Kintsugi is the ancient Japanese art of repairing broken pottery with gold, silver, or platinum. The philosophy of Kintsugi celebrates the history of an object by highlighting its repair instead of disguising it. The repair not only makes the object functional again, but also beautiful through its uniqueness.
Although the art of Kintsugi still exists, a modern offshoot of this art is evolving as part of our everyday lives due to the increasing affordability of 3D printing. Due to differing properties of the polymers used for printing and inability to make perfect color/shape matching, it has led some modern makers to highlight their repairs with unique shapes and colors just as with Kintsugi. In an age where almost everything is standardized and disposable, modern 3D Kintsugi is a breath of fresh air that, in addition to breaking the cycle of consumerism, adds beauty to our lives with unique objects that cannot be purchased on Amazon.
The evolution of 3D printing as a reparative art is in its infancy and a community devoted to these designs has yet to evolve but one can find a number of examples of it in 3D printing communities such as Reddit’s Functional Prints. A few examples are listed below:
As far as my own creations in the medical and hospital space, most of my creative interventions are not reparative in nature but a few of my creations do fit the bill and can be found here:
It is my hope that 3D Kintsugi will continue to evolve as a modern functional art form, extending the longevity of our possessions and adding unique and beautiful elements to our lives.
Due to an unfortunate workplace injury, my friend, colleague, and anesthesia intensivist, the great Pavan Sekhar, MD, needed to use a knee scooter for a few months. In order to better facilitate his job, I designed and 3D printed an organizer for his scooter to allow for better organization and delivery of drugs, procedural equipment, and caffeine.
Here is the design that I conceived of in CAD:
The model contains places for drug vials, syringes, a box of epinephrine, small misc items, and large misc items, as well as a central cup holder for convenient infusion of intensivist caffeine.
Due to Dr. Sekhar’s affinity of the Marvel and DC universes, plus the speed at which he zoomed around the ICU on his scooter, I added a flash emblem to encompasss these traits. I sliced the flash emblem in PrusaSlicer to be used on a Prusa i3 MKS multi-material extruder setup to allow for multicolor printing without intervention.
I printed the box component at 0.3 mm height in PETG for strength and the flash emblem at 0.2 mm layer height in PLA for detail. Here is the final product:
Dr. Sekhar was happy with the final product and it will hopefully improve his organization and provide him with a few extra seconds during emergencies when seconds count!
Recently our hospital standardized a number of the adult vasopressor infusions. Our usual 10mg/250mL phenylephrine bags for infusion were eliminated and replaced by 20mg/250mL bags. Since phenylephrine is our primary vasopressor infusion for most anesthetics, our pharmacy drug trays include both a premixed bag of phenylephrine and a backup 10mg/1mL vial to mix into a 250mL saline bag if that initial bag is depleted. Pictured here is the backup concentrated phenylephrine 10mg/1mL vial in the drug tray:
For the transition to the more concentrated phenylephrine bags, the pharmacy now needed to supply 20 mg of concentrated phenylephrine in order to make backup phenylephrine bags. The two options were to include a larger phenylephrine vial (the next size up being 50mg/5mL) or adding an additional 10mg/1mL vial to the tray for a total of 2x 10mg/1mL vials. When the department was presented with the first option, many attendings were strongly against the 50mg vials since then worried that the less experienced residents may make a life threatening error with such a large, concentrated dose of phenylephrine. As for the second option, the pharmacy was against having 2 vials in the tray as there was no spot for the second vial and the pharmacists were worried about having a “free floating” vasopressor vial in the tray, especially an vial type which is shared by many other drugs. Replacing the blue tray foam inserts was not an immediate option as they had just been replaced a couple months prior and are prohibitively expensive to replace.
In order to expand the single phenylephrine vial spot into one big enough for 2 vials, I conceived of, designed, and 3D printed a quick and simple solution:
The cylindrical portion would slide easily into the vial spot and the rectangular portion would hold 2 horizontal vials. I printed the model in 2 parts to maximize speed and negate the need for 3D printed supports. The final part would be pressed together with a dab of glue. Between 3 Printers, I was able to complete the project overnight so that the pharmacy could implement the project immediately.
The pharmacy was satisfied with the solution and impressed with the speed at which the project was completed. This project, which used approximately $5 worth of materials, is an excellent example of how in-house 3D Design and Fused Deposition Modeling can be used to create immediate and useful solutions to problems that would otherwise require compromise or take months to implement.
On more than one occation, when in a hurry, I have broken a few glass medication ampules. The all glass amps can be broken fairly easy when opening a storage or omnicell drawer as they tend to roll around.
In order to reduce the risk of broken glass and save the expense of wasted medications, I designed a couple varieties of organizers to prevent these issues in the future.
Here are the CAD designs that I conceived of:
The first desgn was intended mostly for lidocaine amps in the anesthesia carts while the second was intended for displaying the amps more clearly in the omnicell.
Here are the 3D Prints and their implementations:
I have yet to break an amp since implementing this organizers. One of the pharmacy techs commented that they thought the main pharmacy had purchased these from a supplier rather than a 3D printed item that I had made on the fly.
In order to ease the fear and discomfort of an anesthetic mask induction, we often use essential oils (we refer to as “mask flavors”) to add a pleasant smell to the oxygen mask which helps to, at least partially, cover the unpleasant smells of the plastic mask and sevoflurane anesthesia. One problem with our work flow is that the flavor vials are typically held in the equipment carts like so:
This method of storage is suboptimal. The vials often tip over and spill, they must be picked up in order to read the label, and the anesthesia techs can not easily tell which vials need to be replaced. Inserting a simple 3D printed organizer would be an easy and cheap solution in order to improve the organization and delivery of this tool.
I conceived the following design in my CAD software:
The model was designed to fit nicely into the existing space. Two rows are positioned to display the vials in an orderly and easy to read manner while the back portion would allow for the storage of a few extra vials.
I printed 2 prototypes on a Prusa i3 MK3S in PLA with 0.2 mm Layer height.
Here is the model in use. It serves its purpose as designed and my anesthesia group was pleased with the upgrade.
Along with one of my colleagues, I continued to print these organizers for the remainder of the anesthesia carts.
Due to the popularity of my OB 3D Printed Emergency Drug Tray, members of my department asked if I could help standardize an emergency drug tray for the endoscopy suite. I polled the CRNAs and attendings that frequently work in endoscopy and made a layout that would include all the important and frequently used drugs to have on hand. Since I had previously measured the sizes and created layouts for all of the drugs in my previous emergency drug tray, creating the new model was straightforward.
3D Model Design: I Printed the Components in 2 parts so that I could have 2 distinct colors: 1 for paralytics (Succinylcholine in this case) and 1 for the other emergency medications. The halves were simply glued together with some standard cyanoacrylate glue. I added non-slip feet to the bottom so the tray can be removed from the drawer and placed on top of the cart if desired.
The 3D printing of an adapter to connect multiple patients to single ventilator is a concept that has been floating around in the news over the past few weeks. Conceptually, the setup is simple, use two 4-way splitters to connect the inspiratory and expiratory limbs of a ventilator to 4 intubated patients. Although the implementation and management of patients ventilated in this manner is not as simple. The first mention of this concept comes from a 2006 article from the Journal of Academic Emergency Medicine entitled “A single ventilator for multiple simulated patients to meet disaster surge.” The first reported implementation occurred in 2017 when Emergency Physicians at Sunrise medical center in Las Vegas successfully placed two patients on a single ventilator after an influx of intubated patients overwhelmed their ED during the Las Vegas Shootings.
Currently, at least one hospital in New York is attempting to place multiple patients on single ventilators during the COVID-19 crisis. It seems unlikely that this technique will be successful in patient with severe lung disease; however, there are groups that are working on more complex valve systems to make the process function better.
Here is my video discussing the 3D printing of a simple Multi-Patient Ventilator adapter:
Here is a great article from PulmCrit discussing the mechanics of performing multi-patient ventilation: PulmCrit
**Disclaimer: Personal protective equipment (PPE) for use in the medical field is extensively tested and FDA approved; any non-FDA approved PPE should be used only in emergency situations when no FDA approved device is available. The information provided here should be considered educational in nature and not medical advice.
The spread of COVID-19 in the US has revealed a severely inadequate supply of personal protective equipment, especially N95 masks. The dwindling supply has lead some healthcare providers to search for creative solutions for respiratory protection. One emerging method is to purchase a reusable 3M 6000 series respirator for use in the hospital environment, however, the cost of replacement filters is high and availability of all N95 filter types is low. With the CDC currently recommending that masks be disposed of after every COVID patient interaction, the cost and availability of replacement filters makes use of these masks impractical.
Small HEPA filters are inexpensive, in high availability, and filter 0.3 micron particles with greater efficiency (> 99.9 %) than N95 masks (95%), making them at least as safe as CDC recommended masks. To utilize these filters I designed and 3D printed an adapter cassette to use inexpensive Roomba vacuum HEPA filters with a 3M 6000 series respirator. With the filter, PLA Filament, and silicone sealant, the final product comes to a total of about $3 each. I also propose that one mask port be capped with a 3D printed cover so only one filter needs to be used with each patient interaction.
In this video I discuss the design, assembly, and testing of a 3D printed cassette to adapt inexpensive HEPA filters to a reusable respirator:
In order to provide immediate access to emergency medications in our Obstetric ORs, we have a medication drawer that is easily accessible to all anesthesia personnel by badge access. Although there have been multiple ideas for organizing the drawer with easy access and safety in mind, the current state or the drawer leaves much to be desired:
Considerations for a new design included clear grouping of medication classes, sturdy construction, easy to clean surface, and modular design for easy revision in the future. I designed a new drawer inlay and discussed the design with the our residents. With some input from them, I clearly separated emergent GA drugs and emergent epidural medications to draw their eyes quickly to drugs that should be grabbed for each situation. Here is the first iteration of the design:
After printing out an example syringe inlay, feedback was that the finger wells were too small to grab the syringe quickly, so the wells were increased in size. Feedback was positive and the design was accepted readily by the department. After a few months of use the pharmacy began stocking rocuronium syringes instead of rocuronium vials. Due to the modular design, it was straightforward to revise the inlays and replace only one section of the inlay. After a couple weeks of use, it became apparent that the succinycholine and rocuronium syringes were being swapped when restocked, so I reprinted the rocuronium inlay in a different color to draw the eyes to the difference.
Here are the inlays currently in use in our all of our Obstetric ORs: