Patent Application
20200121878
The subject disclosure relates to a nose to tragus length measuring tapes and more specifically, to measuring tapes that can correlate a patient's nasal to tragus length (“NTL”) to the insertion depth for an endotracheal tube (“ETT”) for patients ranging in age from newborn (e.g., including premature infant) to pediatric children of different weights and ages. Additionally, the measuring tapes described herein can comprise alternative reference formulas/charts for estimating ETT insertion depth as well equipment and/or supplies information felt to be of value for respiratory emergencies.
Proper ETT placement is critical to reducing the risk of mainstem intubation, airway trauma, pneumothorax, localized pulmonary interstitial emphysema and accidental dislodgment. Estimators for depth of ETT placement in neonates have conventionally relied on the association between patient weight and/or gestational age and the distance to the mid-trachea. Systems such as the “7-8-9 rule,” where the infant's weight is rounded to the nearest kilogram (kg) and then added to 6 centimeters (cm) to estimate ETT insertion depth, perform reasonably well for moderately preterm infants but can be inaccurate for extremely preterm infants and larger term infants. Weight or gestational age-based tables can improve estimates but are cumbersome, require knowledge of the patient that may not be readily available in an emergency and/or can still lead to improver placement in about 8% of infants.
The Neonatal Resuscitation Program (“NRP”) is an educational program jointly sponsored by the American Academy of Pediatrics (“AAP”) and the American Heart Association (“AHA”). Prior editions (e.g., copyright 2011 and earlier) adopted Tochen's weight-based formula (e.g., 6 cm+weight in kg rounded to the closest Integra) because of its ease of memorization and/or reasonable safety, but this formula can lead to incorrect ETT placement in 40% of all neonates and/or 83% of the extremely low birth weight infants.
The 7th edition (e.g., copyright 2016) of NRP addresses this concern by recommending three potential methods for estimating proper ETT placement. However, it leaves to the individual caregivers to decide which of these three methods to utilize. The first method is to use printed depth markers to place the ETT 1 to 2 cm below vocal cords. The second method is an update to the 6th edition (e.g., copyright 2011) gestational age/weight-based chart in which Tochen's formula is now rounded to the nearest 0.5 cm mark. The third method estimates proper ETT depth based on the NTL+1 cm formula, where NTL is measured as the distance between the base of the nasal septum and the tragus of the ear.
Use of the NTL+1 cm formula to estimate the depth of ETT insertion can lead to appropriate placement in 90% of patients over a broad range of gestational ages and weights. Further, the NTL+1 cm estimate can perform well for infants weighing greater than or equal to 2.5 kg and an NTL+0.5 cm estimate performed well for infants weighing less than 2.5, both predicting the correct ETT position as verified by chest X-ray confirmation. The 7th edition of NRP now endorses NTL-based estimates of neonatal ETT depth specially using the NTL+1 cm formula.
The following presents a summary to provide a basic understanding of one or more embodiments of the invention. This summary is not intended to identify key or critical elements, or delineate any scope of the particular embodiments or any scope of the claims. Its sole purpose is to present concepts in a simplified form as a prelude to the more detailed description that is presented later. In one or more embodiments described herein, apparatuses and/or methods regarding determining the insertion depth for an ETT are described.
According to an embodiment, a measuring tape is provided. The measuring tape can comprise an indicium representing an insertion depth of an endotracheal tube based upon a direct correlation between a nasal-tragus length of a patient and the insertion depth.
According to an embodiment, a system is provided. The system can comprise a memory that stores computer executable components. The system can also comprise a processor, operably coupled to the memory, and that can execute the computer executable components stored in the memory. The computer executable components can comprise an insertion depth component that determines an endotracheal tube insertion depth by digitally measuring a nose to tragus length of a patient via an analysis of image data that characterizes an anatomy of the patient.
According to an embodiment, a computer-implemented method is provided. The computer-implemented method can comprise determining, by a system operatively coupled to a processor, an endotracheal tube insertion depth by digitally measuring an NTL of a patient via an analysis of image data that characterizes an anatomy of the patient.
The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.
The following detailed description is merely illustrative and is not intended to limit embodiments and/or application or uses of embodiments. Furthermore, there is no intention to be bound by any expressed or implied information presented in the preceding Background, or in the Detailed Description section.
One or more embodiments are now described with reference to the drawings, wherein like referenced numerals are used to refer to like elements throughout. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a more thorough understanding of the one or more embodiments. It is evident, however, in various cases, that the one or more embodiments can be practiced without these specific details.
When a patient (e.g., an infant, child, or adult) is having difficulty breathing and/or is under-going surgery, a breathing tube can be placed into the patient's mouth or nose to assist their breathing. In the majority of such instances, the breathing tube is placed in the patient's mouth and extends to their lungs. Said breathing tube is referred to as an endotracheal tube (“ETT”), wherein the ETT can be positioned within the patient's trachea. Conventional ETTs have one or more calibrated markings in centimeters (cm) located along a length of the ETTs. Further, ETTs utilized for adults can further comprise a cuff located at a distal end of the ETTs to facilitate creation of a seal once inserted into the patient. ETTs utilized for infant patients can be characterized as having a smaller diameter (e.g., having an outside diameter ranging from greater than or equal to 2.5 millimeters (mm) and less than or equal to 4.0 mm) and/or a shorter length (e.g., ranging from greater than or equal to 13 cm and less than or equal to 19 cm) than ETTs used for adult patients. Also, ETTs used for infant patients can lack a cuff at least because the size of the infant's autonomy renders the existence of a cuff impractical and/or unnecessary.
During intubation of a patient, the ETT can be inserted into the patient's mouth, between the patient's vocal cords, and into the trachea. Once the patient has been intubated, markings on the ETT can be used as references for how deep the ETT is inserted into the patient's trachea. Once, the desired insertion depth is reached, tape and/or a specialized ETT holder can be used to secure the ETT at the lip of the patient based on a depth of insertion indicated by a centimeter mark on the ETT located closets to the patient's lip. In other words, a centimeter mark on the ETT aligns with the patient's lip level to delineate an insertion depth that the ETT is exhibiting within the patient's trachea. As used herein, the term “lip to tip (“L2T”) length” can refer to a distance from the tip of the ETT positioned within a patient's trachea to the outer surface of a patient's lip (e.g., a top lip or a bottom lip). For example, the outer surface can be the top most surface of the patient's lip when the patient's head is lying horizontally on a supporting surface. Thereby, the L2T length can represent an insertion depth of the ETT. In various embodiments, the L2T length can be used to verify that the ETT is inserted to a correct position within the patient's trachea and/or can be used to verify that the ETT has not been accidently moved from said position.
Wherein the patient is an infant, multiple methods exist for determining the proper L2T length for a subject patient, including, for example: utilization of a mathematical formula based on the infant's EGA, utilization of a mathematical formula based on the infant's weight in kilograms, utilization of one or more tables that present information based on the infant's estimated gestation age and/or weight, ETT vocal cord marks (e.g., reference marks used during intubation), and/or utilization of a measurement of the infant's NTL. Amongst the stated determination methods, use of the NTL measurement can be highly reliable and/or accurate, as compared with other methodologies. For example, a patient's estimated gestational age can be inaccurately assessed, a patient's weight may not be known and/or inaccurately estimated, tables can incorporate varying standards of error, and/or vocal cord marks can be difficult to see when the ETT is inserted into the trachea.
Various embodiments described herein can regard a measuring tape that can comprise one or more indicia for measuring a patient's NTL, wherein the one or more indicia can represent an insertion depth of an ETT based on the NTL. For example, one or more indicia located on the measuring tape can correlate a patient's NTL to a proper L2T length of an ETT. Advantageously, a medical practitioner using the measuring tape can determine an insertion depth for the ETT based on the patient's NTL without preforming any mathematical formulas. Additionally, the measuring tape of the various embodiments herein can increase a likelihood of correctly placing a ETT into a patient's trachea at a position where the ETT would be located generally below the first Thoracic Rib (“T1”) and/or above the carina, and not placed within either the patient's right or left bronchus; thereby providing increased reliability for placement of the ETT at the correct level within the patient's trachea, as compared to conventional techniques.
A correlation between a patient's NTL and a proper ETT insertion depth (e.g., L2T length) has been scientifically validated and shown to be highly accurate. For example, ETT insertion depth (e.g., L2T) based on NTL can be patient specific, regardless of the patient's age, weight, and/or sex. For instance, accuracy of ETT insertion depth (e.g., L2T length) based on NTL can be maintained even with regards to patients born during a multi-birth pregnancy (e.g., twins, triplets, etc.).
The one or more indicia (e.g., the one or more first indicia 102, second indicia 104, and/or third indicia 106) can correlate to an insertion depth for an ETT (e.g., a L2T length). For example, the one or more indicia can correlate an NTL with a L2T length in accordance with Equation 1 below:
Lip to Tip Length=NTL+X (1)
Wherein the lip to tip length can be presented in centimeters, the NTL can be measured in centimeters, and “X” can represent a value greater than or equal to 0.25 cm and less than or equal to 1.5 cm. For example, “X” can represent a value of 1 cm for infants having a weight of greater than 2.5 kg, and/or “X” can represent a value of 0.5 cm for infants having a weight of less than 2.5 kg. For instance, the NTL measuring tape 101 depicted in
In one or more embodiments, a medical practitioner using the NTL measuring tape 101 can place the first end 107 of the NTL measuring tape 101 at the patient's nose and extend the NTL measuring tape 101 across the patient's face to the patient's nearest tragus of the patient's ear to correlate the patient's NTL to an ETT insertion depth. For example, the NTL measuring tape 101 can be placed at a patient's nasal septum, and the one or more indicia (e.g., the one or more first indicia 102, second indicia 104, and/or third indicia 106) nearest the patient's tragus can represent the desired insertion depth of an ETT (e.g., a L2T length). For example, when measuring the patient's NTL, if the “8” third indicium 106 presented in the NTL measuring tape 101 shown in
In various embodiments, the NTL measuring tape 101 can be folded horizontally or vertically to allow the measurement side 100 to remain small in size yet provide a larger area for information on the reverse side of the tape. Additionally, in one or more embodiments, the NTL measuring tape 101 can present two or more rows of the one or more indicia. In a first row, the one or more indicia can numerically increase from the first end 107 of the NTL measuring tape 101 to a second end 108 of the NTL measuring tape 101. In a second row, the one or more indicia can numerically increase from the second end 108 to the first end 107. Thereby, a medical provider can easily utilize the NTL measuring tape 101 with the patient's left ear or right ear. Further, wherein the NTL measuring tape 101 can be folded, a first portion of the NTL measuring tape 101 can depict one or more indicia arrangements that correlate to ETT insertion depth based on Equation 1 with a first value for “X”; whereas a second portion of the NTL measuring tape 101 can depict one or more indicia arrangements that correlate to ETT insertion depth based on Equation 1 with a second value for “X”. In various embodiments, the measurement side 100 can be depicted on the front and back side of the NTL measuring tape 101. For example, a front side of the NTL measuring tape 101 can display one or more indicia in accordance with one or more embodiments described herein, and a back side of the NTL measuring tape 101 can display one or more indicia in accordance with one or more embodiments described herein.
The exemplary embodiments depicted in
Although
For example, the starting point 502 can be placed at the nose of the patient, whereupon a first end 107 can extend across the patient's face towards the patient's tragus. A first portion of the NTL measuring tape 101 between the starting point 502 and the first end 107 can comprise a plurality of indicia in accordance with the various embodiments described herein. An indicia comprised within the first portion of the NTL measuring tape 101 and nearest the patient's tragus can indicate the ETT insertion depth. Additionally, or alternatively, the starting point 502 can be placed at the nose of the patient, whereupon the second end 108 can extend across another side of the patient's face towards the patient's other tragus. The NTL measuring tape 101 can comprise a second portion between the starting point 502 and the second end 108. The second portion can comprise another plurality of indicia in accordance with the various embodiments described herein. An indicia comprised within the second portion of the NTL measuring tape 101 and nearest the patient's other tragus can indicate the ETT insertion depth. Thereby, the starting point 502 can be positioned at the patient's nose, and the NTL measuring tape 101 can extend to either the right or left tragus of the patient to determine the ETT insertion depth.
In various embodiments, the starting point 502 can delineate a location at which a medical provider can fold the NTL measuring tape 101 to create first end 107 or second end 108 of the NTL measuring tape 101. For example, a medical provider can fold the NTL measuring tape 101 along the starting point 502 to create a first end 107 of the NTL measuring tape 101 such that the first end 107 created by the fold can be positioned at the nasal septum of the patient to start measurement of the NTL and/or determination of the ETT insertion depth. By folding the NTL measuring tape 101, the medical provider can readily form embodiments in which the indicia arrangement scales in a preferred direction to facilitate measurement of a desired side of the patient's face.
For example, to the right or left of the starting point 502, the one or more indicia can numerically increase from the starting point 502 to a distal end to measure the NTL. Thereby, a medical provider can fold the NTL measuring tape 101 along the starting point 502 to readily utilize the patient's left ear or right ear. Various embodiments of the NTL measuring tape 101 can depict different icons than the nose icon (e.g., a single line or an ear icon) depicted in the figures. Additionally,
Additionally, in one or more embodiments the NTL measuring tape 101 can comprise two or more indicia arrangements, wherein the indicia arrangements can be separated by the horizontal folding line 602. For example, a first indicia arrangement can depict one or more indicia that can correlate to ETT insertion depth based on Equation 1 with a first value for “X”; whereas a second indicia arrangement can depict one or more indicia that can correlate to ETT insertion depth based on Equation 1 with a second value for “X”.
As shown in
A medical provider can fold the NTL measuring tape 101 depicted in
In one or more embodiments, one or more of the portions of the NTL measuring tape 101 can comprise two rows of indicia numerically increasing in opposite directions (e.g., as shown in
Moreover, the portions defined by the horizontal folding line 602 can comprise indicia positioned on the NTL measuring tape 101 based on Equation 1. However, respective portions can utilize different values for “X” in Equation 1. For example, the top portion shown in
As shown in
For example, the one or more notation areas 1002 can be one or more check-off boxes (e.g., as shown in
Further, as shown in
The NTL measuring tape 101 can be made from a strip of flexible material. Example materials that can comprise the NTL measuring tape 101 can include, but are not limited to: paper, plastic, rubber, metal, a polymer, a combination thereof, and/or the like. Additionally, while 74 indicia (e.g., a plurality of first indicia 102, a plurality of second indicia 104, and/or a plurality of third indicia 106) are shown in
Moreover, in one or more embodiments the NTL measuring tape 101 can be mounted and/or housed within an enclosure (not shown). For example, the NTL measuring tape 101 can be mounted within the enclosure to facilitate extension and/or retraction. For instance, the NTL measuring tape 101 can be mounted such that the tape can extend from the enclosure to facilitate measuring the patient's NTL and can retract into the enclosure to facilitate storage of the NTL measuring tape 101.
Reference table 1400 can regard multiple formulae for determining the ETT insertion depth of pediatric patients of various age, weight, and/or size. Reference table 1500 can provide information for various pediatric emergency resuscitation equipment based on a patient's weight. Reference table 1600 can provide multiple straight miller blade sizes for patients of various ages. Reference table 1700 can provide recommended end-tidal carbon dioxide (“ETCO2”) detector sizes for patients of various weights. Reference table 1800 can provide recommended mask sizes for patients of various ages. Reference table 1900 can provide recommended tortle infant head positioner sizes for patients with various head sizes. Reference table 2000 can provide recommended nasal cannula sizes for patients of various ages.
As shown in
Additionally, the reference information presented on the NTL measuring tape 101 can be directed to numerous categories of patients. For example, while the reference tables 1100, 1200, 1400, 1500, 1600, 1700, 1800, 1900, and/or 2000 shown in shown in
Further, one of ordinary skill in the art will recognize that the reference information presented in
At 2102, the method 2100 can comprise determining an ETT insertion depth (e.g., a L2T length) by measuring an NTL of a patient using a measuring tape (e.g., NTL measuring tape 101) that can comprise one or more indicia representing a direct correlation between the NTL and the ETT insertion depth. For example, the NTL measuring tape 101 can comprise one or more indicia (e.g., one or more first indicia 102, one or more second indicia 104, one or more third indicia 106, and/or one or more fourth indicia 202) that can represent an ETT insertion depth (e.g., a L2T length) based on the NTL measurement. For instance, the one or more indicia located on the NTL measuring tape 101 can represent a correlation between the NTL length and an ETT insertion depth in accordance with Equation 1 described herein. For example, the NTL measurement tape 101 can comprise one or more first indicia 102 separated from each other at distance of 0.25 cm to provide enhanced precision for determining the ETT insertion depth for extremely low birth weight (“ELBW”) and/or very low birth weight (“VLBW”) infants.
For instance, the determining at 2102 can be facilitated by placing a first end 107 of the NTL measuring tape 101 at the patient's nose (e.g., at a patient's nasal septum) and extending the NTL measuring tape 101 across the patient's face to the patient's nearest ear tragus to measure the patient's NTL. Further, the determining at 2102 can be facilitated by determining the indicium that most closely aligns with the patient's ear tragus during the measuring of the NTL. In one or more embodiments, the NTL measuring tape 101 can comprise one or more notation areas 1002 for recording the determined ETT insertion depth (e.g., for marking the indicium located closest to the patient's ear tragus).
In another instance, the determining at 2102 can be facilitated by placing a first end 107 of the NTL measuring tape 101 at the patient's ear tragus and extending the NTL measuring tape 101 across the patient's face to the patient's nose (e.g., to the patient's nasal septum) to measure the patient's NTL. Further, the determining at 2102 can be facilitated by determining the indicium that most closely aligns with the patient's nose (e.g., nasal septum) during the measuring of the NTL. In one or more embodiments, the NTL measuring tape 101 can comprise one or more notation areas 1002 for recording the determined ETT insertion depth (e.g., for marking the indicium located closest to the patient's nose).
At 2104, the method 2100 can comprise inserting an ETT into the patient's trachea to the ETT insertion depth determined at 2102. For example, the ETT insertion depth determined at 2102 can correlate to a position between the patient's voice cords and carina. For instance, the ETT insertion depth determined at 2102 can correlate to a position between the patient's second rib and third rib, wherein the ETT is not positioned in either the left or right bronchus. Thus, the inserting at 2104 can be properly and expeditiously conducted via utilization of the NTL measuring tape 101 during the determinations at 2102. Additionally, one or more notation areas 1002 (e.g., check boxes) be utilized by the medical provide to annotate specific values on one or more reference tables provided on the NTL measuring tape 101 (e.g., reference tables 1100, 1200, 1400, 1500, 1600, 1700, 1800, 1900, 2000, and/or the like) that can apply to the specific patient undergoing the current procedure.
Various embodiments of the present invention can be directed to computer processing systems, computer-implemented methods, apparatus and/or computer program products that facilitate the efficient, effective, and autonomous (e.g., without direct human guidance) determination of an ETT insertion depth based on one or more NTL measurements. For example, one or more embodiments described herein can regard computer-implemented methods, systems, and/or computer program products that can perform an image analysis process to determine measure a patient's NTL via one or more images of the patient's face. Further, various embodiments described herein can include correlating the NTL measurement derived from the one or more images to an ETT insertion depth (e.g., in accordance with Equation 1).
The computer processing systems, computer-implemented methods, apparatus and/or computer program products employ hardware and/or software to solve problems that are highly technical in nature (e.g., performing an optically based NTL measurement to facilitate determination of an ETT insertion depth), that are not abstract and cannot be performed as a set of mental acts by a human. For example, an individual cannot measure a patient's NTL through a visual analysis of the patient's face with the accuracy and/or efficiency demonstrated by the various embodiments described herein.
As shown in
The one or more networks 2204 can comprise wired and wireless networks, including, but not limited to, a cellular network, a wide area network (WAN) (e.g., the Internet) or a local area network (LAN). For example, the computer device 2202 can communicate with the one or more input devices 2206 and/or image capturing devices 2208 (and vice versa) using virtually any desired wired or wireless technology including for example, but not limited to: cellular, WAN, wireless fidelity (Wi-Fi), Wi-Max, WLAN, Bluetooth technology, a combination thereof, and/or the like. Further, although in the embodiment shown the insertion depth component 2210 can be provided on the one or more computer devices 2210, it should be appreciated that the architecture of system 2200 is not so limited. For example, the insertion depth component 2210, or one or more components of insertion depth component 2210, can be located at another computer device, such as another server device, a client device, etc.
The one or more input devices 2206 can comprise one or more computerized devices, which can include, but are not limited to: personal computers, desktop computers, laptop computers, cellular telephones (e.g., smart phones), computerized tablets (e.g., comprising a processor), smart watches, keyboards, touch screens, mice, a combination thereof, and/or the like. A user of the system 2200 can utilize the one or more input devices 2206 to input data into the system 2200, thereby sharing (e.g., via a direct connection and/or via the one or more networks 2204) said data with the computer device 2202 and/or image capturing device 2208. For example, the one or more input devices 2206 can send data to the communications component 2212 (e.g., via a direct connection and/or via the one or more networks 2204). Additionally, the one or more input devices 2206 can comprise one or more displays that can present one or more outputs generated by the system 2200 to a user. For example, the one or more displays can include, but are not limited to: cathode tube display (“CRT”), light-emitting diode display (“LED”), electroluminescent display (“ELD”), plasma display panel (“PDP”), liquid crystal display (“LCD”), organic light-emitting diode display (“OLED”), a combination thereof, and/or the like.
A user of the system 2200 can utilize the one or more input devices 2206 and/or the one or more networks 2204 to input one or more settings and/or commands into the system 2200. For example, in the various embodiments described herein, a user of the system 2200 can operate and/or manipulate the computer device 2202 and/or associate components via the one or more input devices 2206. Additionally, a user of the system 2200 can utilize the one or more input devices 2206 to display one or more outputs (e.g., displays, data, visualizations, and/or the like) generated by the computer device 2202, associate components, and/or image capturing device 2208. Further, in one or more embodiments, the one or more input devices 1226 can be comprised within, and/or operably coupled to, a cloud computing environment.
In various embodiments, a user of the system 2200 can input patient information and/or medical technique preferences into the system 2200 via the one or more input devices 2206. For example, the user can utilize the one or more input devices 2206 to enter patient information 802 into the system 2200. Example patient information 802 that can be entered via the one or more input devices 2206 can include, but are not limited to: patient's name, patient's weight, patient's EGA, current date, date of ETT insertion, a combination thereof, and/or the like.
The one or more image capturing devices 2208 can capture image data of a patient's face to facilitate digital measurement of the patient's NTL. For example, the one or more image capturing devices 2208 can comprise one or more cameras and/or camera equipment. The imaging data captured by the one or more image capturing devices 2208 can regard still images of the patient's face and/or video of the patient's face. For instance, the one or more image capturing devices 2208 can capture image data (e.g., photos and/or video) of at least one side of the patient's face, such that the image data depicts the patient's tragus and nose (e.g., nasal septum).
In various embodiments, the one or more computer devices 2202, input devices 2206, and/or image capturing devices 2208 can be comprised within the system 2200 separately and can communicate with each other (e.g., share data) via a direct electrical connection and/or the one or more networks 2204. In one or more embodiments, the one or more computer devices 2202, input devices 2206, and/or image capturing devices 2208 can be comprised within the same structure. For example, the one or more input devices 2206 and/or image capturing devices 2208 can be comprised within the one or more computer devices 2202. For instance, the one or more computer devices 2202 can be a smartphone and/or tablet that incorporates the one or more input devices 2206 (e.g., a touchscreen) and/or image capturing devices 2208 (e.g., camera).
The insertion depth component 2210 can measure a patient's NTL via one or more image analysis processes. For example, the one or more image analysis processes can comprise capturing image data regarding the patient's face (e.g., photos and/or video depicting at least one side of the patient's face, including the patient's tragus and nasal septum). Further, the one or more image analysis processes can include analyzing the image data to identify target reference points comprised within the image data that correlate to the patient's tragus and nasal septum. Additionally, the one or more image analysis processes can comprise measuring the distance between the target references points to determine the patient's NTL. Moreover, the one or more image analysis processes can comprise correlating the determined NTL to an ETT insertion depth (e.g., in accordance with the relationship characterized by Equation 1). Also, the one or more image analysis processes can include presenting reference information (e.g., medical information 304 and/or patient information 802, such as the exemplary reference information depicted in
The communications component 2212 can receive image data from the one or more image capturing devices 2208 and/or patient information entered by a user via the one or more input devices 2206. Further, the communications component 2212 can share the image data and/or patient information with the associate components of the insertion depth component 2210. Additionally, the communications component 2212 can facilitate communication (e.g., data sharing) between the associate components of the insertion depth component 2210.
The target component 2214 can identify one or more target reference points comprised within image data of a given patient's face captured by the one or more image capturing devices 2208. For example, the target component 2214 can identify a first target reference point that correlates to the location of the patient's tragus, as delineated in the image data. Further, the target component 2214 can identify a second target reference point that correlates to the location of the patient's nasal septum, as delineated in the image data. In various embodiments, the target component 2214 can identify the one or more target reference points based on structural features associated with the patient's anatomy.
For instance, the target component 2214 can identify the first target reference point by analyzing anatomical features of the patient's face delineated by the image data and associating one or more of the anatomical features with the patient's tragus. Thereby, the location of the anatomical features characterizing the patient's tragus can be the location of the first target reference point and/or the location of the patient's tragus. For example, reference anatomical features characterizing the general shape of a tragus can be stored in memory 2222, and the target component 2214 can compare anatomical features comprised within the image data to the reference anatomical features to determine whether the given anatomical features correlate to the patient's tragus.
In another instance, the target component 2214 can identify the second target reference point by analyzing anatomical features of the patient's face delineated by the image data and associate one or more of the anatomical features with the patient's nose (e.g., nasal septum). Thereby, the location of the anatomical features characterizing the patient's nose can be the location of the second target reference point, and/or the location of the patient's nose. For example, reference anatomical features characterizing the general shape of a nose (e.g., nasal septum) can be stored in memory 2222, and the target component 2214 can compare anatomical features comprised within the image data to the reference anatomical features to determine whether the given anatomical features correlate to the patient's nose (e.g., nasal septum).
In one or more embodiments, the target component 2214 can utilize one or more artificial intelligence (“AI”) technologies, such as machine learning, to identify the one or more target reference points. As used herein, the term “machine learning” can refer to an application of AI technologies to automatically and/or autonomously learn and/or improve from an experience (e.g., training data) without explicit programming of the lesson learned and/or improved. For example, machine learning tasks can utilize one or more algorithms to facilitate supervised and/or unsupervised learning to perform tasks such as classification, regression, and/or clustering. In various embodiments, the target component 2214 can utilize machine learning to create and/or update reference anatomical features (e.g., stored in memory 2222) that can be used in comparison of the captured image data to identify the one or more target reference points.
For example, in one or more embodiments the target component 2214 can generate one or more neural network models to generate, update, and/or maintain a reference anatomical feature database 2228 that can comprise the reference anatomical features. As used herein, the term “neural network model” can refer to a computer model that can be used to facilitate one or more machine learning tasks, wherein the computer model can simulate a number of interconnected processing units that can resemble abstract versions of neurons. For example, the processing units can be arranged in a plurality of layers (e.g., one or more input layers, one or more hidden layers, and/or one or more output layers) connected with by varying connection strengths (e.g., which can be commonly referred to within the art as “weights”). Neural network models can learn through training, wherein data with known outcomes is inputted into the computer model, outputs regarding the data are compared to the known outcomes, and/or the weights of the computer model are autonomous adjusted based on the comparison to replicate the known outcomes. As used herein, the term “training data” can refer to data and/or data sets used to train one or more neural network models. As a neural network model trains (e.g., utilizes more training data), the computer model can become increasingly accurate; thus, trained neural network models can accurately analyze data with unknown outcomes, based on lessons learning from training data, to facilitate one or more machine learning tasks. Example neural network models can include, but are not limited to: perceptron (“P”), feed forward (“FF”), radial basis network (“RBF”), deep feed forward (“DFF”), recurrent neural network (“RNN”), long/short term memory (“LSTM”), gated recurrent unit (“GRU”), auto encoder (“AE”), variational AE (“VAE”), denoising AE (“DAE”), sparse AE (“SAE”), markov chain (“MC”), Hopfield network (“HN”), Boltzmann machine (“BM”), deep belief network (“DBN”), deep convolutional network (“DCN”), deconvolutional network (“DN”), deep convolutional inverse graphics network (“DCIGN”), generative adversarial network (“GAN”), liquid state machining (“LSM”), extreme learning machine (“ELM”), echo state network (“ESN”), deep residual network (“DRN”), kohonen network (“KN”), support vector machine (“SVM”), and/or neural turing machine (“NTM”).
In one or more embodiments, the target component 2214 can impose one or more target icons (e.g., squares, circles, and/or the like) onto the image data at the location of the one or more target reference points. Further, target component 2214 can share the captured image and/or video with the imposed targets icons with a user of the system 2200 (e.g., via the one or more input devices 2206 and/or networks 2204). For example, the user can view the captured image and/or video of the patient's face with the one or more target icons displayed to delineate the locations of the patient's tragus and/or nose, as identified by the target component 2214. Thereby, the user of the system 2200 can verify that the target component 2214 has correctly identified the location of the patient's tragus and/or nose (e.g., nasal septum) within the image data.
Further, in various embodiments the user can utilize the one or more input devices 2206 to re-position one or more of the target icons on the captured image and/or video. For example, the user can utilize the one or more input devices 2206 (e.g., a touch screen) to move (e.g., drag) one or more of the target icons across the captured image and/or video to correct an identification of the patient's tragus and/or nose (e.g., nasal septum). Additionally, wherein the user re-positions one or more of the target icons, and thereby one or more of the target reference points, the target component 2214 can learn (e.g., via one or more machine learning tasks, such as neural network models) from the location correction and/or update the reference anatomical features comprised within the one or more reference anatomical databases 2228 to increase the accuracy of subsequent identifications. For instances, the target component 2214 can learn from one or more re-positionings to further refine reference anatomical features characterizing a tragus and/or nose.
In one or more embodiments, the measurement component 2216 measure a distance between the identified target reference points based on the image data to determine the patient's NTL. For example, the measurement component 2216 can utilize a digital measuring algorithm to determine the distance between the target reference points and thereby the patient's NTL.
In one or more embodiments, the measurement component 2216 can measure the distance based on meta data (e.g., an exchangeable image file (“EXIF”)) comprised within the captured image data. For instance, the meta data can describe one or more camera features of the image capturing device 2208, such as, for example, the lens size, f-stop, and/or zoom utilized to capture the image data. Further, the one or more image capturing devices 2208 can capture the image data from a defined distance from the patient's face. Based on the defined distance and the meta data of the captured image and/or video, the measurement component 2216 can determine a distance between the identified target reference points.
Also, in one or more embodiments the one or more image capturing devices 2208 can impose one or more boundary lines onto a display used to operate the image capturing devices 2208. For example, positioning of the boundary lines can be based on the one or more camera features of the image capturing device 2208, such that moving the image capturing device 2208 so as to position the patient's head within the boundary lines can inherently move the image capturing device 2208 to the defined distance. In one or more embodiments, the measurement component 2216 can generate a scale relating distance within the image data to the distance between the patient's ear and nose, such that measuring the distance between the target reference points can digitally measure the NTL.
In one or more embodiments, the correlation component 2218 can determine an ETT insertion depth based on the digitally measured NTL (e.g., measured by the measurement component 2216) and Equation 1. For example, the correlation component 2218 can define a value for “X” in Equation 1 based on a user preference and/or patient information entered into the system 2200 via the one or more input devices 2206. For instance, wherein the patient's weight (e.g., as defined by a user using the one or more input devices 2206) is less than 2,500 g, the correlation component 2218 can determine the ETT insertion depth based on the digitally measured NTL and Equation 1 using a value for “X” of 0.5. Alternatively, wherein the patient's weight (e.g., as defined by a user using the one or more input devices 2206) is greater than 2,500 g, the correlation component 2218 can determine the ETT insertion depth based on the digitally measured NTL and Equation 1 using a value for “X” of 1. In another instance, the user of the system 2200 can manually set the value of “X” using the one or more input devices 2206.
In various embodiments, the correlation component 2218 can display the determined ETT insertion depth on the one or more input devices 2206 for review by a user of the system 2200. For example, the correlation component 2218 can display the target icons, NTL measurement, and/or ETT insertion depth superimposed on the captured image and/or video of the patient (e.g., via the one or more input devices 2206).
In one or more embodiments, reference component 2220 can further display reference information, such as medical information 304 and/or patient information 802, for review by the user of the system 2200. For example, the reference information can be displayed via one or more charts, tables, and/or formulas (e.g., as depicted in
At 2302, the method 2300 can comprise determining (e.g., via insertion depth component 2210), by a system 2200 operatively coupled to a processor 2226, an ETT insertion depth by digitally measuring an NTL of a patient via an analysis of image data that characterizes an anatomy of the patient. For example, the determining at 2302 can comprise capturing (e.g., via one or more image capturing devices 2208) the image data (e.g., photos and/or videos) of the patient's face, including the patient's tragus and nose (e.g., nasal septum), in accordance with the various embodiments described herein. Further, the determining at 2302 can comprise identifying (e.g., via target component 2214) one or more target reference points in the image data that can correlate to the location of the patient's tragus and/or nose (e.g., nasal septum) in accordance with the various embodiments described herein. For example, identifying the target reference points can be performed by comparing anatomical features characterized by the image data with reference anatomical features of a tragus and/or nose (e.g., comprised within a reference anatomical feature database 2228) as described herein.
In addition, the determining at 2302 can comprise measuring (e.g., via the measurement component 2216) a distance between the target reference points of the image data via one or more digital measuring algorithms to determine the NTL in accordance with the various embodiments described herein. Moreover, the determining at 2302 can comprise correlating (e.g., via correlation component 2218) the NTL to the ETT insertion depth via one or more relationships characterized by Equation 1. In one or more embodiments, the method 2300 can also comprise displaying the target reference points, NTL digital measurement, and/or ETT (e.g., via one or more input devices 2206) in accordance with the various embodiments described herein. Also, the method 2300 can comprise displaying reference information, such as medical information 304 and/or patient information 802 (e.g., via one or more input devices 2206) in accordance with the various embodiments described herein.
At 2304, the method 2300 can comprise inserting an ETT into the patient's trachea to the ETT insertion depth determined at 2302. For example, the ETT insertion depth determined at 2302 can correlate to a position between the patient's voice cords and carina. For instance, the ETT insertion depth determined at 2302 can correlate to a position between the patient's second rib and third rib, wherein the ETT is not positioned in either the left or right bronchus. Thus, the inserting at 2304 can be properly and expeditiously conducted via digitally measuring captured image data during the determinations at 2302.
In order to provide additional context for various embodiments described herein,
Generally, program modules include routines, programs, components, data structures, etc., that perform particular tasks or implement particular abstract data types. Moreover, those skilled in the art will appreciate that the inventive methods can be practiced with other computer system configurations, including single-processor or multiprocessor computer systems, minicomputers, mainframe computers, Internet of Things (“IoT”) devices, distributed computing systems, as well as personal computers, hand-held computing devices, microprocessor-based or programmable consumer electronics, and the like, each of which can be operatively coupled to one or more associated devices.
The illustrated embodiments of the embodiments herein can be also practiced in distributed computing environments where certain tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules can be located in both local and remote memory storage devices.
Computing devices typically include a variety of media, which can include computer-readable storage media, machine-readable storage media, and/or communications media, which two terms are used herein differently from one another as follows. Computer-readable storage media or machine-readable storage media can be any available storage media that can be accessed by the computer and includes both volatile and nonvolatile media, removable and non-removable media. By way of example, and not limitation, computer-readable storage media or machine-readable storage media can be implemented in connection with any method or technology for storage of information such as computer-readable or machine-readable instructions, program modules, structured data or unstructured data.
Computer-readable storage media can include, but are not limited to, random access memory (“RAM”), read only memory (“ROM”), electrically erasable programmable read only memory (“EEPROM”), flash memory or other memory technology, compact disk read only memory (“CD-ROM”), digital versatile disk (“DVD”), Blu-ray disc (“BD”) or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, solid state drives or other solid state storage devices, or other tangible and/or non-transitory media which can be used to store desired information. In this regard, the terms “tangible” or “non-transitory” herein as applied to storage, memory or computer-readable media, are to be understood to exclude only propagating transitory signals per se as modifiers and do not relinquish rights to all standard storage, memory or computer-readable media that are not only propagating transitory signals per se.
Computer-readable storage media can be accessed by one or more local or remote computing devices, e.g., via access requests, queries or other data retrieval protocols, for a variety of operations with respect to the information stored by the medium.
Communications media typically embody computer-readable instructions, data structures, program modules or other structured or unstructured data in a data signal such as a modulated data signal, e.g., a carrier wave or other transport mechanism, and includes any information delivery or transport media. The term “modulated data signal” or signals refers to a signal that has one or more of its characteristics set or changed in such a manner as to encode information in one or more signals. By way of example, and not limitation, communication media include wired media, such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media.
With reference again to
The system bus 2408 can be any of several types of bus structure that can further interconnect to a memory bus (with or without a memory controller), a peripheral bus, and a local bus using any of a variety of commercially available bus architectures. The system memory 2406 includes ROM 2410 and RAM 2412. A basic input/output system (“BIOS”) can be stored in a non-volatile memory such as ROM, erasable programmable read only memory (“EPROM”), EEPROM, which BIOS contains the basic routines that help to transfer information between elements within the computer 2402, such as during startup. The RAM 2412 can also include a high-speed RAM such as static RAM for caching data.
The computer 2402 further includes an internal hard disk drive (“HDD”) 2414 (e.g., EIDE, SATA), one or more external storage devices 2416 (e.g., a magnetic floppy disk drive (“FDD”) 2416, a memory stick or flash drive reader, a memory card reader, etc.) and an optical disk drive 2420 (e.g., which can read or write from a CD-ROM disc, a DVD, a BD, etc.). While the internal HDD 2414 is illustrated as located within the computer 2402, the internal HDD 2414 can also be configured for external use in a suitable chassis (not shown). Additionally, while not shown in environment 2400, a solid state drive (“SSD”) could be used in addition to, or in place of, an HDD 2414. The HDD 2414, external storage device(s) 2416 and optical disk drive 2420 can be connected to the system bus 2408 by an HDD interface 2424, an external storage interface 2426 and an optical drive interface 2428, respectively. The interface 2424 for external drive implementations can include at least one or both of Universal Serial Bus (“USB”) and Institute of Electrical and Electronics Engineers (“IEEE”) 1394 interface technologies. Other external drive connection technologies are within contemplation of the embodiments described herein.
The drives and their associated computer-readable storage media provide nonvolatile storage of data, data structures, computer-executable instructions, and so forth. For the computer 2402, the drives and storage media accommodate the storage of any data in a suitable digital format. Although the description of computer-readable storage media above refers to respective types of storage devices, it should be appreciated by those skilled in the art that other types of storage media which are readable by a computer, whether presently existing or developed in the future, could also be used in the example operating environment, and further, that any such storage media can contain computer-executable instructions for performing the methods described herein.
A number of program modules can be stored in the drives and RAM 2412, including an operating system 2430, one or more application programs 2432, other program modules 2434 and program data 2436. All or portions of the operating system, applications, modules, and/or data can also be cached in the RAM 2412. The systems and methods described herein can be implemented utilizing various commercially available operating systems or combinations of operating systems.
Computer 2402 can optionally comprise emulation technologies. For example, a hypervisor (not shown) or other intermediary can emulate a hardware environment for operating system 2430, and the emulated hardware can optionally be different from the hardware illustrated in
Further, computer 2402 can be enable with a security module, such as a trusted processing module (“TPM”). For instance with a TPM, boot components hash next in time boot components, and wait for a match of results to secured values, before loading a next boot component. This process can take place at any layer in the code execution stack of computer 2402, e.g., applied at the application execution level or at the operating system (“OS”) kernel level, thereby enabling security at any level of code execution.
A user can enter commands and information into the computer 2402 through one or more wired/wireless input devices, e.g., a keyboard 2438, a touch screen 2440, and a pointing device, such as a mouse 2442. Other input devices (not shown) can include a microphone, an infrared (“IR”) remote control, a radio frequency (“RF”) remote control, or other remote control, a joystick, a virtual reality controller and/or virtual reality headset, a game pad, a stylus pen, an image input device, e.g., camera(s), a gesture sensor input device, a vision movement sensor input device, an emotion or facial detection device, a biometric input device, e.g., fingerprint or iris scanner, or the like. These and other input devices are often connected to the processing unit 2404 through an input device interface 2444 that can be coupled to the system bus 2408, but can be connected by other interfaces, such as a parallel port, an IEEE 1394 serial port, a game port, a USB port, an IR interface, a BLUETOOTH® interface, etc.
A monitor 2446 or other type of display device can be also connected to the system bus 2408 via an interface, such as a video adapter 2448. In addition to the monitor 2446, a computer typically includes other peripheral output devices (not shown), such as speakers, printers, etc.
The computer 2402 can operate in a networked environment using logical connections via wired and/or wireless communications to one or more remote computers, such as a remote computer(s) 2450. The remote computer(s) 2450 can be a workstation, a server computer, a router, a personal computer, portable computer, microprocessor-based entertainment appliance, a peer device or other common network node, and typically includes many or all of the elements described relative to the computer 2402, although, for purposes of brevity, only a memory/storage device 2452 is illustrated. The logical connections depicted include wired/wireless connectivity to a local area network (“LAN”) 2454 and/or larger networks, e.g., a wide area network (“WAN”) 2456. Such LAN and WAN networking environments are commonplace in offices and companies, and facilitate enterprise-wide computer networks, such as intranets, all of which can connect to a global communications network, e.g., the Internet.
When used in a LAN networking environment, the computer 2402 can be connected to the local network 2454 through a wired and/or wireless communication network interface or adapter 2458. The adapter 2458 can facilitate wired or wireless communication to the LAN 2454, which can also include a wireless access point (“AP”) disposed thereon for communicating with the adapter 2458 in a wireless mode.
When used in a WAN networking environment, the computer 2402 can include a modem 2460 or can be connected to a communications server on the WAN 2456 via other means for establishing communications over the WAN 2456, such as by way of the Internet. The modem 2460, which can be internal or external and a wired or wireless device, can be connected to the system bus 2408 via the input device interface 2444. In a networked environment, program modules depicted relative to the computer 2402 or portions thereof, can be stored in the remote memory/storage device 2452. It will be appreciated that the network connections shown are example and other means of establishing a communications link between the computers can be used.
When used in either a LAN or WAN networking environment, the computer 2402 can access cloud storage systems or other network-based storage systems in addition to, or in place of, external storage devices 2416 as described above. Generally, a connection between the computer 2402 and a cloud storage system can be established over a LAN 2454 or WAN 2456 e.g., by the adapter 2458 or modem 2460, respectively. Upon connecting the computer 2402 to an associated cloud storage system, the external storage interface 2426 can, with the aid of the adapter 2458 and/or modem 2460, manage storage provided by the cloud storage system as it would other types of external storage. For instance, the external storage interface 2426 can be configured to provide access to cloud storage sources as if those sources were physically connected to the computer 2402.
The computer 2402 can be operable to communicate with any wireless devices or entities operatively disposed in wireless communication, e.g., a printer, scanner, desktop and/or portable computer, portable data assistant, communications satellite, any piece of equipment or location associated with a wirelessly detectable tag (e.g., a kiosk, news stand, store shelf, etc.), and telephone. This can include Wireless Fidelity (“Wi-Fi”) and BLUETOOTH® wireless technologies. Thus, the communication can be a predefined structure as with a conventional network or simply an ad hoc communication between at least two devices.
What has been described above include mere examples of systems, computer program products and computer-implemented methods. It is, of course, not possible to describe every conceivable combination of components, products and/or computer-implemented methods for purposes of describing this disclosure, but one of ordinary skill in the art can recognize that many further combinations and permutations of this disclosure are possible. Furthermore, to the extent that the terms “includes,” “has,” “possesses,” and the like are used in the detailed description, claims, appendices and drawings such terms are intended to be inclusive in a manner similar to the term “comprising” as “comprising” is interpreted when employed as a transitional word in a claim. The descriptions of the various embodiments have been presented for purposes of illustration, but are not intended to be exhaustive or limited to the embodiments disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the described embodiments. The terminology used herein was chosen to best explain the principles of the embodiments, the practical application or technical improvement over technologies found in the marketplace, or to enable others of ordinary skill in the art to understand the embodiments disclosed herein.
This application claims priority to U.S. Provisional Patent Application Ser. No. 62/747,891 filed on Oct. 19, 2018, entitled “NOSE TO TRAGUS LENGTH BASED (NTLB) TAPE.” The entirety of the aforementioned application is incorporated by reference herein.
| Number | Date | Country | |
|---|---|---|---|
| 62747891 | Oct 2018 | US |
