1
|
Berard D, Navarro JD, Bascos G, Harb A, Feng Y, De Lorenzo R, Hood RL, Restrepo D. Novel expandable architected breathing tube for improving airway securement in emergency care. J Mech Behav Biomed Mater 2020; 114:104211. [PMID: 33285451 DOI: 10.1016/j.jmbbm.2020.104211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/30/2020] [Accepted: 11/15/2020] [Indexed: 11/17/2022]
Abstract
Life-saving interventions utilize endotracheal intubation to secure a patient's airway, but performance of the clinical standard of care endotracheal tube (ETT) is inadequate. For instance, in the current COVID-19 crisis, patients can expect prolonged intubation. This protracted intubation may produce health complications such as tracheal stenosis, pneumonia, and necrosis of tracheal tissue, as current ETTs are not designed for extended use. In this work, we propose an improved ETT design that seeks to overcome these limitations by utilizing unique geometries which enable a novel expanding cylinder. The mechanism provides a better distribution of the contact forces between the ETT and the trachea, which should enhance patient tolerability. Results show that at full expansion, our new ETT exerts pressures in a silicone tracheal phantom well within the recommended standard of care. Also, preliminary manikin tests demonstrated that the new ETT can deliver similar performance in terms of air pressure and air volume when compared with the current gold standard ETT. The potential benefits of this new architected ETT are threefold, by limiting exposure of healthcare providers to patient pathogens through streamlining the intubation process, reducing downstream complications, and eliminating the need of multiple size ETT as one architected ETT fits all.
Collapse
Affiliation(s)
- David Berard
- University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA
| | - Juan David Navarro
- University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA
| | - Gregg Bascos
- University of Texas at San Antonio, Department of Biomedical Engineering, San Antonio, TX, USA
| | - Angel Harb
- University of Texas at San Antonio, Department of Biomedical Engineering, San Antonio, TX, USA
| | - Yusheng Feng
- University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA
| | - Robert De Lorenzo
- University of Texas Health Science Center at San Antonio, Department of Emergency Medicine, San Antonio, TX, USA
| | - R Lyle Hood
- University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA; University of Texas at San Antonio, Department of Biomedical Engineering, San Antonio, TX, USA; University of Texas Health Science Center at San Antonio, Department of Emergency Medicine, San Antonio, TX, USA
| | - David Restrepo
- University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA.
| |
Collapse
|
2
|
Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC, Wright J, Adirim T, Agus MS, Callahan J, Gross T, Lane N, Lee L, Mazor S, Mahajan P, Timm N, Goodloe J, Brown K, Abell B, Alson R, Bachista K, Bowman L, Boynton H, Brown SA, Chang A, Copeland D, De Lorenzo R, Douglas D, Fowler R, Gallagher J, Gilliam S, Guyette F, Holland D, Jarvis J, Kalan C, Keeperman J, Kupas D, Lairet J, Levy M, Lyon K, Manifold C, McCabe-Kline K, Mell H, Miller B, Millin M, Rosen B, Ross J, Ryan K, Sanko S, Schlesinger S, Sheppard C, Sibold H, Smith S, Spigner M, Stracuzzi V, Tanski C, Tennyson J, White C, Wilcocks D, Yee A, Young T, Foresman-Capuzzi J, Johnson R, Martin H, Milici J, Brandt C, Nelson N, Lyng J, Watson S, Remick K, Dietrich A, Bates K, Flake F, Flores G. Pediatric Readiness in Emergency Medical Services Systems. Ann Emerg Med 2020; 75:e1-e6. [DOI: 10.1016/j.annemergmed.2019.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/28/2022]
|
3
|
Akhter F, Schoppe A, Navarro O, Carroll C, Jain P, Pescador R, Feng Y, De Lorenzo R, Hood RL. Characterization of a Novel Emergency Suction Device for Combat Medics. J Med Device 2019. [DOI: 10.1115/1.4043738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Airway clearance is a foremost priority for combat medics dealing with battlefield trauma. This life saving intervention starts with inspection, clearing any obstructions from the airway, and if necessary, placement of an endotracheal tube to secure the airway. For inspecting and clearing the airway under complicated battlefield conditions, combat medics require a portable suction device that is compact, lightweight, rugged, and capable of rapidly evacuating a mix of liquid and solid particles, which may include bone fragments or broken teeth. While several portable suction devices are available on the market, none were developed specifically for the combat environment. Interviews with combat medics and other relevant personnel revealed that currently available systems are limited in utility to the point of often being intentionally omitted from their kits. In addition, these discussions identified several design specifications for a desired system, such as size (30 × 10 × 10 cm), weight (≤1 kg), fluid flowrate (1 L/min), and canister size (0.5–1 L), among others. This research focused on developing and characterizing a functional prototype within the specified design criteria. After designing and fabricating the device, evacuation of water, blood mimicking solution, and simulated vomitus solution were assessed. In addition, a comparative analysis was carried out between the five different commercially available suction catheters by assessing fluid flow rate and obstruction resistance. The results demonstrate the first proof-of-concept characterization for a novel combat-oriented suction system and provide a basis for comparing the performance of suction systems and catheters used in airway management.
Collapse
Affiliation(s)
- Forhad Akhter
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Austin Schoppe
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Omar Navarro
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Christopher Carroll
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Priya Jain
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Ricardo Pescador
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Yusheng Feng
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Robert De Lorenzo
- Department of Emergency Medicine, UT Health San Antonio, San Antonio, TX 78229
| | - R. Lyle Hood
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| |
Collapse
|
4
|
|
5
|
Reid RL, Alexander CA, Deagle EA, Berigan TR, Powell JA, Hagar MJ, De Lorenzo R. Letters to the Editor. Mil Med 1998. [DOI: 10.1093/milmed/163.6.iii] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|