A new handheld, 3D-printed device with a miniature wireless camera could make intubation easier and safer.
Clinicians can use a switch on the comfortable handle to adjust light from an LED near the camera, which feeds high-resolution video to one or multiple monitors.
A team of Rice University bioengineering students designed the laryngoscope, which simplifies intubation for patients undergoing scheduled or emergency procedures.
Kenneth Hiller, an anesthesiologist in private practice, approached the Oshman Engineering Design Kitchen at Rice about collaborating on a laryngoscope that would allow easier access to image the throat and larynx and help place a breathing tube into the trachea.
Hiller, who has a patent on the design, recognized early on that engineering it into a true product would require specialized knowledge.
“Current state-of-the-art devices have limitations,” Hiller says. “Placing an endotracheal tube can be challenging in a significant number of patients’ airways. For years, I’ve mulled over what I’d like in a device that can simplify the process and improve patient safety.”
“He came to us with something built out of popsicle sticks and a metal tube and said, ‘This is what I’m working towards but I don’t know how to build it myself,'” says Rebecca Franklin, who was part of the design team.
“He wanted a video laryngoscope that not only had wireless video but also had a better blade profile,” Victoria Kong says. “There are two main types of laryngoscopes: with straight blades and with curved blades, and all of the video laryngoscopes on the market are in the curved blade format. While that’s great for compressing the tongue to get it out of the way, it has a very high displacement volume. It takes up a lot of room in the mouth.
“That makes it very difficult for the physician to insert the endotracheal tube to give the patient air,” she says. “The straight blade gives you a more direct line of sight. We wanted to combine the stabilization afforded by curved blades and a straight-blade profile, and we did that by tapering our blade.”
Hiller’s request was for a device that would cost under $500. “That’s within the constraints of our project and overall design, but it’s looking like we can easily get it below $200,” Reed Corum says. The vacuum-formed disposable sleeves that cover the blade can be made quickly for pennies.
“It’s unfortunate that we’re developing this so late in the COVID pandemic, because any procedure that requires intubation requires a laryngoscope as well,” David Ikejiani adds.
“I wasn’t really aware of the impact this could have in the context of COVID-19,” Kong says. “But as we got into it, I realized this is an important tool to help airway managers minimize contact with potentially contagious aerosolized particles. And the wireless video capability of our device further creates distance for the safety of the health care provider.”
All of the video-enabled laryngoscopes on the market require wiring to an external monitor, often a small one on the handle of the device itself. “That limits the amount of space and number of people who can be working on the same patient,” she says.
“Having the screen attached makes the scope more delicate and harder to transport from room to room,” Franklin says. “Having the video accessible on a tablet means a doctor in another room can watch and give feedback about technique to the airway manager performing the actual procedure.”
The off-the-shelf camera’s wireless range is about 33 meters (about 108 feet).
The students say they anticipate future refinements to include stainless steel construction for durability. They also see uses for the device beyond the clinic.
“EMTs use their scopes in the field, and we can see expanding to people, for example, in the military who require remote oversight where users may not have expertise gained from years of experience,” Kong says.
Source: Rice University