Iterative Design and Manufacturing of a Low-Cost, Low-Fidelity Simulator for Cricothyroidotomy

In a trauma setting, cricothyroidotomy is a life-saving procedure performed to secure a compromised airway. The rarity and high-stakes nature of the procedure drastically limit training opportunities. Existing models are expensive and inaccessible. Our objective was to design a low-cost, low-fidelity cricothyroidotomy simulator using universally available materials to ensure widespread access. Our technical report used an iterative design-based research methodology. A multidisciplinary team first determined the essential steps of a cricothyroidotomy. We then established the anatomical components required to perform the procedure: skin, subcutaneous tissue, trachea, thyroid cartilage, and cricothyroid membrane. Multiple prototypes built from a variety of materials were tested by performing simulated cricothyroidotomies. Our cricothyroidotomy simulator requires less than five minutes to construct and costs $0.53 USD. The trachea is made from a plastic water bottle. An egg carton mimics the thyroid cartilage. A nitrile glove slides onto the trachea to simulate the cricothyroid membrane. Slime, created using a mixture of glue, detergent, sodium bicarbonate, and cornstarch, is used for the skin and subcutaneous tissues. Each component can be used infinitely, except for the nitrile glove, which needs to be replaced after 10 uses. Our cricothyroidotomy simulator can be used to train healthcare providers in both well-resourced and resource-limited settings. In addition to making our design blueprints open access, we have intentionally chosen widely accessible and eco-friendly materials to make our simulator available worldwide.