TissueDB/Simulators/Neonatal ETT Ultrasound Simulator (Qaim Ali)
General Information
This simulator trains point-of-care ultrasound (POCUS) of the newborn neck — telling a correctly placed (tracheal) endotracheal tube from a misplaced (esophageal) one. It is a single block of beef gelatin mixed with psyllium fibre, with two staggered hollow lumens punched through it: an upper one for the trachea and a lower, deeper one for the esophagus. A small gelatin plug, pushed into the esophageal lumen or left out, switches the block between the sonographic look of a tracheal and an esophageal intubation. Scanned with a linear ultrasound probe across the neck, the gelatin reads as soft tissue and the lumens as the air-filled airway. The model uses cheap, locally available materials and can be made anywhere with a stove and a refrigerator.[2][1]
| Field | Details |
|---|---|
| General Information | Low-cost neonatal intubation ultrasound phantom evaluated by Qaim Ali et al., BMC Medical Education 2020, building on the phantom described by Merali et al. (BMC Pediatrics 2019) and the phantom first described by Seguin & Tessaro (Chest 2017). It is intended for low-resource settings: the materials are cheap and locally available, and the same block teaches both the tracheal and the esophageal sonographic appearance by inserting or removing the plug.[2][1] |
| Features and Basic Operation | One gelatin-psyllium block carries two staggered lumens — an upper simulated trachea and a lower, more posterior simulated esophagus. A removable gelatin plug in the esophageal lumen produces the sonographic appearance of a correct tracheal intubation; with the plug removed, the empty esophagus reproduces the appearance of an esophageal intubation. The block is scanned in the transverse plane with a linear probe at about 2.5 cm depth, so the trainee learns to read both correct and incorrect tube placement on one model.[2][1] |
| Current Development Status | One single-centre study (Qaim Ali 2020, n=60): interpretation time improved significantly with practice; the accuracy gain was not statistically significant; not yet validated on patients.[2] |
| Estimated Build Time and Cost | Overnight — the gelatin block is refrigerated to set; punching the two lumens then takes a few minutes.[1], About US$2.[1] |
| Specialized Tools and Equipment | A point-of-care ultrasound machine with a linear transducer (the study used a Philips Lumify 12-2 MHz), scanned transverse at about 2.5 cm depth, to read the model. For construction: a stove or hot plate to mix the gelatin, a container to set the block, and a cut-off syringe barrel (the Qaim Ali figure shows a 10 mL syringe; the Merali protocol describes a 5 mL syringe) to punch the two lumens.[2][1] |
| Version | Not stated in source |
| Development Team Contact Information | Khushboo Qaim Ali, Sajid Bashir Soofi, Ali Shabbir Hussain, Uzair Ansari, Shaun Morris, Mark Oliver Tessaro, Shabina Ariff and Hasan Merali, across Aga Khan University Hospital (Karachi, Pakistan), the Hospital for Sick Children (Toronto, Canada) and McMaster Children's Hospital (Hamilton, Canada). Original phantom: Seguin & Tessaro (Chest 2017). Corresponding authors: Shabina Ariff (shabina.ariff@aku.edu) and Hasan Merali (meralih@mcmaster.ca).[2][1] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Trachea | 1 lumen | Beef gelatin with psyllium fibre | — | The upper hollow lumen. On a transverse neck scan the air-filled lumen reproduces the sonographic look of the trachea; the surrounding gelatin-psyllium reads as soft tissue. Shares the single block with the esophagus.[2][1] |
| Esophagus | 1 lumen | Beef gelatin with psyllium fibre | US$2 | The lower, more posterior lumen. With the gelatin plug inserted it reads as a filled esophagus (correct tracheal intubation); with the plug removed the empty esophagus reads as an esophageal intubation. The cost covers the whole gelatin-psyllium block.[2][1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Simulated endotracheal tube (plug) | 1 | Gelatin plug expelled from the lumen during construction | — | Pushed into or removed from the esophageal lumen to switch the model between the tracheal- and esophageal-intubation appearance. Made from the same gelatin during lumen formation, at no extra cost.[2] |
Build Instructions
Build sequence from Merali et al. (2019) and the Qaim Ali et al. (2020) figure. The exact gelatin, psyllium and water proportions come from the original phantom of Seguin & Tessaro (Chest 2017), which is not openly available; the steps below give the method without those quantities.[3]
Phase 1: Cook and set the block
- Mix beef gelatin powder, orange-coloured psyllium fibre and water on a stove until dissolved.[1]
- Pour the mixture into a container.[1]
- Refrigerate overnight until the block is firm enough to hold a punched lumen.[1]
Verification: the set block keeps its shape when a syringe barrel is pushed through it.
Phase 2: Form the two lumens
- Cut the barrel off a syringe to make an open tube.[2]
- Push the cut barrel through the set block to core an upper lumen for the trachea; the gelatin pushed into the barrel forms a plug — keep it.[2]
- Core a second lumen below and behind the first for the esophagus.[2]
Verification: the two lumens sit staggered (trachea above, esophagus below and behind) and show as two distinct lumens on a transverse scan at about 2.5 cm depth.[2]
Use between learners
- Insert the gelatin plug into the esophageal lumen for the correct-tracheal-intubation appearance, or remove it for the esophageal-intubation appearance.[2]
- Keep the block refrigerated between sessions to keep it firm.[1]
Not suitable for
- Adult airway training — the model reproduces the neonatal airway appearance.[2]
- Practising the intubation itself — the model trains ultrasound recognition of tube position, not the act of placing the tube.[2]
- Settings without refrigeration — the gelatin block must be set and stored cold.[1]
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 Merali HS, Tessaro MO, Ali KQ, Morris SK, Soofi SB, Ariff S. "A novel training simulator for portable ultrasound identification of incorrect newborn endotracheal tube placement – observational diagnostic accuracy study protocol." BMC Pediatrics. 2019;19:434. DOI: 10.1186/s12887-019-1717-y. PMID: 31722685.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 Qaim Ali K, Soofi SB, Hussain AS, Ansari U, Morris S, Tessaro MO, Ariff S, Merali H. "Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound." BMC Medical Education. 2020;20:409. DOI: 10.1186/s12909-020-02338-4. PMID: 33160342.
- ↑ 3.0 3.1 Seguin J, Tessaro MO. "A simple, inexpensive phantom model for intubation ultrasonography training." Chest. 2017;151(5):1194–1196. (Original phantom design and recipe quantities; not open-access.)
| Alternative names | neonatal intubation ultrasound phantom neonatal airway POCUS simulator gelatin ETT ultrasound trainer |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Neonatal ETT Ultrasound Simulator (Qaim Ali)". Appropedia. Retrieved June 4, 2026. |