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Group Members: Chris Cloney Laura Hadley brian joseph Ian Westhaver Supervisor: Dr. Ted Hubbard Clients: dr. Andrew Milne 1,2 , dr. Dennis Drapeau 1 1 Department of anesthesia – Dalhousie university 2 School of Biomedical Engineering – Dalhousie University.
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Group Members: Chris Cloney Laura Hadley brian joseph Ian Westhaver Supervisor: Dr. Ted Hubbard Clients: dr. Andrew Milne1,2, dr. Dennis Drapeau1 1 Department of anesthesia – Dalhousie university 2 School of Biomedical Engineering – Dalhousie University Magnetic and articulating (MNA) Bougieassisted breathing tube placement during intubation Group #7 Dalhousie University Senior Design Project
Overview • Recap • Introducer • External magnet • Testing • Requirements and Recommendations
Last Semester External Magnet Bougie, a.k.a. Introducer
Introducer – Overview • Tip selection • Design Issues • Tip encasement Pictures of how the device is made and describing what is coming next
Introducer – Type of Tip • Spherical Magnets • Latex Encasing
Introducer – Design Issues • Flop (Flimsy Tip) • Buckling (Force Direction) • Tip encasement Pictures of how the device is made and describing what is coming next
Introducer – Flop Issue • Due to Force of Breathing Tube ?
Introducer – Flop Issue • Due to Force of Breathing Tube ?
Introducer – Flop Issue • Seven 5 mm magnets = 35 mm of magnets • 55 mm maximum length • Leaves 10 – 20 mm plastic
Introducer – Buckling Issue • Buckling issue occurs when the angle between the trachea and mouth is sharp, and the magnetic tip buckles at the tracheal opening ?
Introducer – Tip Encasement External Magnet brought in
Introducer – Tip Encasement – Control – Too Stiff ?
Introducer – Tip Encasement • Layered Latex Dipping – Control – Too Stiff
External Magnet – Overview Cap Mounting Bracket Pin Magnet Stack Handle
External Magnet – Stack Size • The size of the magnet stack was chosen through qualitative testing. • The final magnet stack was as large as possible but still comfortable for a range of hand sizes.
A block of plastic was sized using modeling clay on the intubation mannequin External Magnet - Handle 2 ” 2” 2”
Magnets are sized using standard test procedures discussed last term, and a suitable hole is cut External Magnet - Handle 1 ”
Steel mounting bracket is designed to hold magnets, and placed in the new cavity at right External Magnet - Handle
Curvature of design intended to give more accurate targeting of trachea, and placement under chin contours External Magnet - Handle
Rounded corners for patient and operator safety External Magnet - Handle
Holes placed for additional mounting apparatus External Magnet - Handle
Testing – Overview • Distance • Thick Neck Model • Time Trials • Failure Modes • Neck Positioning
Testing – Distance External Magnet brought down
Testing – Thick Neck Model Thin pieces of rubber representing an obese patient, or a patient with a goiter or tumour.
Testing – Time Trials • Fourteen completed trials: • 12 successful on 1st attempt • 2 successful on 2nd attempt
Testing – Time Trials • Fourteen completed trials: • 12 successful on 1st attempt • 2 successful on 2nd attempt
Testing – Time Trials • Fourteen completed trials: • 12 successful on 1st attempt • 2 successful on 2nd attempt • Introducer Only: 8.7 ± 1.4 s (95% CI) • Breathing Tube Placement: 21.5 ± 2.0 s (95% CI) **Confidence interval was calculated assuming t-distribution
Destructive Testing – Failure Modes **Confidence interval was calculated assuming t-distribution
Recommendations and Unknowns • Material change: Nitrile • Packaging • Cases • Contraindications • Further testing • Cadaver testing • Human clinical trial(s) • Device inspection, classification and approval
Anaesthesiologist Using Our Device • Clients satisfied with level of completion and quality of work • Quotations from meetings: • “”
Questions ? Thank you to: • Department of Anaesthesia • Dr. Dennis Drapeau • Dr. Andrew Milne • Department of Mechanical Engineering • Dr. Ted Hubbard • Peter Jones • Shell