A Novel Approach to Cadaver-Based Soiled Airway Simulation

Effective management of heavily soiled airways is a critical and challenging skill across multiple clinical settings. Existing training methods rely largely on manikin-based simulators, which often lack sufficient anatomical realism and haptic fidelity. Here, we describe a novel, low-cost, and practical technique for simulating soiled airways in clinical-grade cadavers. The method employs readily available equipment, including a bougie, Foley catheter, and continuous bladder irrigation system, to rapidly deliver simulated bloody emesis into the proximal esophagus and oropharynx. This technique was successfully implemented on nine clinical-grade cadavers during emergency medicine (EM) and anesthesiology physician airway training sessions. All surveyed instructors reported marked improvements in realism and haptic fidelity compared with traditional manikin-based approaches, and no adverse events occurred during cadaver preparation or course delivery. This novel, cadaver-based soiled airway simulation technique offers a practical and reproducible approach to enhance soiled airway education and research.