Jump to content

TissueDB/Simulators/Neonatal ETT Ultrasound Simulator (Qaim Ali)

From Appropedia


Four-panel photograph of a gelatin block ultrasound phantom and the cut-off syringe used to form its two lumens
Low-cost intubation ultrasound phantom: (a) the beef-gelatin and psyllium-fibre block with a cut-off 10 mL syringe; (b) the syringe barrel cored through the block, with the expelled gelatin plug beside it; (c) the two staggered lumens — simulated trachea (white arrow, upper) and esophagus (black arrow, lower) — with the retained plug; (d) a transverse anterior-neck ultrasound image of the block showing the simulated trachea (white arrow) and esophagus (black arrow). Image by Merali et al., BMC Pediatrics 2019, CC BY 4.0.

The Neonatal ETT Ultrasound Simulator is a low-cost phantom, built from cheap and locally available materials, for training 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 cored through it: an upper one for the trachea and a lower one for the esophagus. A small gelatin plug, pushed into the esophageal lumen or left out, switches the block between the sonographic appearance of a tracheal and an esophageal intubation. The block is scanned across the neck with a linear ultrasound probe, and the same model can be made anywhere with a stove and a refrigerator.[2][1]

Field Details
Features and Basic Operation The trainee scans the block in the transverse plane with a linear probe at about 2.5 cm depth. With the gelatin plug in the esophageal lumen the block shows the sonographic appearance of a correct tracheal intubation; with the plug removed it shows an esophageal intubation — so one model teaches both.[2][1]
Current Development Status Evaluated in one single-centre provider-training study (Qaim Ali 2020); not yet validated on patients.[2]
Estimated Build Time and Cost ~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 USB probe, which plugs into an Android tablet), 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, a refrigerator to set it overnight, and a cut-off syringe barrel (the Qaim Ali figure shows a 10 mL syringe; the Merali protocol uses a 5 mL one — either bores the lumens) to core the two lumens.[2][1]
Version Version 1
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 it 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 — The lower hollow lumen. With the gelatin plug inserted it reads as a filled esophagus (the correct-tracheal-intubation appearance); with the plug removed, the empty esophagus reads as an esophageal intubation.[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

  1. Mix beef gelatin powder, orange-coloured psyllium fibre and water on a stove until dissolved.[1]
  2. Pour the mixture into a container.[1]
  3. Refrigerate overnight until the block is firm enough to hold a cored lumen.[1]

Verification: the set block keeps its shape when a syringe barrel is pushed through it.

Phase 2: Form the two lumens

  1. Cut the barrel off a syringe to make an open tube.[2]
  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]
  3. Core a second, lower lumen for the esophagus.[2]

Verification: the two lumens sit staggered (trachea above, esophagus below) 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. ↑ 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 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. ↑ 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 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. ↑ Seguin J, Tessaro MO. "A simple, inexpensive phantom model for intubation ultrasonography training." Chest. 2017;151(5):1194–1196. DOI: 10.1016/j.chest.2017.02.014. PMID: 28483123. (Original phantom design and recipe quantities; not open-access.)




Simulator data
Alternative names neonatal intubation ultrasound phantom
neonatal airway POCUS simulator
gelatin ETT ultrasound trainer



Page data
Keywords neonatal intubation, endotracheal tube, ETT, point of care ultrasound, POCUS, ultrasound phantom, gelatin phantom, psyllium, airway simulator, neonatal resuscitation, low-cost simulator, Qaim Ali, Merali
SDG
Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 4 pages link here
Redirects TissueDB/Simulators/Qaim Ali Neonatal ETT Ultrasound Simulator
Views 9 page views (analytics)
Created April 18, 2026 by Arturo Pelayo
Last edit June 22, 2026 by Arturo Pelayo
Cite as Arturopelayo (2026). "TissueDB/Simulators/Neonatal ETT Ultrasound Simulator (Qaim Ali)". Appropedia. Retrieved June 24, 2026.
API queries basic, semantic, html, files, more
Cookies help us deliver our services. By using our services, you agree to our use of cookies.