TissueDB/Simulators/Cricothyrotomy Simulator (D'Auria)
The D'Auria Cricothyrotomy Simulator is the cyber-physical assessment layer applied to the earlier University of Washington BioRobotics cricothyrotomy trainer.[1] The physical White/UW trainer supplies the cardboard trachea, compliant-foam tracheal rings, bicycle-inner-tube skin, 3D-printed laryngeal cartilages, conductive landmark sensors, Arduino and display. D'Auria and Persia use the instrument-contact stream to recognize procedural activities and provide automatic real-time assessment of the emergency cricothyrotomy sequence. The underlying hardware lineage is documented separately at Cricothyrotomy Simulator (White UW).
| Field | Details |
|---|---|
| Features and Basic Operation | Six conductive landmark-contact zones on the White/UW trainer are read through an Arduino-based sensing system. Instrument contacts are time-stamped and processed by the D'Auria/Persia activity-detection framework against expert-defined correct and incorrect activity models. D'Auria and Persia report 81% precision and 98% recall for activity recognition in their reported evaluation. The system provides automated feedback on whether the procedural sequence is performed correctly and in the intended order. |
| Current Development Status | Engineering evaluation completed for automated activity recognition and user/system performance. D'Auria & Persia (2014) report the original CPS assessment approach; their 2015 expanded framework continues the same simulator/evaluation lineage.[2] These are engineering/performance-evaluation studies; they do not demonstrate transfer of surgical skill to patient care or clinical outcomes. |
| Estimated Build Time and Cost | - Less than US$50 for the underlying White/UW physical trainer as reported through the D'Auria source lineage. Cost of the D'Auria/Persia CPS software/evaluation overlay is not separately itemized. |
| Specialized Tools and Equipment | Scalpel, tracheal hook and hemostat wired into the contact-sensing system, plus an endotracheal tube for the final airway-placement step. An Arduino Uno, six conductive contact sensors and an 8×8 LED matrix belong to the instrumented White/UW hardware/CPS chain. |
| Version | D'Auria/Persia CPS lineage: 2014 original automated-evaluation conference paper; 2015 expanded real-time evaluation framework. |
| Development Team Contact Information | Daniela D'Auria and Fabio Persia, Department of Electrical Engineering and Information Technology, University of Naples Federico II, Italy. Contact addresses given in the source paper: daniela.dauria4@unina.it, fabio.persia@unina.it. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Skin | 1 segment | Bicycle inner tube segment | - | Physical skin representation belonging to the White/UW trainer lineage. It conceals the sensor and cartilage landmarks so the cricothyroid region must be located by palpation. D'Auria uses this physical substrate but is not the independent origin of the tissue build. |
| Cartilage — thyroid and cricoid | 1 set | 3D-printed ABS plastic | - | Rigid palpable laryngeal landmarks from the White/UW hardware lineage, including a mobile cricothyroid joint. They provide anatomical context for the instrumented procedure. |
| Cartilage — tracheal rings | - | Compliant foam strips | - | Soft tracheal-cartilage rings belonging to the White/UW physical build. Ring count and exact foam grade are not specified in the D'Auria source. |
| Trachea | 1 tube | Thin cardboard tube | - | Physical airway wall and lumen from the White/UW trainer lineage. It provides the airway into which the endotracheal tube is introduced. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Arduino Uno | 1 | Microcontroller board — Atmel ATmega328 | - | Part of the instrumented White/UW/CPS system. Reads the conductive contact zones and supports the real-time sensing and feedback chain used by the D'Auria/Persia evaluation framework. |
| Conductive foil contact sensors | 6 | Conductive foil; exact grade not specified | - | Six instrument-contact zones positioned at defined airway landmarks. These sensors belong to the instrumented hardware substrate; D'Auria/Persia process their contact sequence for automatic activity recognition. |
| 8×8 LED matrix | 1 | LED matrix display | - | Provides visible system/contact feedback as part of the instrumented trainer. |
Build Instructions
System lineage and prerequisite
This page describes the D'Auria/Persia cyber-physical assessment layer.
The physical cricothyrotomy trainer is the earlier University of Washington BioRobotics system. Its construction lineage is separate and should not be presented as a D'Auria-originated tissue simulator.
Use or prepare the physical trainer according to:
Cricothyrotomy Simulator (White UW)
The required physical context includes:
- 3D-printed thyroid and cricoid cartilage components;
- a thin cardboard tracheal tube;
- compliant foam tracheal rings;
- bicycle-inner-tube skin;
- six conductive contact zones;
- Arduino-based acquisition; and
- an LED display.
Phase 1: Confirm the instrumented White/UW substrate
- Confirm that the required White/UW physical trainer is available.
- Confirm that the laryngeal landmarks remain palpable through the skin layer.
- Confirm that the airway lumen can accommodate the endotracheal tube used for the procedure.
Provenance note: these physical properties belong to the White/UW hardware lineage. They are prerequisites for the D'Auria assessment system and are not a second independently originated D'Auria build.
Phase 2: Confirm the six sensor zones
D'Auria & Persia describe six conductive contact zones:
- A — posterior tracheal wall;
- B — right lateral trachea / cricothyroid region;
- C — midline cricothyroid-membrane region, the correct incision zone;
- D — left lateral trachea / cricothyroid region;
- E — cricoid cartilage; and
- F — lower tracheal cartilaginous ring.
- Confirm that the six contact zones are present on the physical trainer.
- Confirm that the zones connect to the Arduino-based acquisition system.
- Preserve the source-defined distinction between the correct midline contact region and the surrounding incorrect-contact zones.
Phase 3: Configure the D'Auria/Persia CPS layer
- Acquire the time-stamped contact stream from the instrumented trainer.
- Apply the source-described 20 ms debounce handling to reduce contact chatter.
- Use the source-described processing chain for the recorded contact data, including the reported 10 Hz low-pass filtering stage.
- Use the contact sequence as input to the Activity Detection Engine.
- Compare the observed sequence with the expert-defined correct and incorrect activity models described by D'Auria & Persia.
- Use the resulting state to provide real-time procedural feedback.
The source describes temporal stochastic activity models and the tMagic activity-detection method. The complete expert model definitions and a complete standalone software implementation are not published on this page and must not be invented.
Procedure represented by the assessment system
The instrumented task records the sequence associated with emergency cricothyrotomy, including:
- palpating and stabilising the larynx;
- identifying the cricothyroid region;
- making the skin incision;
- opening the cricothyroid membrane;
- introducing the tracheal hook;
- spreading the opening with a hemostat; and
- introducing the endotracheal tube.
These actions describe the procedure being assessed. They do not constitute a second physical construction recipe.
Editorial system check
Before a training session, it is reasonable to confirm:
- that each sensor produces a detectable signal;
- that instrument contacts are acquired by the microcontroller;
- that the display responds; and
- that the activity-detection system receives the contact sequence.
These are TissueDB editorial readiness checks. They must not be represented as a formal published D'Auria pass/fail fabrication protocol unless a source explicitly provides such a checklist.
Evidence history
2014 — original CPS/activity-detection publication
D'Auria & Persia describe automatic evaluation of procedural performance using the instrumented cricothyrotomy trainer and report engineering activity-recognition results.
2015 — expanded framework
The same authors subsequently published an expanded framework covering the same real-time evaluation lineage, including data acquisition/storage, activity detection and performance evaluation.
The 2015 publication does not:
- create a second physical simulator lineage;
- supersede the White/UW hardware origin; or
- establish clinical skill transfer.
Cost and reproducibility boundaries
- The less-than-US$50 figure refers to the underlying White/UW trainer reported through the D'Auria evidence chain.
- A separate D'Auria/Persia CPS-overlay cost is not itemized.
- Total build time is not stated.
- Detailed physical construction belongs to the White/UW trainer.
- Complete activity-model definitions/software specifications are not sufficiently published here for independent reconstruction from this page alone.
- Do not infer missing dimensions, material grades, electronics or software parameters.
- Do not merge the D'Auria and White/UW simulator pages without separate navigation/governance authorization.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Cricothyrotomy Simulator (D'Auria)". Appropedia. Retrieved September 12, 2026. |
- ↑ D'Auria D, Persia F. "Automatic evaluation of medical doctors' performances while using a cricothyrotomy simulator." 2014 IEEE 15th International Conference on Information Reuse and Integration (IRI 2014), 13–15 August 2014, pp. 514–519. DOI: 10.1109/IRI.2014.7051932.
- ↑ D'Auria D, Persia F. "A Framework for Real-Time Evaluation of Medical Doctors' Performances While Using a Cricothyrotomy Simulator." In: Data Management Technologies and Applications. DATA 2014. Communications in Computer and Information Science. Springer, Cham, 2015, pp. 182–198. DOI: 10.1007/978-3-319-25936-9_12.