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EVALUATION OF AN EFFICIENT INEXPENSIVE TEACHING MODEL FOR VENOUS CUT DOWN

Because of its life-saving potential, teaching of emergency intravenous access including saphenous cutdown technique demands high priority in pediatric training programs. An inexpensive porcine foot cutdown model has been developed and tested on two pediatric housestaff populations in Syracuse, NY and Madison, WI (n=50).Residents were instructed to place a 2 cm transverse incision 2-3 cm superior to the intersection of the first and second digits on segments of pig extremities split midline in the saggital plane. Veins may be located superficially or within deep fascial compartments. Although nonviable tissue is utilized, characteristics of the skin, connective tissue, fascia, tendons, bones, and veins provide a reasonable approximation of structures encountered in the child. Cannulation by direct insertion, by Seldinger technique, and by surgical flap and vein dilator are all serially compatible utilizing this model.Residents exposed to this teaching device have readily completed cutdowns with minimal difficulty, with little cost, with satisfaction for the model, and without the need for anesthetized live animals.Most pediatricians are likely to encounter situations where saphenous vein cutdown may be lifesaving. Initial practice utilizing the porcine foot model provides an inexpensive but realistic teaching device for this fundamental procedure.