Accelerating COVID-19 Swab Collection Training with Medical Manikins

With the COVID-19 pandemic where patients far outnumber the medical personnel, an urgent need has risen globally to furnish essential medical equipment to front-line healthcare workers who are at the center of all of this. In a scramble where demand far outstrips supply, 3D printing has risen to the fore in addressing the shortfalls.

As we adjust to the new normal in Singapore, there is a growing and urgent need to train more swabbers to ramp up wider swab testing efforts in these unprecedented times. Typically, a swabbing procedure involves the collection of clinical test samples from the back of the nose and throat by inserting a swab into the nostril.

In Singapore, training for swab collection is carried out by many health professionals who have voluntarily taken time off to selected civilians who often do not possess medical knowledge. Existing medical manikins in the market are deemed lacking representative features to facilitate the execution of these three essential procedures:

  • Nasal mid-turbinate swab
  • Nasopharyngeal swab
  • Oropharyngeal swab

A front-line training organization approached Creatz3D, a Singapore-based 3D printing solutions provider, to produce life-sized manikins that could simulate swab collection scenarios. Special care was taken by Sales and Applications Manager, Sally, to understand the requirements effectively for the project to kick off.

Roping in its sister company, AuMed, a bespoke medical simulator company, Senior Biomedical Engineer, Catherine, then designed the manikin using several anatomical 3D models derived from AuMed’s CT and MRI library, before fusing them into one big piece using Materialise’s Mimics Innovation Suite (MIS) Medical.

At the same time, there was constant feedback and suggestions from the ENT doctors/clinicians working in local hospitals in creating this model, to resolve the inaccuracies of existing manikins in the markets that were also expensive and limited in quantity. After 2 rounds of intense modifications, manikins that can be used for both nasal and throat swab collection training and hands-on were produced.

Most manikins out there are usually opaque, either for throat or nasal training, with prices starting from 3,000 USD. With the 3D printed manikin, training can be integrated with 1 mobile and 1 compact size model at the price (or lower, depending on quantity) of 1 typical manikin, with 5 to 7 turnaround time.

The manikins also presented opportunities to train more effectively alongside the existing training materials and arrangements (training slides, hands-on sessions, etc.). Compared to the available general manikins (e.g. for airway simulation), the 3D printed manikins targeted crucial anatomies specifically for respiratory swab collection.

Previously considered as a black box, the 3D printed manikins provided these training enhancements:

  • Observation of the nasal, mouth, and throat internal structures which are otherwise not possible with a real person being swabbed.
  • Enabling the trainers to demonstrate the procedures clearly and highlight special cautions to ensure safer execution of swab collection, using standard medical-grade swabs.
  • Encouragement of interactions between the trainers and trainees with the same manikin.

Feedback from users was promising with many impressed by the bounceable tongue for simulation with a tongue depressor, and the crucial anatomies (e.g. turbinates, pharynx, and uvula) as indicators for performing the swab collection. Most importantly, the manikins were in real-life size, perfect for standard medical-grade swab sticks to be used. Further design improvement has already started thanks to the users’ feedback.

Ultimately, this crisis has highlighted how 3D printing is capable of stepping up to adapt to the needs of users in producing badly-needed essentials on demand with short turnaround time.

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