Zhaohui Xia, PhD1, Hong Li1, Nicholas Milef1, Adam Ryason1, Daniel Jones, MD2, Suvranu De, PhD1, Stephanie Jones, MD2. 1Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, Troy, NY, 2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
INTRODUCTION: Endotracheal intubation (ETI) is one of the most frequently performed procedures in operating rooms (OR), intensive care units (ICUs) and emergency departments (ED). Failure to intubate may result in severe morbidity and mortality. The traditional training methods, e.g., plastic mannequins or patient-based training, limit the opportunity for residents to deliberately practice this skill in varied patient anatomical and clinical conditions. Therefore, a virtual reality (VR)-based ETI trainer with visual and haptic feedback as well as skill assessment is highly desired.
OBJECTIVES: The goal of this study is to develop a high-fidelity physics-based anatomically accurate virtual airway skill trainer for ETI, which aims to provide trainees real time visual and haptic feedback, allowing them to attain competence in a controlled environment with no risk to patients.
METHODS: There are four modules involved in the virtual ETI simulator: (1) real time rendering; (2) haptic interface; (3) physics-based simulation; and (4) performance recording and assessment metrics. Real time rendering allows the training tasks of ETI to be performed in a high-fidelity 3D virtual environment. Haptic feedback mechanisms provide the interaction forces, while physics-based simulation algorithms enable the complicated simulation for tissue deformation, collision detection and tool-tissue interactions. Meanwhile, the ETI simulator collects the trainees’ performance data to provide feedback.
RESULTS: Four tasks including positioning the patient, insertion of the direct laryngoscopy blade into the oropharynx, achieving the optimal laryngeal view, and inserting the endotracheal tube are designed for the training of ETI procedures with two haptic tools (one for the laryngoscopy blade and the other for the endotracheal tube). The first task aims to tilt and elevate the patient’s head for proper positioning. The second task involves inserting the laryngoscope into the mouth and interacting with the vallecula, avoiding collision with the teeth. The goal of the third task is obtaining a clear view of the vocal cords and epiglottis. The fourth task is to insert the endotracheal tube, while avoiding contact with the surrounding anatomy. Experiments on performing the ETI tasks show that the simulator is able to run at interactive rates.
CONCLUSIONS: A novel high-fidelity physics-based virtual ETI simulator has been developed. Our simulator can provide interactive training experience and collect useful performance information which can be further analyzed for evaluation purpose.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94575
Program Number: P400
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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