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

## TL;DR

A low-cost, medium-fidelity surgical airway training model using pig tracheas and synthetic skin was found to be effective for teaching emergency airway procedures.

## Contribution

A cost-effective hybrid simulation model for emergency airway training that is accessible in low-resource settings.

## Key findings

- 81.4% of participants rated the model's anatomy as identical or very similar to the human trachea.
- 82.3% of participants rated the simulator as 'very useful' or 'ideal' for practicing cricothyrotomy techniques.

## Abstract

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.