1. 1. The No-Hurt Insert: Proximity Device to Monitor ETT Position Hyde, Manuel, Russin, Shrestha Senior Projects Conference May 9, 2014
2. 2. Complications of Endotracheal Intubation Esophageal Intubation Patient hypoxia Bronchial Intubation Right lung hyperinflation Left lung collapse These problems are caused by prolonged endotracheal tube (ETT) misplacement Divatia, J.V., and K. Bhowmick. "Complications of Endotracheal Intubation and Other Airway Management Procedures. Indian Journal of Anaesthesiology 49.4 (2005): 308-18. Adapted from Wikipedia user PhilippN Problem Solutions Specifications Design Prototype Testing Review Future carina
3. 3. Problems with Current Solutions Chest X-Ray Verifies ETT placement inside trachea (Hossein-Nejad 2013) Radiation exposure on the order of 3-4 mRem (Bubsy 2011) Bilateral Ausculation Listening to breaths using a stethoscope 60% of main stem bronchial intubations occurred despite the presence of equal breath sounds (Brunel et al. 1989) Bubsy, Bruce. "Radiation and Risk." The Radiation Information Network. Idaho State University. 2011. Brunel, W., D.L. Coleman, D.E. Schwartz, E. Peper, and N.H. Cohen. "Assessment of Routine Chest Roentgenograms and the Physical Examination to Confirm Endotracheal Tube Position." Chest 96.5 (1989): 1043-1045. Adapted from Khan 2009 Adapted from gstatic.com Problem Solutions Specifications Design Prototype Testing Review Future
4. 4. Problems with Current Solutions Capnometry Monitoring of concentration and partial pressure of CO2 in exhaled air Cannot detect endobronchial intubation An ideal solution would involve continuous monitoring of the position of the ETT so that it would always be where it needs to be Problem Solutions Specifications Design Prototype Testing Review Future Sanders, A.B.. "Capnometry in Emergency Medicine." Annals of Emergency Medicine 18.12 (1989): 1287-90.
5. 5. Specifications Problem Solutions Specifications Design Prototype Testing Review Future Product Specification Design Specification 1. Product cannot fall off in patient Degree of Collapse < 0.5 under ISO standard 10079-3 2. Airflow change caused by the product must be insignificant Airflow cannot be reduced by more than 20% under ASTM F 1242-96 and ISO 5631 3. End user is alerted with well- understood alarms Alerts with tonal sequence of A4-C4-F4- A4-C4 under IEC 60601 4. Immune to the operational environment Variations in humidity and temperature do not affect the results 5. Negligible time to first results Time for data acquisition is less than half a second 6. Electrical components must be isolated from the patient No exposed wires and leakage current will meet IEC 60601 (under 300 A) 7. Materials are biocompatible Product composed of same material as endotracheal tube
6. 6. Standards-Driven Specifications Problem Solutions Specifications Design Prototype Testing Review Future PS 1: FIXATION Same Material as ETT Diameter deformation of