Moulage Casts Reality with Mock Injuries

At first it appears to be the set of Hollywood's latest horror film: torn tissue, blood, lacerations, broken bones and even vomit are enough to make the strongest person nauseous and woozy. But this isn't theater—it's the Center for Domestic Preparedness (CDP) in Anniston, Ala.

The use of artificial injuries isn't a new concept and it's evolving. Moulage techniques have been used by emergency response personnel for years. Moulage comes in many forms—the most practical are wounds made of rubber or latex that are placed on living role players or mannequins. However, it can be quite difficult. Taking the process a step further, adding makeup and a variety a materials, is a recipe for realistic training.

The CDP has used the art of moulage for almost 10 years, but until recently the staff couldn't create the injuries; they were all premade and purchased off the shelf from different vendors who deal in this gruesome science.

Now, three CDP staffers provide experience and art form during emergency response exercises, in addition to their regular duties. In early 2007, these artisans participated in basic moulage training from a local responder. After assisting in moulage application over several days for an emergency response exercise, it was time for advanced training at the Image Perspectives' School of Moulage in Carson City, Nev.

"Moulage dates back to the Renaissance," said Delois Champ, CDP Operations Center manager. "Moulage is used to provide realistic injuries for exercise and training purposes," she added. "Deep cuts, major trauma and open fractures take several days to complete prior to applying to the victim. Depending on the severity of the injuries it may take several hours working on victims to complete moulage."

Exercise planning, to include moulage requirements, begin a few months before an exercise. Multiple meetings are held to determine the types and numbers of injuries required for exercise objectives. After the injuries are identified, the moulage team brainstorms on the creation and application of the injuries each victim will exhibit. The smallest details—down to blood pressure and pulse rate—are included.

"I love being creative and seeing how realistic I can make the wounds appear," said Wendi Feazell, operations and support staff. "Plus it affords you the opportunity to meet other staff members. We also have an opportunity to work with responders and get a better understanding of what they could see day-today."

Moulage isn't as easy as it may seem. The person behind the makeup needs a touch of artistic skill and creativity to add the realistic effect.

"I've always been an artistic person," said Barry Snow, physical security staffer. "Blisters, cuts, and bruising are the easiest for me to create. Most of the materials we use only stay in their liquid or workable form for a short period of time, which requires working very quickly. You also need a very good sense of what the real injury that you are trying to simulate looks like, so the responder can react, diagnose, and treat the injury correctly to maximize their training benefit. In other words, it has to be believable."

"This is an interesting technique that makes our exercises unique," said Feazell. "Moulage is a great aspect of our training, and although we're behind the scenes, I feel a sense of accomplishment by having added more realism that may help a responder in a real situation."

Using moulage as part of the training exercise with live, simulated victims develops a responder's reaction. Their response to a trauma scene could be the difference between life and death, especially with the added stress of unnerving sights.

"Moulage significantly enhances the realism and effectiveness of exercises and training," said Champ. "This is a unique skill that enhances my ability to contribute to the CDP's mission."

"Using these effects allows role player victims to simulate their injuries better," said Snow. "It provides realistic training for our responders. I've received comments that the appearance was unbelievable and looked painful."

Each victim has specific injuries and symptoms. The moulage experts are on the scene hours before the exercise applying the blood, open fractures, vomit, and lacerations.

"Regardless of the situation or scenario, the addition of moulage adds a whole new emergency twist," said Feazell. "Using moulage changes the makeup—no pun intended—of the exercise. It's no different from theater special effects, and can sometimes be a little scary, but always real."

The look and feel of the trauma scene is more realistic using moulage as the ultimate training aid. But the casts and molds to create unsightly injuries aren't products pulled off the shelves at the local moulage shop. These injuries require hours to create. Supplies such as special makeup, stage blood, blood powder, simulated charred skin, liquid starch, latex, and gelefects are common tools used to build moulage combinations.

"I know moulage enhances the training exercise," said Feazell. "This specialized technique prepares the responder for real-life emergencies."

Moulage may not be for the squeamish, but it does promote a realistic training environment. This technique prepares responders for real-life emergencies using a method that commands an immediate response and insight to potential injuries.

"The bottom line," stressed Feazell, "what is realistically experienced is better learned and retained."