Development, implementation, and evaluation of a 3D-printed high-fidelity pediatric mannequin with expected hard-to-intubate airway

Abstract

Clinical simulation is fundamental for the healthcare staff to learn and enhance their procedural skills without causing harm to the patients. Despite its importance, in literature appears a deficiency of pediatric pathological mannequins, especially those simulating difficult airway management due to the obstruction of the passage of tubes, fiberscopes, or catheters. Given the importance of simulating complex scenarios in the medical staff's training, the authors decided to realize a modular high-fidelity pathological mannequin with nasal access using reverse engineering and additive manufacturing techniques within T3Ddy, a joint laboratory between Meyer Children's Hospital of Florence and the Department of Industrial Engineering of the University of Florence. The mannequin is developed from diagnostic images of a significant 30-month-old polymalformative patient also affected by Pierre-Robin syndrome modifying the tracheobronchial tree to reproduce an abnormal status. Rigid parts and silicone cast molds are manufactured using 3D-printed ABS/ASA while platinum-cure-silicones are used for the soft ones. Meyer's anesthesiologists collaborated to the realization providing feedback during design and production. The device is evaluated with a 5-point Likert scale questionnaire and results in a useful tool for the training of procedural skills related to difficult intubation as its realism, anatomical geometry, and tactic feedback are positively evaluated.