Applicability of a Low-Cost, Medium-Fidelity Simulation Model to Develop Surgical Skills in Emergency Airway Management.

INTRODUCTION

Training healthcare professionals to manage a surgical airway in emergency scenarios is essential, yet the opportunity to do so is often limited. These procedures are rarely performed, and access to high-fidelity simulation tools is generally restricted due to their cost and complexity, particularly in low-resource settings. To offer a more accessible alternative, our team developed a hybrid, medium-fidelity simulation model using porcine tracheas and synthetic skin, aiming to mimic the anatomical features of the human neck.

METHODS

This prospective observational study was conducted during Advanced Trauma Life Support (ATLS) courses at Hospital Ángeles Lomas between May 2022 and January 2025. A total of 102 physicians and trainees from multiple specialties participated in structured hands-on training sessions using the simulator. The primary outcome measures were participant-rated anatomical similarity and perceived usefulness of the model for teaching both surgical and percutaneous cricothyrotomy, assessed using Likert-scale-based surveys completed immediately after the session. The simulator assembly process involved cleaning and preparing mature porcine tracheas and mounting them onto wooden bases, demonstrating feasibility and cost-effectiveness within a standardized ATLS educational setting.

RESULTS

Of the 102 participants, the majority rated the model's anatomy as identical or very similar to the human trachea (83/102, 81.4%). Regarding training value, 82.3% (84/102) rated the simulator as "very useful" or "ideal" for practicing both surgical and percutaneous cricothyrotomy. Importantly, no participants provided negative ratings.

DISCUSSION: Beyond its practical function, this tool also encouraged repeated, hands-on experience in a low-risk environment. While high-fidelity models certainly offer more complex scenarios and broader learning in non-technical skills, this low-cost alternative allows for the focused development of essential manual techniques.

CONCLUSION

By removing financial and logistical barriers, the hybrid simulator provides a realistic and reproducible option for institutions seeking to strengthen emergency airway training without overextending their resources. It not only supports technical skill-building but also enhances clinical preparedness in high-stakes, time-sensitive situations where every second counts.