Wound of the Month (Industrial Series): Closed Fracture With Bruising

Time: 2–4 minutes (includes drying time)

Skill level: Beginner

Supplies (available at www.moulageconcepts.com):

• Color Stix, bright red
• Color Stix, blue
• Color Stix, maroon

Equipment:

• Fan brush
• Makeup sponge, pocked (small pieces removed from edges, center)

Technique: Create closed-fracture bruising: Using a makeup sponge that has been lightly dipped in red makeup, apply light coloring to the skin using a gentle blotting technique.

Using a fan brush dipped in blue color, create random patterns of capillary bruising over the reddened skin by lightly pressing the tip of the brush to the skin in a random pattern.

When creating “fresh” bruising, take care to alternate the intensity of color placed on the skin by the amount of pressure applied to the applicator and allowing some of the natural skin color to show through. Using water-based makeup products allows thorough coverage without absorption into the skin and enables you to quickly fix areas of overapplication. Using additional latex, adhere filled packing bubble to skin.

Training scenario:

Dispatch: Medic 12, respond to Covington Steel for a report of a worker injured in an accident. Caller reports a metal bar fell from a forklift and struck the patient in the arm.

On scene: Using a makeup sponge, create skin reddening by applying pink makeup to the forehead, chin, and neck of an adult simulator, blending it well into the hairline. Using an “ash” tone powder to simulate dust, apply powder to clothing, hair, and surrounding surfaces.

Underneath the shirt sleeve, apply fracture bruising to the lower arm and wrist of the simulator. Carefully turn over the equipment and place it on top of the lower arm.

Create an appearance of dishevelment by tousling the hair and applying dirt to the back of the shirt.

Using training glass and metal, apply multiple small pieces of rubberized shards to hair, clothes, and the scene. Apply a light mist of premade sweat mixture to the forehead, chin, neck, and upper arms.

Use in conjunction with: First- and second-degree abrasions

Helpful hint: Need a latex-free option? Use flesh or clear moulage gel or silicone in place of latex. Proceed through the next steps as described.

Cleanup and storage: Carefully remove the fracture wound from the skin of the simulator. Using your fingers or a paper towel, grab and lift the wound around the edges. Using a gentle upward motion, continue to peel away the wound until all product has released from the skin. Using a soft, clean cloth or per manufacturer’s instructions, remove any remaining product residue from the skin.

See more free training tutorials at www.moulageconcepts.com.

Bobbie Merica is a medical/trauma moulage expert, author and president of Moulage Concepts Inc., a global moulage company specializing in training, supplies and wound customization. Recipes are from her book Medical Moulage—How to Make Your Simulations Come Alive (F.A. Davis, 2011).