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BME 272 Senior Design Group 20 Project Undertaken by: Fritz Haimberger

Emergency Airways Modification of Transtracheal Jet Ventilation and Retrograde Intubation Techniques. BME 272 Senior Design Group 20 Project Undertaken by: Fritz Haimberger Advisor: Dr. Steven J. White, Asst. Professor of Emergency Medicine, VUMC. Background. Emergency Airway Maintenance

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BME 272 Senior Design Group 20 Project Undertaken by: Fritz Haimberger

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  1. Emergency AirwaysModification of Transtracheal Jet Ventilation and Retrograde Intubation Techniques BME 272 Senior Design Group 20 Project Undertaken by: Fritz Haimberger Advisor: Dr. Steven J. White, Asst. Professor of Emergency Medicine, VUMC

  2. Background • Emergency Airway Maintenance • Pre-hospital care • PtL • Combitube • Endotracheal (ET) Tube • Nasotracheal Tube • Hospital Care • ET tube

  3. Transtracheal Jet Ventilation (TTJV) • Used to rapidly initiate ventilation in a trauma case with difficult airway access in the ER • Temporizing measure until a patent airway can be secured via ET tube placement • Usually followed by retrograde intubation

  4. Retrograde Intubation • Performed via second puncture hole in cricothyroid membrane • Catheter is aimed cephalad instead of toward the lungs • Wire inserted through catheter, advanced up trachea and out mouth • ET tube placed over guide-wire and advanced down the windpipe into position for use as a patent airway

  5. Tracheal Anatomy and Device Placement

  6. Project Definition • Come up with one device that conforms to the following requirements: • Provide rapid temporary airway with manual jet ventilator • Provide means to perform retrograde intubation • Accomplishes retrograde intubation through separate lumen in catheter that allows for insertion of wire to be eventually withdrawn from mouth and used for ET tube insertion • Safely combines these two sequential procedures (one being rapid and temporizing while the other is more time-consuming yet definitive) into one step that significantly decreases the composite risk

  7. Market Analysis • Ability for use in any emergency department, most likely a Level 1 Trauma Center (VUMC) • Any case with upper airway compromise • Total cost, disposable and non-disposable equipment approaches $1,000 • Disposable (tubes, catheters) = $250-300 • Non-disposable (laryngoscope blades, oxygen regulator, jet ventilator) = $600

  8. Current Status • Researching • History of TTJV and retrograde intubation • Costs of procedures at various hospitals • Setting up times for ER observation • Develop more regular meeting schedule with advisor

  9. Future Work • Research more on current devices’ traits and brainstorm proposed designs • Investigate the FGH engineering shop’s progress regarding buying a rapid prototype machine next semester

  10. Questions???

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