TissueDB/Simulators/Infant Intraosseous Infusion Simulator (Micallef)
General Information
The Micallef Infant Intraosseous Infusion Simulator is a 3D-printed training device for practising intraosseous (IO) needle insertion into infant tibial bone. The bone fragments are printed in PLA at 0% infill so they are hollow inside, representing the infant proximal tibial head. Eight consumable fragments are housed in a custom storage and training platform called "maxSIMbox," which accommodates four simultaneous trainees.[1]
| Field | Details |
|---|---|
| General Information | Second maxSIMhealth simulator in TissueDB (see also Bowel Anastomosis Simulator (Habti)). Designed with a "design-to-cost" approach, deliberately omitting a skin layer to reduce cost and complexity, with disposable components suited to COVID-era safety protocols. Best-practice commercial comparator: Sawbones solid foam tibial bone stimulator (Vashon Island, Washington); the redesign targets a better cost-to-use ratio. |
| Features and Basic Operation | The maxSIMbox holds five slides — four IO slides (two friction-fit bone fragments per slide, eight bones total) plus one tools slide — and accommodates four simultaneous trainees. Suction cups on the base and a table-attachment clamp secure the box during drilling. A dedicated tools slide holds the IO access driver, needles, or 3D-printed drill bit between sessions.[1] |
| Current Development Status | First-pass engineering — built, iteratively refined with stakeholder feedback, and in routine use for Neonatal Resuscitation Program training; not yet formally validated.[1] |
| Estimated Build Time and Cost | ~3 days for the maxSIMbox; ~20 minutes per bone fragment.[1], US$30.52 (CAD 38.01, FX 0.8030 USD/CAD at 2021-10-16, x-rates).[1] |
| Specialized Tools and Equipment | Arrow EZ-IO Power Driver (Teleflex Medical) with EZ-IO needle set, or a custom 3D-printed drill bit designed to fit the EZ-IO needle on a conventional drill. Ultimaker S5 FDM 3D printer; Fusion 360 CAD for the STL files; white Ecotough recycled PLA filament.[1] |
| Version | Infant redesign of the adult proximal tibia IO simulator described by Engelbrecht et al. (2020).[1] |
| Development Team Contact Information | Adam Dubrowski, Ontario Tech University, Oshawa, Canada; adam.dubrowski@gmail.com.[1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone | 8 per set | Hollow PLA bone fragments | US$0.90 (CA$1.12) | Represents the infant proximal tibial head; printed at 0% infill so the fragment is hollow inside. Consumable — replaced after each use. Cost is for the set of 8 (Table 1).[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| maxSIMbox stand | 1 | PLA | US$12.76 (CA$15.89) | Custom 3D-printed storage and training platform. Holds five slides — four IO plus one tools.[1] |
| IO slide | 4 | PLA | US$8.43 (CA$10.50) | Holds two bone fragments via friction-fit groove. Cost is for all four slides (Table 1).[1] |
| Table attachment clamp | 1 | PLA | US$1.85 (CA$2.31) | Holds the maxSIMbox to the table surface and secures the slides.[1] |
| Tools slide | 1 | PLA | US$2.53 (CA$3.15) | Storage slide for IO access tools.[1] |
| Suction cups | 4 | Rubber | US$4.05 (CA$5.04) | Provide stability during drilling. Added after stakeholder feedback.[1] |
Build Instructions
Phase 1: Print bone fragments and maxSIMbox components
Step 1: Obtain and modify the adult proximal tibia STL files. Source files from Engelbrecht et al. (2020) and modify in Fusion 360 to infant tibial proportions (head of tibia only, reduced size per stakeholder feedback).[1]
Step 2: Transfer STL files to the printer. Send the modified files to an Ultimaker S5 3D printer (or equivalent FDM printer) via SD card.
Step 3: Print 8 infant tibial bone fragments. Use PLA filament at 0% infill so the fragments are hollow inside. (The source reports the bone wall thickness inconsistently: Table 1 lists 1.2 mm; the main text states 2.0 mm.) Each bone takes ~20 minutes to print.[1]
Step 4: Print maxSIMbox components. Print 1 maxSIMbox stand, 4 IO slides, 1 tools slide, and 1 table-attachment clamp at 20% infill, 1.2 mm wall thickness. Full maxSIMbox print time is ~3 days.[1]
Checkpoint: Verify all 8 bone fragments are hollow, with a groove for securing to slide plates. Confirm each bone fragment friction-fits into its slide position.
Phase 2: Assemble maxSIMbox
Step 5: Attach suction cups. Affix 4 suction cups to the base of the maxSIMbox stand.
Step 6: Insert IO slides and bone fragments. Slot 4 IO slides into the maxSIMbox, each loaded with 2 bone fragments. Insert the tools slide into the remaining slot.
Step 7: Secure the maxSIMbox to the work surface. Attach the table attachment clamp to fix the maxSIMbox in place.
Step 8: Stage IO access tools. Place the Arrow EZ-IO Power Driver, EZ-IO needle set, or custom 3D-printed drill bit in the tools slide for storage.[1]
Checkpoint: Verify the maxSIMbox is stable on the table surface via suction cups. Confirm all slides can be inserted and removed smoothly. Verify bone fragments remain secured in grooves during IO needle insertion.
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 Micallef J, Arutiunian A, Hiley J, Benson A, Dubrowski A (2021). "The Development of a Cost-Effective Infant Intraosseous Infusion Simulator for Neonatal Resuscitation Program Training." Cureus 13(10):e18824. DOI: 10.7759/cureus.18824. PMID: 34804681.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Infant Intraosseous Infusion Simulator (Micallef)". Appropedia. Retrieved June 4, 2026. |