Moulage of the Month: CO Poisoning

Objective:

Assist responders in recognizing signs and symptoms of CO poisoning—a colorless, odorless, highly poisonous gas that is accompanied by headache, shortness of breath, dizziness, confusion, nausea and vomiting. In some cases, the skin, mucous membranes and nails of a person with CO poisoning are cherry red or bright pink. (See Figures 1A and 1B.)

Time:

2-4 minutes

Skill Level:

Beginner

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

Color stix, red

Color stix, white

Equipment:

Make-up sponge

Cotton swab

Technique:

Using a make-up sponge that has been dipped in red make-up, apply circular patches approximately 4-6 inches wide to face, chest and trunk of victim, allowing areas of natural skin to show through. To create a natural fade of colorant, pull sponge outward, away from the point of contact, and blend edges into victim’s natural skin. Use additional colorant to connect the skin flushing in larger areas such as neck and torso.  (See Figures 2A and 2B.)

Using a make-up sponge that has been dipped in white make-up, lightly apply colorant along the edges of the "flushed" skin, blending inward toward the victim’s natural skin. 

Quick Fix:

Too much color? Using a make-up remover cloth, gently blot the colorant to lighten the "flush" and create skin mottling.

Training Scenario:

Dispatch: Medic 32, respond Code 3 to Moyers Parking Garage; unresponsive male inside vehicle. Nearest cross street, 25th & Pike. 1500 hrs. Dispatch clear.

On Scene: Using an adult male victim, create a "flush" of color on face, chest and extremities. With a make-up sponge, lightly apply red make-up over the skin of the victim, allowing some natural skin to show through, and blend well. Redden the area around victim’s face, neck and chest area. Using a red make-up pencil, carefully apply colorant to end of cotton swab. Gently apply colorant to the lower inside opening of both nares. Place victim sitting in car, head resting backward on seat headrest. Advise patient to be non-responsive and short of breath. Place "faux" bag of marijuana (dried moss, small stick, buds) and drug paraphernalia on the passenger seat of the car. Turn ignition in car to "on" but not running with gas tank on empty. (Note: If using simulators, make-up techniques may be duplicated using the SIM-Safe make-up series.)

Use in Conjunction With:

Vomitus

Cleanup and Storage:

Using a soft clean cloth or make-up remover towelette, remove the make-up and any remaining product residue from the skin of the victim. Drug paraphernalia can be stored in moulage box for future use.

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.