SWIFT ACUTE EMERGENCY PERSONAL NOVEL VIDEO LARYNGOSCOPE (SAPNOSCOPE): AN INNOVATIVE SOLUTION AND POTENTIAL GAME-CHANGER ON THE HORIZON FOR INTUBATION IN RESOURCE-LIMITED COUNTRIES

Abstract

SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Video laryngoscope (VL) has emerged as a well-established tool among various health care providers both prehospital and in-hospital settings. Video laryngoscope(VL) has the advantage of higher endotracheal intubation success among nonexpert, shorter learning curve, lesser cervical spine manipulation. Intubation can be done away from the line of sight, therefore, avoiding direct droplet infection from the airway. However widespread use of Video laryngoscope(VL) is solely restricted by the cost of Video Laryngoscope(VL). We aimed to develop safe, reliable, portable, easy to manufacture and inexpensive video laryngoscope and compare with conventional Macintosh. METHODS: Flexible video borescope is an optical device that allows visualization of difficult to access place it consists of a miniature camera at one end of a flexible tube and high definition screen at the other end. Video Flexible borescope with 4.3 inch HD screen (Screen endoscope F200, Cost-34 USD )was aligned and attached to the Macintosh blade no 3(Cost-14 USD) at 5 cm from the tip. The orientation of the camera and the field was checked following which the position was secured using EPOKE epoxy resin US FDA approved(Cost-10 USD/bottle). The device was called SAPNOSCOPE(Swift Acute emergency Personal Novel video laryngoSCOPE). The overall cost of the device was 56 USD. The safety and efficacy of the device were tested on a mannequin. Intubation performed on the mannequin by 50 physicians of different specialities using SAPNOSCOPE and Macintosh laryngoscope. Rates of successful Intubation, the grade for visualization of the glottis by Cormack-Lehane score, ease of intubation, visual clarity, number of attempts, time to intubate and complication were observed. RESULTS: Both in SAPNOSCOPE and Macintosh groups were similar in the rates of successful Intubation, grade for visualization of the glottis by Cormack-Lehane score and ease of intubation. However visual clarity was better with SAPNOSCOPE 100%( 50/50). 20%(10/50) in SAPNOSCOPE required 2 nd attempt for intubation as compared to 40% (20/50) in the Macintosh group. No difference was observed in average time to intubate in SAPNOSCOPE 50.2 secs and Macintosh group 46.6 secs,( p=0.122). The complication of esophageal intubation was observed only in the Macintosh group 20% (10/50). CONCLUSIONS: SAPNOSCOPE(Swift Acute emergency Personal Novel video laryngoSCOPE ) was found to be in par with conventional Macintosh and can be a potential alternative to Macintosh for endotracheal intubation. SAPNOSCOPE has scope to be the next game-changer in a resource-limited setting CLINICAL IMPLICATIONS: The device is reliable, inexpensive and durable making it ideal for a spectrum of fields like the emergency department, paramedics, anaesthesia and education. The versatility of device allows for portability, documentation, storing, transfer of data and research. DISCLOSURES: No relevant relationships by Sapan Kumar, source=Web Response No relevant relationships by Priyamvada Singh, source=Web Response