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

Tartan Intubation for Microgravity

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.

http://www.haworth21.karoo.net/Image24.gif | http://www.doctorsoxygenservice.com/home/Portals/0/images/products/Laryngeal%20Masks/Igelimage4.jpg | https://encrypted-tbn0.gstatic. 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

Oropharyngeal Supraglottic Laryngeal Nasopharyngeal Endotracheal

1

The “sniffing position” results in the easiest view of the vocal cords.

http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/anesthesia/site/content/figures/3039F03.gif | Morocco and Reichman, 2004

2

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

Morocco and Reichman, 2004.

3

Many terrestrial treatments exist, but none have been fully developed for space.

Doerr, et al., 2007

Success: 14/14 12/15 17/17

Kneel Cradle Trap Doerr

4

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

• pen airway pathway in partial and

microgravity environments

6

Several criteria must be addressed for a medical device used in space.

Space

• Reusable
• Stand alone
• Portable
• Manual

Medical

• Quickly

implemented

• Simple to use
• 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.

http://www.kingsystems.com/wp-content/uploads/2010/09/LTSDFeature.jpg

10

King LTS-D is a versatile and simple to use airway tool that minimizes airway trauma.

http://www.scdhec.gov/health/Ems/ResourcesKingLT.pdf

11

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

Surg, vol. 194, pp. 802-812, Jun. 2002.

• D. T. Davis, et al. “Intubation Pillow,” U.S. Patent 20110056502 A1,

March 10, 2011.

• H. K. Doerr, et al. “Development of Sub-Optimal Airway Protocols

for the International Space Station (ISS) by the Medical Operation Support Team (MOST)”. (2007). Internet: http://ntrs.nasa. gov/archive/nasa/casi.ntrs.nasa.gov/20070031831_2007025747.pdf [October 30, 2013].

• M. Engoren, et al. “Hospital and Long-term Outcome after

Tracheostomy for Respiratory Failure”, Chest, vol. 125, pp. 220- 227, Jan. 2004.

• M. Morocco, and Reichman, E.F. Emergency Medicine Procedures,

37(2004).

• NASA. “Preliminary Report Regarding NASA’s Space Launch

System and Multi-Purpose Crew Vehicle.” Internet: http://www. nasa.gov/pdf/510449main_SLS_MPCV_90-day_Report.pdf January 2011 [December 10, 2013].

• NASA. “Small Business Innovation Research Small Business

Technology Transfer.” Internet: http://sbir.gsfc.nasa. gov/sbirweb/search/firmSearch.jsp?firm_id=8400500 November 01, 2013 [October 30, 2013]. Orbital Medicine, Inc. “Evaluation of a Medical Chest Drainage System Functional in the Microgravity Environment.” Internet: https: //flightopportunities.nasa.gov/media/technology/26/26-pentachart. pdf [October 30, 2013].

• K. Laffrty. “Rapid Sequence Intubation.” Internet: http://emedicine.

medscape.com/article/80222-overview [October 13, 2013]. Patient.co.uk. “Airways and Intubation”. Internet: http://www.patient. co.uk/doctor/airways-and-intubation [October 13th, 2013].

• H. J. Schmitt, and Mang H. “Head and neck elevation beyond the

sniffing position improves laryngeal view in cases of difficult direct laryngoscopy.” Clinical Anesthesia, vol. 14, pp. 335-338, Aug. 2002.

• M. L. Sole, et al. “Oropharyngeal Secretion Volume in Intubated

Patients: The Importance of Oral Suctioning,” American Journal of Critical Care, vol. 20, pp. e141-e145, 2011.

• H. E. Wang, et al. “Out-of-hospital airway management in the

United States.” Resuscitation, vol. 82, pp. 378-85 (2011).

• N. M. Woodall, and Cook, T.M. “National census of airway

management techniques used for anaesthesia in the UK: first phase

• f the Fourth National Audit Project at the Royal College of

Anaesthetists.” Br J Anaesth, vol. 106, 266-271, (2011).

• S. Zenios, et al. Biodesign: The Process of Innovating Medical
• Technologies. New York, NY, Cambridge University Press, 2010.

Questions?

Hadfield, 2013