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WARNING SYSTEM TO DETECT CONTACT WITH UPPER TEETH DURING LARYNGOSCOPY

Department of Anesthesia, Health Science Centre, St. John's, NF A1B 3V6

INTRODUCTION

Damage to the teeth is the most common complication during laryngoscopy⁽¹⁾ with an incidence of 0.02% to 0.7%⁽²⁾.

METHODS

A size 3 Macintosh Laryngoscope blade was modified to incorporate a Force Sensing Resistor (FSR), connected by a wire to an integrated circuit that could activate a buzzer and two light-emitting diodes (LED). "Slight" pressure resulted in slow beeping and a yellow flashing light (warning signal) and greater pressure faster beeping and a red flashing light (crisis signal). Ten intubations were performed on a training manikin by each of 21 Respiratory Therapy students and staff (RT) with a size 7 styletted endotracheal tube. The buzzer was switched on in random order for half the trials without the RT's knowledge. The signals (buzzer / light) per intubation were recorded, with success confirmed by inflating the lungs. Data were analyzed using Chi-Square.

RESULTS

199 of 210 trials were successful (mean time 12 sec.) with a contact signal(s) in 36.1%. Persistent pressure was significantly more frequent with the buzzer off (p<0.000).

The modified laryngoscope appeared to successfully detect contact with the upper teeth. Repeated contact occurred in 73.1% and 59.9% with the buzzer off and on respectively with these inexperienced personnel, but this did not reach significance at the 5% level. Persistent pressure occurred only once with the buzzer on, significantly less than when the buzzer was off. The system showed promise for future use in clinical trials.

REFERENCES

1 Anesthesia Intensive Care 2000; 28: 133-145.

2 Endo Dent Traumatol 1999; 15: 33–36.

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