Assessment of Movement Patterns during Intubation between Novice and Experienced Providers Using Mobile Sensors: A Preliminary, Proof of Concept Study

Abstract

Background. There are likely marked differences in endotracheal intubation (ETI) techniques between novice and experienced providers. We performed a proof of concept study to determine if portable motion technology could identify the motion components of ETI between novice and experienced providers. Methods. We recruited a sample of novice and experienced providers to perform ETIs on a cadaver. Their movements during ETI were recorded with inertial measurement units (IMUs) on the left wrist. The signals were assessed visually between novice and experienced providers to identify areas of differences at key steps during ETI. We then calculated spectral smoothness (SS), a quantitative measure inversely related to movement variability, for all ETI attempts. Results. We enrolled five novice and five experienced providers. When visually inspecting the data, we noted maximum variability when inserting the blade of the laryngoscope into the mouth and while visualizing the glottic opening. Novice providers also had greater overall variability in their movement patterns (SS novice 6.4 versus SS experienced 26.6). Conclusion. Portable IMUs can be used to detect differences in movement patterns between novice and experienced providers in cadavers. Future ETI educational efforts may utilize portable IMUs to help accelerate the learning curve of novice providers.

Muscle activity during endotracheal intubation using 4 laryngoscopes (Macintosh laryngoscope, Intubrite, TruView Evo2 and King Vision) – A comparative study

“…The energy developed by muscles is transmitted to the patient's airway through the laryngoscope in the form of horizontal and perpendicular forces to expose the glottis. The traditional direct laryngoscopy using the Macintosh laryngoscope blade requires the line-of-sight alignment of the patient's mouth, pharynx, and larynx and adjustment of body posture to gain binocular vision and produce optimal lifting and pushing [2]. The laryngoscope Intubrite is advertised by the manufacturer as a new, ergonomic shape handle.…”

“…3. Model badawczy -pomiar aktywności mięśni używanych w trakcie intubacji za pomocą oprogramowania komputerowego i aparatu MyoPlus 2 in the left arm and shoulder [2]. The studied muscles were: biceps brachii, triceps brachii and deltoideus in the left upper limb.…”

Evaluating the Use of an Aerosol Box During Simulated Intubations

“…Literature supports the use of commercial motion sensors as a cost-effective method for kinematic evaluations involving human performance [19], but there are currently only a handful of articles that have described investigations involving motion sensors during intubations [6,[21][22][23][24]. However, to our knowledge, this is the first study that makes use of accelerometry motion sensors as a surrogate for evaluating how endotracheal intubation technique differs when practitioners are placed under experimental conditions.…”

Manikin Laryngoscopy Motion as a Predictor of Patient Intubation Outcomes: A Prospective Observational Study

“…Other investigators have compared the motion of experienced and novice laryngoscopists. Carlson and colleagues 34 reported that emergency medicine attendings differed from residents and beginners in smoother laryngoscope acceleration, less variability in movement patterns, and greater consis- tency in the angle of the laryngoscope handle. 32 Rahman and colleagues found that laryngoscope angle was a distinguishing feature with experienced anesthetists tilting the laryngoscope farther from vertical than did medical students.…”