The evaluation of using new trachea and skin manikins for practicing emergency anterior neck access

Emergency anterior neck access may be performed if intubation and ventilation fail. Practicing this life-saving procedure with manikins before facing a real-life emergency anterior neck access is required to do this procedure successfully when we encounter a difficult airway situation. The current manikins are expensive and thus are sometimes difficult to acquire in low-cost settings such as Thailand. We devise a cost-effective training manikin using less expensive materials but retaining the simple design of the trachea and skin areas which are flexible polyurethane (PU) foam and silicone, but which still had the same utility as the current manikins. Five items were evaluated, and then scores were rated by experienced physicians from 1 to 5 points for each item, 1 being the least and 5 the highest. The mean score concerning the appropriate size of the manikins was 4.55 ± 0.56. The mean score of the ease of use for practicing was 4.58 ± 0.59. The mean score of the similarity of the skin of the manikins to human skin was 3.85 ± 0.66. The mean score of the similarity of the trachea of the manikins to the human trachea was 3.80 ± 0.69. The mean score of the sensation of inserting the tube in the manikin compared to a real trachea was 3.90 ± 0.67. The mean overall benefit score of practicing on the manikins was 4.38 ± 0.45. Our trial indicates that this low-cost and simply designed manikin can be useful for practicing emergency airway management procedures to save patients who are struggling with lack of oxygen or intubation failure or failure of ventilation or other airway equipment such as endotracheal intubation and supraglottic airway devices (SGA).