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Magnetic and articulating (MNA) Bougie assisted breathing tube placement during intubation

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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Magnetic and articulating (MNA) Bougie assisted breathing tube placement during intubation

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  1. 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

  2. Overview • Recap • Introducer • External magnet • Testing • Requirements and Recommendations

  3. Problem

  4. Problem

  5. Problem

  6. Problem

  7. Last Semester External Magnet Bougie, a.k.a. Introducer

  8. Final Device

  9. Introducer – Overview • Tip selection • Design Issues • Tip encasement Pictures of how the device is made and describing what is coming next

  10. Introducer – Type of Tip

  11. Introducer – Type of Tip

  12. Introducer – Type of Tip

  13. Introducer – Type of Tip

  14. Introducer – Type of Tip • Spherical Magnets • Latex Encasing

  15. Introducer – Design Issues • Flop (Flimsy Tip) • Buckling (Force Direction) • Tip encasement Pictures of how the device is made and describing what is coming next

  16. Introducer – Flop Issue • Due to Force of Breathing Tube ?

  17. Introducer – Flop Issue • Due to Force of Breathing Tube ?

  18. Introducer – Flop Issue • Seven 5 mm magnets = 35 mm of magnets • 55 mm maximum length • Leaves 10 – 20 mm plastic

  19. 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 ?

  20. Introducer – Buckling Issue ?

  21. Introducer – Buckling Issue

  22. Introducer – Tip Encasement External Magnet brought in

  23. Introducer – Tip Encasement ?

  24. Introducer – Tip Encasement – Control – Too Stiff ?

  25. Introducer – Tip Encasement • Layered Latex Dipping – Control – Too Stiff

  26. Introducer – Final Design

  27. External Magnet – Overview Cap Mounting Bracket Pin Magnet Stack Handle

  28. 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.

  29. A block of plastic was sized using modeling clay on the intubation mannequin External Magnet - Handle 2 ” 2” 2”

  30. Magnets are sized using standard test procedures discussed last term, and a suitable hole is cut External Magnet - Handle 1 ”

  31. Steel mounting bracket is designed to hold magnets, and placed in the new cavity at right External Magnet - Handle

  32. Curvature of design intended to give more accurate targeting of trachea, and placement under chin contours External Magnet - Handle

  33. Rounded corners for patient and operator safety External Magnet - Handle

  34. Holes placed for additional mounting apparatus External Magnet - Handle

  35. Testing – Overview • Distance • Thick Neck Model • Time Trials • Failure Modes • Neck Positioning

  36. Testing – Distance External Magnet brought down

  37. Testing – Distance

  38. Testing – Thick Neck Model Thin pieces of rubber representing an obese patient, or a patient with a goiter or tumour.

  39. Testing – Time Trials • Fourteen completed trials: • 12 successful on 1st attempt • 2 successful on 2nd attempt

  40. Testing – Time Trials • Fourteen completed trials: • 12 successful on 1st attempt • 2 successful on 2nd attempt

  41. 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

  42. Testing – Neck Contortion

  43. Destructive Testing – Failure Modes **Confidence interval was calculated assuming t-distribution

  44. Requirements

  45. Recommendations and Unknowns • Material change: Nitrile • Packaging • Cases • Contraindications • Further testing • Cadaver testing • Human clinical trial(s) • Device inspection, classification and approval

  46. Anaesthesiologist Using Our Device

  47. Anaesthesiologist Using Our Device • Clients satisfied with level of completion and quality of work • Quotations from meetings: • “”

  48. Questions ? Thank you to: • Department of Anaesthesia • Dr. Dennis Drapeau • Dr. Andrew Milne • Department of Mechanical Engineering • Dr. Ted Hubbard • Peter Jones • Shell

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