Carey Jason P, Gwin Morgan, Kan Andrew, Toogood Roger, Finegan Barry
Department of Mechanical Engineering, University of Alberta, Edmonton, AL, T6G 2G8, Canada.
Department of Anesthesiology and Pain Medicine, University of Alberta, 8-120 Clinical Sciences Building, Edmonton, AB, Canada, T6G 2G3.
J Med Device. 2010 Sep 1;4(3):031009. doi: 10.1115/1.4002237. Epub 2010 Sep 9.
Cricothyrotomy is one of the procedures used to ventilate patients with upper airway blockage. This paper examines the most regularly used and preferred cricothyrotomy devices on the market, suggests critical design specifications for improving cricothyrotomy devices, introduces a new cricothyrotomy device, and performs an engineering evaluation of the device's critical components. Through a review of literature, manufacturer products, and patents, four principal cricothyrotomy devices currently in clinical use were identified. From the review, the Cook™ Melker device is the preferred method of clinicians but the device has acknowledged problems. A new emergency needle cricothyrotomy device (ENCD) was developed to address all design specifications identified in literature. Engineering, theoretical, and experimental assessments were performed. In situ evaluations of a prototype of the new device using porcine specimens to assess insertion, extraction, and cyclic force capabilities were performed. The device was very successful in its evaluation. Further discussion focuses on these aspects and a comparison of the new device with established devices. The proposed emergency needle cricothyrotomy device performed very well. Further work will be pursued in the future with in-vitro and in-vivo with canine models demonstrates the capabilities of the ENCD.
环甲膜切开术是用于为上呼吸道阻塞患者进行通气的手术之一。本文研究了市场上最常用且最受青睐的环甲膜切开术器械，提出了改进环甲膜切开术器械的关键设计规格，介绍了一种新型环甲膜切开术器械，并对该器械的关键部件进行了工程评估。通过对文献、制造商产品和专利的综述，确定了目前临床使用的四种主要环甲膜切开术器械。经综述发现，库克™梅尔克尔器械是临床医生的首选方法，但该器械存在公认的问题。为满足文献中确定的所有设计规格，开发了一种新型紧急环甲膜切开针器械（ENCD）。进行了工程、理论和实验评估。使用猪标本对新器械原型进行原位评估，以评估其插入、拔出和循环力能力。该器械在评估中非常成功。进一步的讨论聚焦于这些方面，并将新器械与现有器械进行了比较。所提出的紧急环甲膜切开针器械表现非常出色。未来将进一步开展工作，通过犬类模型进行体外和体内实验，以证明ENCD的能力。
