1. The No-Hurt Insert: Proximity Device to Monitor ETT Position
Hyde, Manuel, Russin, Shrestha Senior Projects Conference May 9,
2014
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. 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. 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. 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. Standards-Driven Specifications Problem Solutions
Specifications Design Prototype Testing Review Future PS 1:
FIXATION Same Material as ETT Diameter deformation of