A patent airway must be maintained when a patient is undergoing - PowerPoint PPT Presentation

T artan I ntubation for M icrogravity Group 5 Jeffrey Chen, Joshua Chen, Anusha Chinthaparthi, Rebecca Lui, Gillian Tay, Jessica Yuan 42-401: Fundamental of BME Design Thursday, December 12, 2013 Wean Hall 5302

A patent airway must be maintained when a patient is undergoing respiratory distress. Oropharyngeal Supraglottic Laryngeal Nasopharyngeal Endotracheal http://www.haworth21.karoo.net/Image24.gif | http://www.doctorsoxygenservice.com/home/Portals/0/images/products/Laryngeal%20Masks/Igelimage4.jpg | https://encrypted-tbn0.gstatic. 1 com/images?q=tbn:ANd9GcRNhXnU3ROiZI6BipDZO-PWt-YYzm1Kj04yi1YUQKSHBGxnQ_ii | http://www.aic.cuhk.edu.hk/web8/Hi%20res/Intubation.jpg | http://www.cathlabdigest.com/files/3%20PersPatientCare_Cover_Fig%202.png

The “sniffing position” results in the easiest view of the vocal cords. 2 http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/anesthesia/site/content/figures/3039F03.gif | Morocco and Reichman, 2004

Although terrestrial intubations are very common, there are many associated risks. ● Easy to confuse trachea with esophagus ● High risk of damage to vocal cords, teeth, and/or throat ● Possibility of more blood and fluid accumulating 3 Morocco and Reichman, 2004.

Many terrestrial treatments exist, but none have been fully developed for space. Kneel Cradle Trap Doerr Success: 14/14 12/15 17/17 4 Doerr, et al ., 2007

Space adds a new dimension of problems not experienced on Earth. ● Very small habitable area (~11 cubic yards) ● Microgravity → Need for restraints ● Fluid shift → Tissue volume increased ● Organ Shift → Different medical considerations ● Edema from fluid shift → Can cause swelling in brain leading to respiratory inhibition 5

Need: An improved device for ensuring an open airway pathway in partial and microgravity environments 6

Several criteria must be addressed for a medical device used in space. Space Medical ● Reusable ● Quickly ● Stand alone implemented ● Portable ● Simple to use ● Manual ● Long-term solution ● Minimize recovery period ● Maintain a clean environment 7

TIM has two components - support and facial. 8

The support component features a collapsible design. 9

The facial component is a face mask attached to a King’s Airway. 10 http://www.kingsystems.com/wp-content/uploads/2010/09/LTSDFeature.jpg

King LTS-D is a versatile and simple to use airway tool that minimizes airway trauma. 11 http://www.scdhec.gov/health/Ems/ResourcesKingLT.pdf

To summarize, the two-component TIM addresses multiple needs. ● Removes necessity for caregiver restraint ● Adjustable straps for different sizes ● Collapsible and easy to handle ● Easy to use airway system ● Can incorporate fluid suction ● Face mask prevents liquids escaping 12

Our plan of action is divided into seven phases. 13

Acknowledgments Sam Hussey Dr. Michael Dishart John McQuillen Dr. Richard Cole Donna Beck Jenn Hayden Trent Wells Prof. Conrad Zapanta

References M. R. Campbell. “A Review of Surgical Care in Space”, J Am Coll Orbital Medicine, Inc. “Evaluation of a Medical Chest Drainage Surg , vol. 194, pp. 802-812, Jun. 2002. System Functional in the Microgravity Environment.” Internet: https: //flightopportunities.nasa.gov/media/technology/26/26-pentachart. D. T. Davis, et al. “Intubation Pillow,” U.S. Patent 20110056502 A1, pdf [October 30, 2013]. March 10, 2011. K. Laffrty. “Rapid Sequence Intubation.” Internet: http://emedicine. H. K. Doerr, et al . “Development of Sub-Optimal Airway Protocols medscape.com/article/80222-overview [October 13, 2013]. for the International Space Station (ISS) by the Medical Operation Support Team (MOST)”. (2007). Internet: http://ntrs.nasa. Patient.co.uk. “Airways and Intubation”. Internet: http://www.patient. co.uk/doctor/airways-and-intubation [October 13 th , 2013]. gov/archive/nasa/casi.ntrs.nasa.gov/20070031831_2007025747.pdf [October 30, 2013]. H. J. Schmitt, and Mang H. “Head and neck elevation beyond the M. Engoren, et al . “Hospital and Long-term Outcome after sniffing position improves laryngeal view in cases of difficult direct Tracheostomy for Respiratory Failure”, Chest , vol. 125, pp. 220- laryngoscopy.” Clinical Anesthesia , vol. 14, pp. 335-338, Aug. 2002. 227, Jan. 2004. M. L. Sole, et al. “Oropharyngeal Secretion Volume in Intubated M. Morocco, and Reichman, E.F. Emergency Medicine Procedures, Patients: The Importance of Oral Suctioning,” American Journal of 37(2004). Critical Care , vol. 20, pp. e141-e145, 2011. NASA. “Preliminary Report Regarding NASA’s Space Launch H. E. Wang, et al . “Out-of-hospital airway management in the System and Multi-Purpose Crew Vehicle.” Internet: http://www. United States.” Resuscitation , vol. 82, pp. 378-85 (2011). nasa.gov/pdf/510449main_SLS_MPCV_90-day_Report.pdf January 2011 [December 10, 2013]. N. M. Woodall, and Cook, T.M. “National census of airway management techniques used for anaesthesia in the UK: first phase NASA. “Small Business Innovation Research Small Business of the Fourth National Audit Project at the Royal College of Technology Transfer.” Internet: http://sbir.gsfc.nasa. Anaesthetists.” Br J Anaesth , vol. 106, 266-271, (2011). gov/sbirweb/search/firmSearch.jsp?firm_id=8400500 November 01, 2013 [October 30, 2013]. S. Zenios, et al. Biodesign: The Process of Innovating Medical Technologies. New York, NY, Cambridge University Press, 2010.

Questions? Hadfield, 2013