Dataset Information

Design, development, and face validation of an intubation simulation device using real-time force data feedback.

ABSTRACT:

Objectives

To develop a novel laryngoscope device capable of dynamically measuring force and torque measurements in real-time during intubation and to explore the efficacy of such a device through a face validation simulation.

Methods

The torque sensor laryngoscope is designed for use during intubation and is modeled after a standard, single-use plastic laryngoscope. After device calibration, a face validation study was performed with intubation experts in the field. Quantitative data (intubation force metrics) and qualitative data (expert feedback on the device) were collected from three intubations using a Mac blade and three intubations with the Miller blade.

Results

Three experts (two anesthesiologists and one otolaryngologist) participated in the study. The mean maximum force exerted with the Mac blade was 24.5 N (95% confidence interval [CI], 22.3-26.8). The average force exerted was 13.6 N (95% CI, 11.7-15.5). The average total suspension time was 13.1 s (95% CI, 10.4-15.8). The average total impulse was 164.6 N·s (95% CI, 147.9-181.4). The mean maximum force exerted with the Miller blade was 31.6 N (95% CI, 26.4-36.8). The average force exerted was 15.8 N (95% CI, 13.8-17.9). The average total suspension time was 11.3 s (95% CI, 9.9-12.6). The average total impulse was 216.2 N·s (95% CI, 186.5-245.9). The mean maximum force (p = .0265) and total impulse (p = .009) were significantly higher in the Miller blade trials than in the Mac blade trials. Survey results found that this device, while bulky, intubated similarly to standard-use models and has potential as an intubation teaching tool.

Conclusion

The torque sensor laryngoscope can measure and display real-time intubation force metrics for multiple laryngoscope blades. Initial validation studies showed a significantly lower maximum force and total impulse when intubating with the Mac blade than with the Miller blade. Face validation survey results were positive and suggested the potential for this device as a teaching tool.

Level of evidence

Level 5.

SUBMITTER: Rao GM

PROVIDER: S-EPMC9575137 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Design, development, and face validation of an intubation simulation device using real-time force data feedback.

Rao Gopikrishna M GM Rao Vishwanatha M VM Juang Jeremy J Benoit Justin J Feng Allen L AL Song Phillip C PC

Laryngoscope investigative otolaryngology 20220915 5

<h4>Objectives</h4>To develop a novel laryngoscope device capable of dynamically measuring force and torque measurements in real-time during intubation and to explore the efficacy of such a device through a face validation simulation.<h4>Methods</h4>The torque sensor laryngoscope is designed for use during intubation and is modeled after a standard, single-use plastic laryngoscope. After device calibration, a face validation study was performed with intubation experts in the field. Quantitative ...[more]

PMID: 36262463

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Project description:BackgroundMajor incidents correspond to any situation where the location, number, severity, or type of casualties requires extraordinary resources. Major incident management must be efficient to save as many lives as possible. As any paramedic or emergency medical technician may unexpectedly have to respond to major incidents, regular training is mandatory. Those trainings usually include simulations. The vast majority of major incident simulations are limited by the fact that simulated patients do not evolve during the simulation, regardless of the time elapsed and treatment decisions. Therefore, most simulations fail to incorporate the critical temporal effect of decision-making.ObjectiveThis study aimed to develop and validate a simplified mathematical model of physiology, capable of plausibly simulating the real-time evolution of several injuries.MethodsA modified version of the user-centered design framework, including a relevance, development, and validation phase, was used to define the development process of the physiological model. A 12-member design and development team was established, including prehospital physicians, paramedics, and computer scientists. To determine whether the developed model was clinically realistic, 15 experienced professionals working in the prehospital field participated in the validation phase. They were asked to rate clinical and physiological parameters according to a 5-point Likert scale ranging from 1 (impossible) to 5 (absolutely realistic).ResultsThe design and development team led to the development of the HUMAn model (Human is an Uncomplicated Model of Anatomy). During the relevance phase, the team defined the needed features of the model: clinically realistic, able to compute the evolution of prehospital vital signs, yet simple enough to allow real-time computation for several simulated patients on regular computers or tablets. During the development phase, iterations led to the development of a heart-lung-brain interaction model coupled to functional blocks representing the main anatomical body parts. During the validation phase, the evolution of nine simulated patients presenting pathologies devised to test the different systems and their interactions was assessed. Overall, clinical parameters of all patients had a median rating of 5 (absolutely realistic; IQR 4-5). Most (n=52, 96%) individual clinical parameters had a median rating of 5, the remainder (n=2, 4%) being rated 4. Overall physiological parameters of all patients had a median rating of 5 (absolutely realistic; IQR 3-5). The majority of individual physiological parameters (n=43, 79%) had a median rating of 5, with (n=9, 17%) rated 4, and only (n=2 ,4%) rated 3.ConclusionsA simplified model of trauma patient evolution was successfully created and deemed clinically realistic by experienced clinicians. This model should now be included in computer-based simulations and its impact on the teaching of major incident management assessed through randomized trials.

Dataset Information

Design, development, and face validation of an intubation simulation device using real-time force data feedback.

Objectives

Methods

Results

Conclusion

Level of evidence

Publications

Design, development, and face validation of an intubation simulation device using real-time force data feedback.

Similar Datasets

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