blending well into the hairline. Using a blush brush that has been dipped in white make-up, create skin mottling on the face, chest, hands and feet of the patient. Using a watercolor marker discolor fingernails using cyanosis blue make-up. Using a fan brush or stipple sponge, create a blue tinge around the victim’s lips, blending lightly with tissue. Using a small paint brush that has been dipped in blue make-up, create under-eye circles by lightly applying colorant from the inside corner of the eye to approximately 2/3 across, and blot lightly to blend. Using a clear, water-based lubricant, create nasal drainage by applying a small amount of fluid to the base of the nares and allow the mixture to run downward, toward the lips. Create an appearance of dishevelment by tussling the hair and adding scalp flakes, wrinkling the clothes and untying one of the shoes. Use instant potato flakes to create scalp flakes, especially dramatic in dark hair. Using black make-up and blood mixture, create small open sores and track marks to the "bruised" area of the skin of the victim. Put a small amount of colored fluid in a clean, empty syringe (minus the needle). Using spirit gum, adhere syringe to skin of victim, simulating insertion of needle. Apply a small amount of modeling wax around syringe to strengthen entry point of needle and coat with liquid latex. Place additional drug paraphernalia and empty beer cans on the floor around the victim. Advise the victim to slump forward toward the floor with slow, shallow breathing. Instruct friends around scene to speak with slurred speech and confusion.

Use in Conjunction With:

Scabs; picking sores

Cleanup and Storage:

Carefully remove syringe from skin of victim. Using a soft, clean cloth or make-up remover towelette, remove the make-up and remaining wax residue from the skin. 

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. All works are based on her popular Moulage Mastery! Bridging the GapTM 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. For more information, visit www.moulageconcepts.com.