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:
The epidural cart that we roll into labor and delivery rooms had a poor organizational system for commonly used items during epidural placement. The tegaderms, tape, and other items were stored in an “organizer” that was essentially a cardboard box sitting on top of the cart;
This system was not straightforward to inventory and it was often discovered, once already in the patient’s room, that items needed to be restocked. As it was a just box resting on top of the cart it was also occasionally knocked onto the floor.
To allow for better restocking and improved access to the individual items, I designed and 3D printed a new organizer. The design implements clear labelling, maximizes utilization of the space, and has suction cups integrated to prevent falling from the cart. The organizer was printed on a Prusa i3 MK3s with a total print time of about 20 hours, printed in 2 parts due to print ped dimension constraints.
There’s little worse than your patient sitting at the bedside and having to rummage through a pile of spinal and epidural needles during difficult neuraxial placement. I designed and 3D printed inserts for our existing storage bins for better organization. My goals were to reduce time searching for specific equipment, allow for better inventory/restocking of equipment, and provide a method for non-anesthesia personnel to assist anesthesia personnel that are performing a sterile procedure.
Here is the 3D Design:
The geometry and size of the inserts were not conducive to effective printing so the models were split into more appropriate shapes and sizes. This would also allow for efficient reprinting of certain components if they required adjustments:
The components were sliced in Cura 4 and printed on a modified Creality Ender 3 with a total print time of approximately 30 hours. The components were affixed to the storage bins with double sided tape producing the following product:
Our department has a large number of McGrath video laryngoscopes. The battery packs were stored in the anesthesia tech room as follows:
This seemed like a poor way to store batteries that cost $75 each. I Designed and 3D printed a tray to hold the batteries; the goal being to provide better organization, improved accessibility, and assist the techs with inventory/ordering. Here is the 3D design:
What better addition to your office knick knacks than a Lego Minifig anesthesiologist. Unfortunately, the only available minifigs are generic doctors; no accessories are available to indicate our noble profession. I started with the Lego “surgeon” minifig and planned to create my own Lego sized laryngoscope. I found a 3D model on Thingiverse by user Mvetto labelled laryngoscope pendant to start with. I edited the proportions to fit a minifig hand and exaggerated the size of the blade to make it the model somewhat comical. Here is the result, a custom anesthesiologist minifig.
If you’re interested in anesthesia and operating room lego builds, the flickr account of canadian anesthesiologist Lucie Filteau has some really cool setups: Here
