Abstract of WO 2007006698 (A1) Surgical drill system comprising a mechanical drill bit and means ... more Abstract of WO 2007006698 (A1) Surgical drill system comprising a mechanical drill bit and means for imaging the vicinity of the drill bit tip, said means comprising: at least one optical fiber having a distal end and a proximal end, said distal end being located adjacent said drill bit tip, an optical processing unit, said proximal end of said at least one optical fiber being operatively connected to said processing unit, said at least one optical fiber directing light transmitted therethrough to the vicinity of said drill bit tip and collecting light reflected back from the vicinity of the drill bit tip, whereby an image in the vicinity of the drill bit tip is produced, wherein at least one optical fiber is housed within the drill bit.
The demand for increased patient safety has led to greater use of simulation training of health p... more The demand for increased patient safety has led to greater use of simulation training of health professionals performing medical procedures. The study aim was to evaluate the usefulness of the Mediseus® Epidural Simulator in teaching basic epidural needle-handling skills. Three groups of 15 anaesthetists (Novice=zero to two year anaesthesia trainees; Intermediate=three- to five-year anaesthesia trainees; Expert=consultants and regional-specialist anaesthetists) from three different medical centres participated. Each participant performed 20 simulated epidural needle insertions and was scored on several parameters (e.g. time, success of the insertion, bone collisions). Following familiarisation with the simulator and the needle insertions, participants answered seven questions on the applicability of the simulator to the teaching of basic epidural needle-handling skills. There was a clear learning effect with regard to the simulation procedure time, this decreasing throughout the exp...
Modern, video laryngoscopes provide an easier view of the glottis, possibly facilitating easier i... more Modern, video laryngoscopes provide an easier view of the glottis, possibly facilitating easier intubations. We describe an objective method for evaluating the benefits of video-assisted laryngoscopy, compared with standard techniques using force measurements. Macintosh and video laryngoscopes (both Karl Storz, Tuttlingen, Germany) were used on the patients until the anesthesiologist was convinced he or she had the best possible view of the glottis. Actual intubation was only performed with the second of the laryngoscopes. Sensors measured the forces directly applied to the patients' maxillary incisors. Additionally, common subjective pre- (e.g., Mallampati) and intraintubation (e.g., Cormack-Lehane [C&L]) metrics of intubation difficulty were evaluated by the anesthesiologists. All patients (24 female, [50 +/- 16 yr], 20 male [56 +/- 13 yr]) included in the study were successfully intubated with both the classic and video laryngoscopes. The forces recorded for the classic Macintosh blade ranged from 0 to 87.4 N with a median of 15.3 N, whereas the video laryngoscope forces ranged from 0 to 45.2 N, with a median of 2.1 N. The only factor determined to be significantly influential on the associated forces applied to the maxillary incisors was the laryngoscope type (P < 0.01). Video-assisted laryngoscopes reduced the applied forces over standard blades. Mallampati and C&L grade were not predictive of the forces applied. Video-assisted laryngoscopes seem beneficial when considering forces applied to the maxillary incisors as an objective metric of intubation difficulty. In this study, we could not support that Mallampati and C&L grades predict the forces that are applied to the maxillary incisors.
... 107:3535 3. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kr... more ... 107:3535 3. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kranke P, Myles P, Philip BK ... To the Editor: Gonzalez et al.1 showed the im-portance of increased neck cir-cumference in predicting difficult tracheal intubations in obese pa-tients ...
Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier int... more Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade. Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope(®) (Verathon Inc., Bothell, WA, USA), V-Mac™ Storz(®) (Karl Storz, Tuttlingen, Germany), and McGrath™ (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz(®) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior to the vocal cords, with actual intubation carried out only with the second of the laryngoscopes. Sensors measured the forces directly applied to the patient's maxillary incisors while inserting the ETT. Other common metrics of intubation difficulty (e.g. Mallampati grade, Cormack-Lehane grade, and time) were also recorded. Only one patient was not intubated within the standard study parameters and was converted to the hospital protocols for difficult intubations. The forces applied to the maxillary incisors were significantly greater with the Macintosh blade compared with all VLSs. There were no differences between the VLSs with regard to the forces. Patient characteristics, including Mallampati grade, were not predictive of the forces applied. All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy.
Abstract of WO 2007006698 (A1) Surgical drill system comprising a mechanical drill bit and means ... more Abstract of WO 2007006698 (A1) Surgical drill system comprising a mechanical drill bit and means for imaging the vicinity of the drill bit tip, said means comprising: at least one optical fiber having a distal end and a proximal end, said distal end being located adjacent said drill bit tip, an optical processing unit, said proximal end of said at least one optical fiber being operatively connected to said processing unit, said at least one optical fiber directing light transmitted therethrough to the vicinity of said drill bit tip and collecting light reflected back from the vicinity of the drill bit tip, whereby an image in the vicinity of the drill bit tip is produced, wherein at least one optical fiber is housed within the drill bit.
The demand for increased patient safety has led to greater use of simulation training of health p... more The demand for increased patient safety has led to greater use of simulation training of health professionals performing medical procedures. The study aim was to evaluate the usefulness of the Mediseus® Epidural Simulator in teaching basic epidural needle-handling skills. Three groups of 15 anaesthetists (Novice=zero to two year anaesthesia trainees; Intermediate=three- to five-year anaesthesia trainees; Expert=consultants and regional-specialist anaesthetists) from three different medical centres participated. Each participant performed 20 simulated epidural needle insertions and was scored on several parameters (e.g. time, success of the insertion, bone collisions). Following familiarisation with the simulator and the needle insertions, participants answered seven questions on the applicability of the simulator to the teaching of basic epidural needle-handling skills. There was a clear learning effect with regard to the simulation procedure time, this decreasing throughout the exp...
Modern, video laryngoscopes provide an easier view of the glottis, possibly facilitating easier i... more Modern, video laryngoscopes provide an easier view of the glottis, possibly facilitating easier intubations. We describe an objective method for evaluating the benefits of video-assisted laryngoscopy, compared with standard techniques using force measurements. Macintosh and video laryngoscopes (both Karl Storz, Tuttlingen, Germany) were used on the patients until the anesthesiologist was convinced he or she had the best possible view of the glottis. Actual intubation was only performed with the second of the laryngoscopes. Sensors measured the forces directly applied to the patients' maxillary incisors. Additionally, common subjective pre- (e.g., Mallampati) and intraintubation (e.g., Cormack-Lehane [C&L]) metrics of intubation difficulty were evaluated by the anesthesiologists. All patients (24 female, [50 +/- 16 yr], 20 male [56 +/- 13 yr]) included in the study were successfully intubated with both the classic and video laryngoscopes. The forces recorded for the classic Macintosh blade ranged from 0 to 87.4 N with a median of 15.3 N, whereas the video laryngoscope forces ranged from 0 to 45.2 N, with a median of 2.1 N. The only factor determined to be significantly influential on the associated forces applied to the maxillary incisors was the laryngoscope type (P < 0.01). Video-assisted laryngoscopes reduced the applied forces over standard blades. Mallampati and C&L grade were not predictive of the forces applied. Video-assisted laryngoscopes seem beneficial when considering forces applied to the maxillary incisors as an objective metric of intubation difficulty. In this study, we could not support that Mallampati and C&L grades predict the forces that are applied to the maxillary incisors.
... 107:3535 3. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kr... more ... 107:3535 3. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kranke P, Myles P, Philip BK ... To the Editor: Gonzalez et al.1 showed the im-portance of increased neck cir-cumference in predicting difficult tracheal intubations in obese pa-tients ...
Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier int... more Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade. Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope(®) (Verathon Inc., Bothell, WA, USA), V-Mac™ Storz(®) (Karl Storz, Tuttlingen, Germany), and McGrath™ (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz(®) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior to the vocal cords, with actual intubation carried out only with the second of the laryngoscopes. Sensors measured the forces directly applied to the patient's maxillary incisors while inserting the ETT. Other common metrics of intubation difficulty (e.g. Mallampati grade, Cormack-Lehane grade, and time) were also recorded. Only one patient was not intubated within the standard study parameters and was converted to the hospital protocols for difficult intubations. The forces applied to the maxillary incisors were significantly greater with the Macintosh blade compared with all VLSs. There were no differences between the VLSs with regard to the forces. Patient characteristics, including Mallampati grade, were not predictive of the forces applied. All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy.
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