final presentation - senior design course project
TRANSCRIPT
Dynamic Adult Airway Management Trainer (DAAMT)Team 10Ara Bablouzian, Aakash Gupta, Tushar Kesavadas
Endotracheal Intubation
http://airwayeducation.homestead.com/intubation.html
Previous Team - Overall Realism
skin tongue forces for jaw-opening
Inflamed Tongues (Angioedema)
Bramante, R. M., and M. Rand. "Angioedema." New England Journal of Medicine 365.2 (2011). Print.Cohn, J.R., McDaniel, C., Richards, N., Au, C., Baram, M., Airway Obstruction Secondary to Angiotensin Converting Enzyme Inhibitor (ACEI) Induced Angioedema. Thomas Jefferson University and Hospitals, 2012.
Tongue Simulator Needs
Metrics and Specifications# Metric Units Marginal
Value Ideal Value
1 User Testing - Behavior of Tongues Likert Scale Realistic (4) Very Realistic (5)
2 User Testing - Shape and Size Likert Scale Realistic (4) Very Realistic (5)
3 User Testing - Repeated Intubation Before Failure
Number of Intubations 100 200
4 User Testing - Preparation Time Seconds 300 60
5 Max Change in Length mm 5 10
6 Max Change in Width mm 5 10
7 Max Change in Height mm 5 11
Final Design: Overall
1.Model normal and inflamed tongues
a.size, shape, feel
2.Deform realistically
3.Withstand intubation forces
Final Design Criteria - Tongues
Final Design - Tongues
Length Width
Height
Normal vs. Inflamed
Tongue Composition
Shore 00
1.Correctly position tonguea.Touch epiglottis
2.Attach to Silicone3.Withstand forces
Final Design Criteria - Attachment
Attachment Design: Tongue Plate
Attachment Design: Jaw Plate
Attachment Design: Overall
User Testing 1 - Tongue Composition
User Testing 1 - Tongue Composition
height ratio =
X--h
Constant compositionVariable composition
User Testing 1 - Tongue Composition
height ratio
=
X--h
User Testing 1 - Tongue Composition
Constant compositionVariable composition
height ratio =X--h
User Testing 1 - Tongue Composition
Constant compositionVariable composition
X
XXX = Selected Composition
height ratio =X--h
User Testing 2 - Laerdal ComparisonER Doctors (n = 6)
User Testing 2 - Laerdal ComparisonMovement of the Tongue
Paired Difference = (Score for our model) - (Score for Laerdal)
User Testing 2 - Laerdal ComparisonCompressibility of the Tongue
Paired Difference = (Score for our model) - (Score for Laerdal)
User Testing 2 - Laerdal ComparisonOverall Feel of Intubation
Paired Difference = (Score for our model) - (Score for Laerdal)
User Testing 3 - Intubation DifficultyResidents, ER Doctors, Nurses (n = 18)
User Testing 3 - Intubation Difficulty
● Residents = 11○ Emergency Medicine○ Anesthesia
● CRNAs = 3
● Practitioners = 4○ Emergency Medicine○ General Surgery
User Testing 3 - Intubation Difficulty
User Testing 3 - Intubation Difficulty
User Testing 3 - Intubation Difficulty
User Testing 3 - Intubation Difficulty
● Repeated Measures ANOVA (p < 0.001)○ 4 groups○ Paired analysis
● Post-Hoc Bonferroni Multiple Comparisons○ alpha = 0.05/6 = 0.0083
***
User Testing 4 - Time to InterchangeStudents and shop guys (n = 5)
User Testing 4 - Time to Interchange
● Normal Tongue○ Mean = 55.0 seconds○ SD = 7.38 seconds
● Severely Inflamed Tongue○ Mean = 79.8 seconds○ SD = 22.6 seconds
Metrics and Specifications# Metric Units Marginal
Value Ideal Value Final Value
1 User Testing - Behavior of Tongues Likert Scale Realistic (4) Very Realistic (5)
3.5, 3, 4, 4
2 User Testing - Shape and Size Likert Scale Realistic (4) Very Realistic (5)
3.5, 4, 4, 4
3 User Testing - Repeated Intubation Before Failure
Number of Intubations 100 200 80
4 User Testing - Preparation Time Seconds 300 60 55, 80
5 Max Change in Length mm 5 10 10
6 Max Change in Width mm 5 10 10
7 Max Change in Height mm 5 11 11
Future WorksCover entire face with continuous skin
Create obstructions in the airway itself
Standardize frenulum and tongue positioning
ANY QUESTIONS?Special thanks to:
Professor Gatchell, Dr. Jared Novack, Joe Luciani,Steven Houg, and NorthShore Sim Labs
Technical Drawings - Tongue Plate
Technical Drawings - Jaw Plate
Tongue Sizes - ?????????
Inflamed
Healthy
Top ViewSide View
Final Tongue Dimensions
Tongue Sizes Length (mm) Width (mm) Height (mm)
Normal 83.1 44 23
Minimally Inflamed
83.1 44 28
Moderately Inflamed
88.1 49.5 30.5
Severely Inflamed
93.1 55 33
1.Maintain realistic forces
2.Accurate resting gape
3.Acommodate for interchangeable tongues
Final Design Criterion - Jaw