Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure designed to treat non-compressible torso hemorrhage. Because this is a high-acuity lowoccurrence event, it is difficult to train providers on the procedure and difficult for trained providers to stay proficient. Our primary objective was to develop a low-cost, high-fidelity teaching model to increase emergency medicine (EM) resident knowledge, confidence, and proficiency in performing REBOA. We utilized readily available materials to allow for ease of replication and cost-effectiveness. The aorta was simulated by a bicycle tire inner tube, and the femoral artery was simulated by natural rubber tubing. Once connected, these simulated vascular structures were threaded through a plastic torso mold and filled with simulated blood. Participants then performed the REBOA procedure with very little time required for reset between participants. After completing the training using our model, participants completed a survey rating aspects of the session on a five-point Likert scale. Participants included 21 EM residents from all levels of training. Participants rated the fidelity of the REBOA insertion trainer very highly (mean = 4.05, SD 0.67) and felt that the training was overall very useful (mean = 4.29, SD 0.56). Comments regarding the model were universally positive. We present a novel low-cost REBOA task trainer that is easy to build, reusable, and portable, and can be utilized either in a hospital or austere training environment.

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Resuscitative hysterotomy (RH) is a rare, time-sensitive, invasive procedure that can be frightening for emergency physicians and yet potentially life-saving for fetus and mother. Several low-cost RH task trainers have been described in the literature. We set out to construct a model using improved synthetic materials for the uterine and abdominal wall and to devise hemorrhage capability. The primary aim of this study was to evaluate the model's perceived usefulness of its features. Secondarily, we wished to assess the confidence of emergency medicine (EM) residents before and after performing a RH using our task trainer in a simulated environment.We constructed an inexpensive task trainer that can function both as a table-top model (TTM) and be adapted to a high-fidelity simulator. We created the abdominal wall and uterus from polyurethane carpet padding, subcutaneous fat from upholstery foam, fascia from synthetic chamois, and blood vessels from IV tubing and angio-catheters. We utilized the task trainer during our monthly EM residency simulation conference. After completing a simulation of a gravid female in cardiac arrest requiring a RH on a highfidelity simulator adaptated model (HFSAM), residents repeated the procedure during debriefing on a TTM. Residents then completed anonymous paper surveys in which they rated aspects of the RH model and their procedural confidence on a 10-point Likert scale. 20 EM residents took part in the RH simulation scenario followed by a TTM demonstration. All (100%) residents completed the survey. 11 (55%) of the residents performed a RH on either the HFSAM or the TTM while the others assisted. The residents rated the overall educational value of the training event as very high (mean 9.8 (SD 0.68)). Both the TTM (mean 8.9 (SD 1.15)) and HFSAM (mean 8.7 (SD 1.29)) were similarly rated as highly realistic. Before the simulation session, residents rated their confidence in performing a RH as low (mean 4.0 (SD 2.62)). After the session, they were much more confident in their ability to perform a RH (mean 7.9 (SD 1.48); P<0.001). Most residents rated bleeding as very important to the utility of a RH model (mean 8.6 (SD 1.74)).We demonstrate an inexpensive but realistic RH task trainer that can be used as a stand-alone model or adapted to a high-fidelity simulator. A single simulation using the TTM and the HFSAM lead to increased resident confidence in their ability to perform a RH.