A Low-Cost, Reusable Cricothyroidotomy Simulator for Resource-Limited Settings: Design and Initial Teaching Use

Purpose: Cricothyroidotomy is a lifesaving emergency procedure for managing airway obstruction. However, training opportunities in low- and middle-income countries (LMICs) are limited by the high cost and complexity of existing simulation models. Recognizing this gap, we developed a low-cost, reusable cricothyroidotomy simulator intended for surgical skills training in LMICs. Methods: The simulator is built from medical gloves, bandage, corrugated cardboard and duct tape, following an illustrated 13-step guide. It represents the skin, soft tissue, thyroid and cricoid cartilages, and cricothyroid membrane, and weighs under 2 lb (0.9 kg). After each attempt, the glove, bandage and membrane tape are replaced and the cardboard framework is reused. Material costs were prorated from retail prices. Three trauma surgeons examined the model informally during conference judging, and it was then used in teaching sessions with trainees. Results: Buying one package of each material cost US$19.12. The materials consumed in building one simulator cost US$1.84, and the replacement layers for each further attempt cost US$0.85. Furthermore, assembly took under five minutes and replacing the consumable layers about one minute. The surgeons commented that the landmarks were identifiable by palpation and that the procedural sequence could be completed on the model. During teaching, learners incised the skin and membrane, confirmed airway entry digitally and inserted a tube, and the cardboard framework remained intact across repeated attempts. Conclusion: This low-cost, reusable cricothyroidotomy simulator represents an early-phase training innovation intended to improve access to repeated hands-on practice in resource-limited settings. Structured evaluation and field testing in LMICs are planned.