A Novel Approach to Evaluate Skills in Endotracheal Intubation Using Biomechanical Measurement System

Endotracheal Intubation (ETI) is a common airway procedure used to connect the larynx and the lungs through the windpipe of patients under emergency situations. The process is carried out by a laryngoscope inserted into the mouth, and helps doctors in viewing the glottis and inserting the tube. In 2012, we developed a humanoid robot for ETI training, called WKA-5R, which was able to simulate various patients and scenarios and to evaluate the doctor's medical skills according to applied force, position of laryngoscopes and tubes, and procedure time. In 2013, we have focused our study on the development of a system for the biomechanical evaluation during simulated ETI. We conducted an experiment with 5 expert and 6 novice anesthesiologists and measured 3 biomechanical parameters: angular velocity of wrist joint and elbow joint, surface electromyography (sEMG) of the upper limb, and some angles on the upper part of the body, in order to evaluate joint stiffness in the arm and posture during ETI. In this paper, the authors show the experimental results on comparison between experts and novices, followed by discussion.