Endotracheal Tube Support System

Endotracheal intubation is the process of inserting a PVC tube into the trachea through the mouth or nose and establishing an airway to a ventilator to support patients unable to breathe independently. The ventilation system acts as a mechanized diaphragm, inducing airflow into and out of the lungs. The tube itself has a pre-shaped bend to feed down into this portion of the throat smoothly. Our device is designed specifically for the more common form of intubation, which is oral intubation through the mouth.

When a patient is intubated for a long period of time, such as when a patient is undergoing a lengthy procedure or is comatose, the tube can put pressure on a certain portion of the throat called the posterior larynx leading to the possibility of a recovery period or even permanent damage to the vocal cords that can cause the loss of vocal capability. The posterior larynx is a portion of the throat near the voice box which is made of hard tissue, and is therefore un-malleable and tends to lose blood flow when pressure is applied due to the presence of the endotracheal tube. As depicted in the second figure below, the endotracheal tube sits to the posterior portion of the trachea, pressing up against the posterior larynx. This action leaves a relatively large portion of the trachea open. In the anterior region lie the vocal cords, which are far more malleable to external pressure, and much less likely to be damaged by the presence of the tube.

In these short-term cases, patients often report feeling discomfort or pain in the throat due to the pressure the endotracheal tube puts on the throat. In longer-term cases, such as the treatment of comatose patients, the prolonged pressure can lead to more serious negative effects such as the formation of scar tissue that can cause permanent voice loss or even the permanent loss of the ability to swallow.

The Elbow clip design is based on the idea of being “Simple, efficient, affordable.” Figure 3 below presents the CAD model of the design for the 7.0 Hi-Lo Oral/Nasal Tracheal Tube Cuffed Endotracheal Tube made and distributed by Covidien.

Objectives:

The Elbow clip design is aimed to remove pressure from voice box. To achieve this:

• Must produce bend in tube when applied

• Must relieve pressure from the posterior larynx

• Must fit within the prescribed area of application

• Must stay secured to the tube

• Easy to applicate by anyone under various situation

We end up having array of clips available for a wide range of endotracheal tubes with different sizes and shapes. Additionally, the bending angle of the elbow clip is designed to be easily modifiable, with a selection of desired bending angles available.

Outcomes:

• All clips creates effective bending and remove force from the posterior larynx area. For example, the 85º clip decrease the force by approximately 30 g. The clip reduced approximately 43% of the force. The pressure sensor testing would provide more information about this.

• According to various Mannequin and cadaver testings, we are confident to say that the 90º entrance is able to let the tube in while securing the clip position

• According to USP Class VI and ISO 10993, the PMMA we used is medical grades. The Ansys Granta EduPack: Level 3_Bioengineering Database has been used for material selection.