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PORTABLE LARYNGOSCOPE LIGHT INTENSITY MEASUREMENT APPARATUS

Department of Anesthesia and Biomedical Engineering , Dalhousie University, Queen Elizabeth II Health Sciences Centre, 1796 Summer Street, Halifax, Nova Scotia, B3H 3A7

INTRODUCTION: Adequate light may be critical to successful tracheal intubation. Currently there is no reliable apparatus to evaluate the illumination of laryngoscopic tools. To better evaluate and maintain the fiber optic laryngoscope blades for our clinical practice, a prototype apparatus was created for measuring light intensity in lux units. We designed a device that will consistently measure all Macintosh fiber optic blades (FOB) (#3 and 4) in the clinical setting. The device was designed to be portable and reliable for users with little training so that consistent measurements of illumination can be achieved for different operator.

METHOD: A prototype device was created using a PVC tube with a specially designed cap and base and a nylon ledge to hold the tip of the blade in place. Different specialized cap adaptors allow for the evaluation of other laryngoscope blades, such as the miller blades, and the illumination intensity of the handle alone. The tube measures 8 cm in diameter and 10 cm in height. A Tenma® Digital lux light meter was used to record the light intensity in lux from the blades. This device has a sensor with the lux measurement accuracy of ± 5%. With this apparatus, the tip of the blade will be placed precisely at 1 cm from the sensor and the light source shines directly at the center of the senor surface. To evaluate the precision of the measurements of the apparatus, ten different Heine® fiber optic blades (MAC#3,4) blades were separately placed in the device for 10 sec and measurements were recorded. This was repeated at 30 sec intervals. To determine the interrater reliability, eight staff were given a short (5 min) in-service on the use of the device. Each staff was asked separately to evaluate 3 different blades that would produce low, medium, and high levels of light intensities. The mean and the standard deviation for each tester were calculated and the standard deviation was represented as a percentage of mean.

RESULTS: The precision of the apparatus as a value for the % of standard deviation to the mean was calculated for the 10 different blades and was found to be 2.6%. The interrater reliability from the testing of blades at three levels of light intensity resulted in of 3.5 % of the standard deviation of the mean.

DISCUSSION: Our data show that this portable and inexpensive prototype device can measure the laryngoscope illumination with good precision. This device may be useful clinically to evaluate the laryngoscope illumination prior to intubation to ensure adequate light source for the procedure.

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