A Landmark-Guided Pericardiocentesis Simulator for Resource-Limited Procedural Training: A Development Informed by Prior Techniques

Pericardial tamponade is defined as a medical emergency where the pericardium of the heart fills with fluid, compressing and preventing it from pumping blood efficiently. If left untreated, progressive hemodynamic instability and cardiac arrest would occur. The management of this clinical condition necessitates a pericardiocentesis, which is the aspiration of fluid from the pericardial sac. For high-acuity, low-occurrence scenarios like this, medical simulation provides a psychologically safe environment to practice advanced emergency procedures such as pericardiocentesis. However, due to financial and supply chain constraints, it may be difficult to ensure adequate access to training simulators for clinicians practicing in remote and rural areas. To address this issue and to support skill acquisition for clinicians practicing in these areas, we designed a cost-effective and reusable pericardiocentesis trainer, building upon prior methods using ballistic gels as the medium for model making. The simulator is designed to allow adequate practice of both landmark-guided and ultrasound-guided pericardiocentesis from the three main approaches (substernal, apical, and parasternal).