Curved Bougie Guide for Hyperangulated Intubation
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Solution Overview
Problem
Endotracheal intubation via video laryngoscopy remains challenging due to the difficulty in guiding the endotracheal tube into the trachea, especially with hyperangulated approaches, where existing bougies are either too stiff and risky or too flexible to maintain a curved shape effectively.
Innovation Solution
A pre-shaped, curvilinear guide apparatus is used to deliver a flexible bougie into the trachea under videoscopic visualization, featuring a tapered, elongate tube with primary and secondary curvatures forming an 's' shape to align with the trachea, allowing easy passage and positioning of the bougie, and subsequently the endotracheal tube.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stability of the object's composition
If a stiff, malleable bougie is used to guide the endotracheal tube, then the bougie can hold a curved shape effectively, but it risks potentially fatal injury to the trachea or deeper airways
Solution Approach 1:
A pre-shaped curvilinear guide is introduced as an intermediary device between the operator and the flexible bougie. The guide maintains the desired curved trajectory through its rigid pre-formed shape while the flexible bougie passes through it, allowing the bougie to be shaped without direct manual manipulation that could cause trauma.
Solution Approach 2:
The guide is pre-shaped with the exact curvature needed to navigate the hyperangulated approach and align with the trachea before the procedure begins. This preliminary configuration eliminates the need to manually bend the flexible bougie during the procedure, preventing tracheal injury while ensuring proper alignment.
2Ease of operation
If a soft, non-malleable bougie is used to guide the endotracheal tube, then the bougie is easier to pass between the vocal cords, but it cannot hold a curved shape effectively during video laryngoscopy
Solution Approach 1:
The pre-shaped curvilinear guide serves as a mediator that provides the structural support for maintaining the curved shape, while the flexible bougie passing through it provides the ease of manipulation and passage. The guide's aperture allows the bougie to move freely while the guide itself maintains the trajectory.
3Measurement precision
If a hyperangulated video laryngoscope blade is used to visualize the glottis, then visualization success approaches 100%, but the angle of approach becomes so anterior that the endotracheal tube cannot be slipped beyond the vocal cords
Solution Approach 1:
The pre-shaped curvilinear guide incorporates specific curvatures (primary and secondary) that match the anatomical path from the hyperangulated blade position to the trachea. This curved geometry allows the guide to navigate the anterior angle created by the hyperangulated blade while still aligning with the tracheal entrance.
Solution Approach 2:
The guide changes the angular parameters of the approach by incorporating pre-formed curvatures that convert the hyperangulated blade position into proper tracheal alignment. The primary curvature (approximately 90 degrees) and secondary curvature (approximately 45 degrees) adjust the trajectory to match anatomical requirements.
Data Source
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AI summary
A guide, system and method for endotracheal intubation using a pre-shaped, curvilinear guide to deliver a flexible bougie into the trachea under videoscopic visualization. The guide comprises an elongate tube with sufficient rigidity to maintain a pre-shaped path with multiple curvatures to provide a conduit through which the bougie is passed to the proper location and orientation with respect to the glottis and upper trachea.