TissueDB/Simulators/Massive Hemoptysis Simulator (New)

The Massive Hemoptysis Simulator (New) is an adult manikin-based airway trainer built around an industrially 3D-printed (selective-laser-sintered) airway tree seated inside a repurposed intubation manikin — not built from locally available materials — for practising the management of massive (life-threatening) hemoptysis. A 3D-printed TPU airway tree (trachea, main bronchi, and segmental bronchi, derived from a deidentified CT scan) replaces the manikin's internal airways; peripheral IV catheters glued to selected segmental bronchi feed simulated blood from an external bag through roller-clamped tubing, so a facilitator can drive controllable bleeding into chosen airway segments. The trainer supports endotracheal and mainstem intubation, endobronchial blocker placement, lateral decubitus positioning, and bronchoscopic airway clearance with real clinical equipment. It was developed at the University of Colorado, and a companion paper reports a curriculum built on it.^[1][2]

1. Obtain a deidentified CT scan and generate a digital 3D rendering of the main airways including trachea, bronchi, and segmental bronchi.^[1] The airway-tree model file is provided in the paper's e-Appendix 1, and the digital workflow is described in Jacobson et al. 2023.^[3]
2. Print the airway tree using an SLS printer (EOS P770, EOS) with EOS TPU 1301 powder (EOS). Note: this requires industrial SLS infrastructure, not consumer FDM equipment.^[1]

Verification checkpoint: Confirm that the printed airway tree includes trachea, bilateral main bronchi, and segmental bronchi with lumens large enough to accept a standard bronchoscope.

1. Remove the internal manikin components in the chest cavity space, including the original manikin airways.^[1]
2. Seat the 3D-printed airway tree in the anatomically appropriate position just distal to the manikin vocal cords.^[1]
3. Fix the airway tree in place with adhesive glue.^[1]

Verification checkpoint: Confirm that a standard endotracheal tube can be advanced through the manikin vocal cords into the 3D-printed trachea, and that a bronchoscope can navigate through the trachea into bilateral main bronchi and segmental bronchi.

1. Cut the catheters off peripheral IVs and glue them to the ends of selected segmental bronchi bilaterally to create liquid channels for simulated bleeding.^[1]
2. Connect extension tubing to the IVs on the airway tree and extend to the outside of the manikin.^[1]
3. Attach a roller clamp to each extension tube to control the rate of bleeding into selected airways.^[1]
4. Prepare simulated blood: mix 20 mL red food coloring, a few drops of blue food coloring, and 1 tablespoon of corn starch into a 1 L bag of normal saline or water. Agitate the bag to suspend the corn starch.^[1]
5. Connect the simulated blood bag to the external end of the extension tubing.^[1]

Verification checkpoint: Open a roller clamp and confirm that simulated blood flows through the extension tubing, through the IV catheter, and into the targeted segmental bronchus. Confirm that the flow rate is controllable by adjusting the roller clamp. Verify there are no leaks at the catheter-bronchus junction.

• Double-lumen endotracheal tube placement training — only 40% of content survey respondents selected this as important for massive hemoptysis; not a primary design target^[1]
• Electrocautery — selected by only 30% of respondents; not incorporated into the paper's validation^[1]
• Learner groups beyond pulmonary and critical care medicine — the simulator was studied only with pulmonary and critical care medicine attendings and internal medicine residents; suitability for other groups was not assessed^[1]
• Chronic or low-volume hemoptysis — the simulator replicates the massive (life-threatening) hemoptysis scenario with active bleeding requiring immediate intervention^[1]