title: Simulated emergency department procedures with minimal monetary investment: cricothyrotomy simulator.
abstract: BACKGROUND
  Existing patient simulators require the imagination, suspension of disbelief, and often verbal cuing to mitigate their lack of fidelity for some procedures. This limitation can reduce their utility as a mode for evaluation of students' procedural skill and procedural competence. This article outlines the materials and methods for making a simulated sheep trachea holder, which enhances existing simulation modalities and augments the interface between device and learner. This simple addition increases the fidelity of low fidelity procedural trainers.
  
  
  METHODS
  A sheep trachea holder was created and presented to attending Emergency Medicine physician-educators at Evanston Northwestern Healthcare as an adjunct for procedural training. The materials and methods for making the simulated sheep trachea holder are outlined in this article.
  
  
  RESULTS
  The limiting factor of production is access to the foam and silicone used to make the simulator. The sheep trachea holder has been reproduced twice, features a washable exterior, and is used biweekly as a teaching tool for the cricothyrotomy skill.
  
  
  CONCLUSIONS
  The homemade simulated sheep trachea holder is a safer and better-received alternative to our previous educational modality.
authors.affiliation: Division of Emergency Medicine, Evanston Northwestern Healthcare, Center for Simulation Technology and Academic Research (CSTAR), Evanston, IL, USA. cpettineo@yahoo.com
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Pettineo
authors.forename: John A
authors.initials: JA
authors.lastname: Vozenilek
authors.forename: Ernest
authors.initials: E
authors.lastname: Wang
authors.forename: John
authors.initials: J
authors.lastname: Flaherty
authors.forename: Morris
authors.initials: M
authors.lastname: Kharasch
authors.forename: Pam
authors.initials: P
authors.lastname: Aitchison
mesh_terms: D000818:Animals; D002983:Clinical Competence; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital; D004867:Equipment Design / Q000191:economics; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000379:methods*; D008953:Models, Anatomic; D012756:Sheep; D014132:Trachea