Very hard to mimic real life for surgical airways.
No one volunteers. And cadavers are not always available.
Some skilled trainers/partial skill manikins come with a neck but w/o a chest or some come with the chest and no chin or chin connected to a face. Some have a cachectic appearing neck that even a diabetic with neuropathy of both hands can get the procedure of cricothrotomy done. There is no manikin that looks like the man above and his neck.
Challenges of educators is how to mimic bad scenarios that may happen once or several times in your career. Neck Mass, or Ludwig's Angina or significant neck trauma or just an morbidly obese neck.
Two Ideas I care to share.
One is using the Upper Body form skin provided for TRAUMAMAN by SIMULAB. This would be warming up the student/trainee on just skinlike material over the desired cut neck of the skilled airway trainer/manikin.
Second is once the practice is done, to promote competition and rehearsal of a difficult surgical airway scenario.
I would Abdominal Compartment of the DPA (Diagnostic Peritoneal Aspirate) module of TRAUMAMAN as well to mimic a FAT NECK for a Can't intubate via the mouth, Can't rescue ventilate/oxygenate scenario
And draping over the neck of a Laerdal Deluxe Difficult Airway Trainer. May just need to pull the membranous lining at the bottom of the Abdominal Pad before overlying the trachea of the Airway manikin. It can make passage of the bougie, tracheostomy tube or 6.0 endotracheal tube very difficult into the desired lumen of the Manikin.
Ideally the construct of the trachea would be more realistic like the ones designed by Dr. Levitan for his airway courses but hasn't made it available to market yet.
Or the ones designed by Trucorp, a manufacturer of Airway training manikins. Larynx Combo.
Tell me what you think.