Is It Time to FONA Friend? A Novel Mixed Reality Front of Neck Access Simulator

Emergency cricothyroidotomy is a life-saving but infrequently performed procedure for emergency airway difficulty. This is performed as the final “rescue” step, after all non-invasive intubation techniques have failed. This time critical procedure must be performed with efficiency and proficiency. Such expertise is developed through experience; however as this procedure is rarely encountered, these skills are taught through simulation. Hence this research sought to develop a simulation for practice of front of neck access that is easily accessible, cheap and ethically sustainable that offers moderate realism. Hence a mixed reality cricothyroidotomy simulation was created, whereby a mobile application demonstrates the technical steps in CCT using augmented reality and then later records the participant performing the procedure on a 3D anatomically correct larynx model. Though the technology is still experimental, the protype and pilot test have demonstrated positive results, with the majority of the participants agree that there should be increased frequency in training CCT and that this simulator is adequate for this task. There is still scope for further development; the model can be modified to demonstrate the anatomical variations of gender and age as well as developing a new semi-rigid material for 3D printing that has greater similarity to cartilage. The application can be further enhanced by making the AR animation more streamline, the educational information more detailed and the feedback more intuitive. The advancement of technology will bring with it an abundance of new directions for this application and for medical education