Team 4
Elizabeth Hales, Blake Mersman, Maria Nasab, Christopher Raymond
Feedback Driven Self-Guided Training Laryngoscope
Team 4 is sponsored by Dr. Dylan Cooper, IU School of Medicine, Brian Overshiner B.S., R.T.(T.), and Tim Nisi B.A, IU Health's 3D Lab Innovation. The project consisted of finding a solution to train rising medical professionals on how to intubate without the constant assistance of a trained medical professional, meaning that a trainee can learn the procedure without a trainer looking over their shoulder to see how the procedure is being done. Team 4 worked on designing a laryngoscope that provided immediate feedback to the user while performing the intubation process on a mannequin.
Background & Significance
A laryngoscope is used by a medical professional primarily to look into a patient’s throat and achieve the best view of the larynx and vocal cords. Patients who require intubation need breathing assistance during severe illness, anesthesia, or sedation. Intubation is necessary for a patient under anesthesia because the patient’s muscles become paralyzed, including the diaphragm, so the patient is unable to breathe without assistance.
33,000 people die per year in the U.S. due to ‘wrong pipe’ intubation. Some studies have cited 25% to 39% of patients requiring direct laryngoscopies accrue minimal to extensive dental damage to the maxillary incisors with an average of $2000 in corrective dental expenses. Anesthesiologists and hospitals may experience lawsuits in which liability is determined by whether the physician’s place of work covers liabilities.
Point of Care
User Needs
The team identified 4 key user needs that the prototype needs to have in order to adhere to the standards of the solution.
Reusable
A typical airway head trainer is meant to last a lifetime so, the laryngoscope should function similarly.
Reliable
The device will need to have a measure of accuracy to ensure that the learner is properly performing the procedure.
Independent
The device shall allow the user to use the device independent of an instructor.
Capable of Live Feedback
The device should alert the user with live feedback based on the angle and location of the laryngoscope.
Prototype Overview
Phase 1 (Placement)
The placement of the tip of the Laryngoscope in the vallecula is critical to achieving a proper view of the airway. To tackle this problem, the team created a circuit through the laryngoscope that would make an LED light up when the user is in the correct place. To do this, the team adhered the TENS patch (conductive material) onto the silicone in the vallecula in order to complete the circuit. Now when the user sees the LED light up, the user knows the tip of the laryngoscope is in the correct place. Figure 1 shows the prototype designed when the laryngoscope's tip is at the vallecula.
Phase 2 (Orientation)
The second phase is more technical as it is imperative for a proper angle to be maintained throughout the second phase of the procedure. The laryngoscope cannot be rocked backward onto the teeth, as this causes dental damage and possible surgical complications. To prevent this rocking motion, a gyroscope was placed on the laryngoscope to monitor the angle at which the laryngoscope is moved. When the level observed a change outside a certain specified degree of motion, a signal would be sent to a small speaker which will audibly alert the user should the angle limitations be exceeded. Testing was conducted with the project sponsor to determine an angle of 47.2 degrees (relative to the z-axis) is the maximum ideal angle during the second phase of the procedure which will avoid hitting the teeth. Figure 2 shows the speaker that alerts the user upon exceeding the accepted angle range.
Figure 1. Picture showing the feedback LED light up when the tip of the laryngoscope is in contact with the TENS patch which is adhered onto the vallecula.
IMG_8925.movFigure 2. Video of a user intubating using the feedback laryngoscope. The speaker is alerting the user when an unacceptable angle is reached.
Poster
Team04_Poster_2022_WITHOUT_FEA.pptxWho we are
Blake Mersman is in the Biomechanics depth area and is planning on moving into the 5 year Masters program at IUPUI for the '22-'23 school year. Upon Completing the Masters program, he plans on moving into industry.
Maria Nasab is a Bioinstrumentation focus who is planning to work in industry at either at a medical device or pharmaceutical company after graduation. She is also aiming to obtain an MBA to further her business acumen.
Elizabeth Hales is completing her B.S. in Biology degree from Marian University in conjunction with her BME degree (depth in biomaterials and tissue engineering). She has accepted a job offer to work in product development at Exelead, a biopharmaceutical company specializing in liposomal formulations.
Christopher Raymond is a dual degree student. Getting his Butler Degree is Computer Science and his IUPUI degree is BME Bioinstrumentation focus. After graduation Christopher’s plan is to work at a start-up that integrates AI and wound healing to estimate and provide the best course of corrective action.
Acknowledgments
We would like to thank Dr. Cooper, Tim Nisi, and Brian Overshiner for presenting us with the opportunity to experience first-hand the biomedical engineering design process in the scope of industry. We want to share our gratitude toward Dr. Yoshida for providing his expertise. We would also like to extend a special thank you to Sherry Clemens for her constant support and optimistic encouragement.