The ExAC Trainer
ExAC has developed the first manikin in the world that allows healthcare workers to practice external aortic compression as well as uterine massage. Both maneuvers are essential to obtain bleeding control. Training on external aortic compression will increase the confidence of health professionals in performing the maneuver, improve medical practice and reduce costs and risks associated with PPH.
The ExAC Trainer is a torso that allows the students to recognize the femoral artery and abdominal aorta. The pulsation in the femoral artery will be reduced and ultimately cease when the abdominal aorta is compressed against the spinal column.
When modified to a postpartum torso it allows the students to recognize the changes in the abdominal wall after delivery and how this affects the access to aorta and uterus.
It also allows the students to recognize an atonic uterus and upon instruction learn uterus massage and compression. As the instructor may initiate uterus contractions, the student will be able to recognize a well contracted uterus.
The ExAC Trainer consists of several replaceable parts and does not include advanced electrical or digital functions. This makes it possible to use the ExAC Trainer in most regions of the world independent of level of infrastructure.
The ExAC Trainer makes training on external aortic compression possible. This will increase the confidence of health professionals in performing the maneuver, improve medical practice and reduce costs and risks associated with PPH.
The ExAC Trainer has been tested with great success in various contexts: Rwanda, Sierra Leone, Ethiopia, Canada, Sweden, Brazil, Uganda, The Netherlands, Kenya, The Arabic Emirates, Namibia and Norway.
Professionals participating in the testing have reported that they had the chance to successfully use external aortic compression in clinical settings after practicing on the ExAC Trainer.
Experiences with the ExAC Trainer
"By training on the ExAC Trainer, my colleagues and I have for the first time learned how to recognize an atonic uterus, provide uterus massage and perform external aortic compression. This training has made me as a paramedic more confident in providing adequate care for women giving birth prehospitally. We have also realized the importance of protocols for how to prevent and treat postpartum hemorrhage,"
Linn Ulvøy
Paramedic, Østfold Hospital, Norway
"I have had the pleasure of evaluating the ExAC Trainer over the past month. It is the finest model I’ve ever used with realistic aortic pulsations and femoral artery confirmation. Great trainer."
Matt Douma
Adjunct Assistant Professor
Department of Critical Care Medicine
University of Alberta, Canada
"We had a very good experience with training on the ExAC Trainer. It is really a precious knowledge shared with us. The doll has shown us a possible way of uterine massage and aortic compression and I strongly recommend its promotion to reduce postpartum hemorrhage,"
Dr Ronald Tubasiime
Consultant General surgeon
Head of department of surgery, Kibogora District Hospital
Rwanda
"The ExAC Trainer has been a valuable tool for introduction, discussion, teaching and training. I recommend all obstetric services and especially all obstetric training institutions to adopt and introduce the model in their future training programs.."
Maarten Glas
Gynecologist obstetrician
MSF Sierra Leone and The Netherlands
"This week, for the first time, we had great use of the training when we received a patient who suffered heavy bleeding in the ward. Two assistant nurses had to take turns to maintain aortic compression. Both assistant nurses had participated in the training."
Madelaine Eriksson
Medic, Head of operation unit
Sahlgrenska University Hospital, Sweden
"The ExAC Trainer has given students, as well as experienced midwifes, the possibility to practice external aortic compression and evaluate the technique. It is highly recommended."
Tone Henriksen
Midwife with 20 years of experience.
Østfold hospital, Kalnes, Norway
"After 17 years as a professional, I performed external aortic compression for the first time using the ExAC Trainer.
I truly believe that if this procedure is trained to medical workers and more emphasis is put on the use of this maneuver when healthcare workers treat patients with postpartum hemorrhage, many women will be saved from unnecessary deaths."
Robert Maina,
Clinical officer
MSF and Ministry of Health, Kenya
