Styrofoam, Duct Tape and Tomato Sauce: The Aussie Simulation for Emergency Front of Neck Access
Author : Paige Hudson, Russel Krawitz, Julie O’Connell, Justin Yeung, Fiona Reid
Abstract :Introduction: Emergency front of neck access via cricothyroidotomy (eFONA) is a critical skill all surgical doctors should be familiar with. In the can’t intubate, can’t ventilate scenario, eFONA can be a lifesaving intervention. Given its time-critical nature, knowledge of this skill should not be limited to surgical subspecialties. This is particularly important in areas with limited resources, such as rural and remote regions. Utilising affordable and available equipment, we aimed to find an innovative way to teach eFONA to junior surgical doctors. Method: To create the eFONA model, a rectangular hollow was cut into the neck of the Styrofoam head (representing the tracheal lumen) and overlayed with duct tape (representing cricothyroid membrane), a tomato sauce packet (representing pre-tracheal muscles), and a second duct tape layer (representing skin). Participants were first taught how to locate the cricothyroid membrane on themselves. Using the model, participants were instructed to incise the layers, insert an endotracheal tube into the opening and inflate the balloon. Following the simulation, participants completed an anonymous survey. A cost analysis was completed. Results: From 2022 to 2025, 147 surgical junior doctors participated in the eFONA simulation at the tertiary hospital’s annual Surgical Orientation. The simulation had a mean rating of 4.6/5, with 70% of participants rating it 5/5 (n=103). In 2025, the cost was $3 per simulation. This is in comparison to $300-$999 off-the-shelf FONA trainers. Conclusion: eFONA can be simulated using readily available and affordable materials. Effective simulations can increase confidence in junior doctors, potentially improving patient outcomes.
Keywords :Low-Cost eFONA Simulation Model to Train Junior Surgical Doctors in Airway Emergencies
Conference Name :International Conference on Healthcare Simulation, Physical Diagnosis and Surgery (ICHSPDS-25)
Conference Place Melbourne, Australia
Conference Date 24th Oct 2025
