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

Clinical simulation is fundamental for the healthcare staff to learn and enhancetheir procedural skills without causing harm to the patients. Despite its impor-tance, in literature appears a deficiency of pediatric pathological mannequins,especially those simulating difficult airway management due to the obstruc-tion of the passage of tubes, fiberscopes, or catheters. Given the importanceof simulating complex scenarios in the medical staff’s training, the authorsdecided to realize a modular high-fidelity pathological mannequin with nasalaccess using reverse engineering and additive manufacturing techniques withinT3Ddy, a joint laboratory between Meyer Children’s Hospital of Florence andthe Department of Industrial Engineering of the University of Florence. Themannequin is developed from diagnostic images of a significant 30-month-oldpolymalformative patient also affected by Pierre-Robin syndrome modify-ing the tracheobronchial tree to reproduce an abnormal status. Rigid partsand silicone cast molds are manufactured using 3D-printed ABS/ASA whileplatinum-cure-silicones are used for the soft ones. Meyer’s anesthesiologists col-laborated to the realization providing feedback during design and production.The device is evaluated with a 5-point Likert scale questionnaire and results ina useful tool for the training of procedural skills related to difficult intubation asits realism, anatomical geometry, and tactic feedback are positively evaluated.