Undergraduates simplify intubation tool for senior design project
San Diego, Calif., April 16, 2020 --A team of UC San Diego undergraduate engineers helped design a simple, all-in-one tool to perform endotracheal intubations, which could simplify the steps clinicians need to take when performing the time-sensitive, complex procedure. The mechanical engineering students took on the challenge as their senior design project, with direction from project sponsor Dr. Taylor Graber of the Department of Anesthesiology at the UC San Diego School of Medicine.
“Our device essentially combines multiple devices into one that can be used using only one hand,” said David Ivison, a mechanical engineering student and team member. “This could save time as well as ensure that the anesthesiologist's attention stays on the airway. This can help ensure patient safety and save lives by reducing procedural time and lowering risk to the patient.”
Endotracheal intubation is most often performed when a patient isn’t able to breathe on their own, either due to trauma or in preparation for a significant surgery. During an intubation, an anesthesiologist inserts a tube into a patient’s mouth and down into their trachea, clearing the airway. Intubation allows the patient to be hooked up to a ventilator to keep them breathing during a procedure, or, as we’re seeing during the COVID-19 pandemic, if a patient is unable to breathe on their own for other reasons.
Currently, anesthesiologists need to use several separate devices over the course of the intubation procedure, which is often completed in less than a minute. Having to transition between these different tools is not optimal, since intubation is a critical procedure performed at a time when a patient is not breathing, and yet their organs are still using up their body’s oxygen stores. Dr. Graber, an anesthesiologist in residency at the UC San Diego School of Medicine with a background in biomedical engineering, tasked the team of four students with developing and iterating on a design for a tool he thought could make the process simpler.
The students spent winter quarter working with Dr. Graber to design a device that combines two previously separate tools required for intubation-- the laryngotracheal cannula and endotracheal tube stylet-- into one streamlined device which could simplify the procedure. A provisional patent for the design has been filed in collaboration with the UC San Diego Office of Innovation and Commercialization. Dr. Graber hopes to obtain investment funding in the future to be able to manufacture the prototype, and then work toward FDA approval for patient trials.
|.The students' final design.|
An intubation currently requires several separate devices: an endotracheal tube, the actual plastic tube connecting the lungs to the oxygen source; a laryngoscope, a device used to move the tongue and soft tissues and provide direct visualization of the vocal cords and trachea with or without a small lens or camera; a stylet, the malleable metal device that goes inside the endotracheal tube, guiding it down the trachea; and the laryngotracheal cannula, which is used to spray lidocaine into the trachea to numb the soft tissues and mucosal surfaces of the airway.
The student’s device, which combines the laryngotracheal cannula and endotracheal tube stylet, simplifies the steps anesthesiologists have to perform. After using a laryngoscope to get a view of where the tube will be inserted, anesthesiologists simply insert the unified device, consisting of the combination laryngotracheal stylet and cannula housed inside of the endotracheal tube, which can be easily guided through the airway and vocal cords into the trachea and spray the lidocaine out of its tip to reduce the noxious stimulus of intubation. The combination device is then removed from the interior of the endotracheal tube, where the tube is left in place in the trachea, providing a conduit for oxygen and mechanical ventilation from a ventilator.
Ivison said that he and the team learned a lot through the project and the senior design course, and not just about the technical skills required to design a complicated device for medical use.
“This class essentially taught students what a real-world project would be like. Projects don't only need knowledge in engineering standards. Real projects need project management skills, budget management skills, and social skills in order to keep sponsors and supervisors or professors up to date as well as ensure that they are on board with progress.”
Team Members: David Ivison, Ascher Ramsay, Jiahao Sun, Daniel Lee
Jacobs School of Engineering