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Video Demonstration

For Inquiry and Purchase

Dr. M. Christopher M.D. (Anaes),
Chris Innovations India,
Ph: +91 9443412873, +91 9487410467
E-mail: dr.chris.judith@gmail.com

Important Notice

The inventor is willing to transfer his technology to any medical devices manufacturing and marketing company that comes forward so that the futuristic vision of the Chris Airway Monitor is realized and millions of lives are saved.

Introduction

Welcome to our Official website

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Dr. M. Christopher M.D. is an Anaesthetist from the state of Tamil Nadu in India. For the past 15 years, he had been working on a new idea, which would revolutionize the field of medical diagnostics. The idea pertained to a life-saving anaesthesia monitor that could aid in intubation procedures. When he had presented his idea on a national level conference in the Indian Institute of Technology (IIT) Madras in the year 2006, he was awarded the L-RAMP Innovations Award of Excellence for the concept of what is now called the Chris Airway Monitor™. Following this award, the device was studied in the year 2011 by Kaybase – a Chennai based market research agency – and concluded that the device was welcomed by surgeons, anaesthetists and critical care specialists throughout its study group (details below).

Following the study, Dr. Christopher had displayed the Chris Airway Monitor in several national and international level Medical Equipments Expo and Anaesthesia conferences. In the year 2017, he had personally visited major Tertiary hospitals throughout India, including the All India Institute of Medical Sciences (AIIMS) New Delhi, and demonstrated the Chris Airway Monitor. He has received numerous positive feedbacks to this end. Now, for the first time after 15 years of meticulous research and careful analysis, Dr. Christopher is ready to let the world become aware of his breakthrough medical innovation.

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Problem Statement

Airway management

Airway management is the first step in the ABCs of emergency Cardio Pulmonary Resuscitation (CPR). Among the several methods of securing the airway tract, endotracheal intubation is the gold standard method of airway protection, allowing positive pressure ventilation of the lungs without gaseous inflation of the stomach, gastric regurgitation, and pulmonary soiling. In this method, one end of an endotracheal tube is inserted into the trachea through either the mouth (orotracheal intubation) or the nose (nasotracheal intubation) of the patient. The other end of the tube is then connected either to a Bag Mask Valve for manual ventilation or to a mechanical ventilator. This procedure of inserting the endotracheal tube into the trachea through either the mouth or the nose is called endotracheal intubation.

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However, endotracheal intubation requires that the tracheal position of the endotracheal tube be confirmed by another equipment. Immediate confirmation of the proper lodgment of the endotracheal tube inside the trachea following endotracheal intubation is very important in order to assure adequate oxygen supply to the patient. If the tube is accidentally inserted into the esophagus – which happens very often in clinical practice due to difficult tracheal intubation1 – then a prompt diagnosis has to be made within seconds and the endotracheal tube has to be taken out and reinserted into the trachea. Failure to detect an accidental esophageal intubation can lead to many complications in the patient, including increased risk of hypertension, desaturation, unexpected admissions to the intensive care unit (ICU) and death-on-table. In an analysis of 1541 claims2, death or brain damage occurred in 85% of cases due to adverse respiratory events and among those, esophageal intubation was reported to be the cause in 18% of cases.

End tidal CO2 monitoring (Capnography) is till date the gold standard methodology to confirm the tracheal placement of the endotracheal tube.3 Despite its limitations as an endotracheal tube position detector (see below), it is still regarded as the front-line monitor to confirm an endotracheal intubation.

In spite of its popularity, the Capnography is under-used. There was a study conducted in the United Kingdom about the usage of the Capnography in Intensive Care Units (ICUs) across the country. According to the study4, Capnography during intubation was regularly used by only 32% of ICUs. The remaining 43% of ICUs used it sometimes and the rest 25% of ICUs never used the Capnography during intubation to confirm the endotracheal tube position. The usage of the Capnography outside the hospitals (pre-hospital settings) such as in roadside trauma is even rarer, particularly in developing countries like India. Hence, naturally, endotracheal intubation – which is the gold standard method of airway management – has never become the standard protocol in Cardio Pulmonary Resuscitation (CPR).

The main reason for the limitation of the Capnography as an endotracheal tube position detector is because it is based on the principle of gas exchange in the lungs. Hence any medical condition of the patient that would limit gaseous exchange in the lungs would lead to a false negative reading in the Capnography. Such medical conditions would include cardiac arrest5, circulatory shock, severe airway obstruction, pulmonary embolism, status asthmaticus and so on. Other techniques for confirmation of endotracheal tube location, such as ultrasound imaging and the Esophageal Detector Devices have their own limitations as well and they are not currently endorsed for widespread implementation.6

A word about the videolaryngoscope has to be mentioned as well. Since the videolaryngoscope provides direct visualization of the trachea, it is very useful inside Operation Rooms to guide endotracheal intubation. However, a meta-analysis7 on the use of videolaryngoscopes has noted that there are different designs of videolaryngoscopes and it is unlikely that all of them perform equally. And considering its high cost, videolaryngoscopes can never become the standard of care in pre-hospital settings and in all primary level hospitals particularly in developing countries like India. Moreover, in road traffic accidents where the victim is suspected to have a cervical spine injury, videolaryngoscopes can never be used for endotracheal intubation because the neck needs to be mobilized before intubation. Blind nasotracheal intubation is the only option available to secure the airway in such a situation and even experienced hands never attempt a blind nasaotracheal intubation because it is associated with significantly high chances of accidental esophageal intubation.

The American College of Emergency Physicians has declared that at present there is no single technique that is 100% reliable to detect the endotracheal tube position in all circumstances.8-9 In the absence of an efficient, affordable, portable and standard equipment to confirm the endotracheal tube position, endotracheal intubation is rarely done as part of the airway management in roadside emergency situations. Alternative sub-standard methods of securing the airway (eg. Esophageal Obturator Airway, Esophageal Tracheal Airway, etc.) are being advocated instead. Millions of lives are being lost because of the absence of an efficient, affordable, portable and standard endotracheal tube position detector. There is, therefore, an urgent need to develop an affordable and reliable endotracheal tube position detector so that airway management is given its proper place in the ABCs of CPRs.

Chris Airway Monitor

The Chris Airway Monitor is the next generation endotracheal tube position detector that combines 100% diagnostic precision with affordability, thereby making it the ideal device for implementation worldwide.



CAPNOGRAPHY CHRIS AIRWAY MONITOR
CO2 Technology Non-CO2 Technology
Gold standard for ET tube detection following intubation. Same diagnostic precision as the Capnography
Unreliable in many medical conditions including cardiac arrest, status asthmaticus and pulmonary embolism. Overcomes all the drawbacks of the conventional Capnography and yields 100% accuracy in all conditions.
Costly Affordable
Many hospitals in the world do not have a Capnography monitor. It can be conveniently used in every level of healthcare systems worldwide.

Conclusion

Endotracheal intubation is a life-saving procedure done on a routine basis in clinical practice. There is, at present, no single affordable technology that helps confirm the correct placement of the endotracheal tube with 100% accuracy in every circumstance, particularly when performing roadside Cardiopulmonary Resuscitation (CPR). But with the Chris Airway Monitor, we can liberalize the hand so that anyone can be trained to safely perform the life saving intubation procedure, including nurses and ambulance drivers. This way, airway management can take its rightful place as the A in the ABCs of emergency resuscitation and millions of lives can be saved.

References

Here are the various references available

  1. The incidence of difficult tracheal intubation is as frequent as 7.5% in the normal surgical population. See Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth 1988; 61: 211–6 and Jacobsen J, Jensen E, Waldau T, Poulsen TD. Preoperative evaluation of intubation conditions in patients scheduled for elective surgery. Acta Anaesthesiol Scand 1996; 40: 421–4.
  2. Caplan RA, Posner KL, Ward RJ, Cheney FW. Adverse respiratory events in anesthesia: A closed claims analysis. Anesthesiology 1990; 72: 8280-33.
  3. Robert E. O'Connor & Robert A. Swor. Verification of endotracheal tube placement following intubation, Prehospital Emergency Care, 1999, 3:3, 248-250, DOI: 10.1080/10903129908958945.
  4. A. Georgiou, S. Gouldson, A. Amphlett. Use of Capnography and the Availability of Airway Equipment on UK Intensive Care Units. Critical Care 2010 14(Suppl 1):P167. Online open access: https://doi.org/10.1186/cc8399 (last accessed on 16.03.2018).
  5. Bruce A MacLeod, Michael B Heller, Jody Gerard, Donald M Yealy, MD James J Menegazzi. Verification of endotracheal tube placement with colorimetric end-tidal CO2 detection, Annals of Emergency Medicine, March 1991, Volume 20, Issue 3, Pages 267–270. Online access: https://doi.org/10.1016/S0196-0644(05)80937-0. Last accessed on 15.03.2018.
  6. ACEPNow, Confirmation and Assessment of Endotracheal Tube Location. Online access: http://www.acepnow.com/article/confirmation-assessment-endotracheal-tube-location/2/?singlepage=1. Last accessed on 15.03.2018.
  7. S. R. Lewis, A. R. Butler, J. Parker, T. M. Cook, O. J. Schofield-Robinson, A. F. Smith; Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review, BJA: British Journal of Anaesthesia, Volume 119, Issue 3, 1 September 2017, Pages 369–383, Online access: https://doi.org/10.1093/bja/aex228. Last accessed on 15.03.2018.
  8. ACEPNow, Confirmation and Assessment of Endotracheal Tube Location. Online access: http://www.acepnow.com/article/confirmation-assessment-endotracheal-tube-location/2/?singlepage=1. Last accessed on 15.03.2018.
  9. Robert E. O'Connor & Robert A. Swor. Verification of endotracheal tube placement following intubation, Prehospital Emergency Care, 1999, 3:3, 248-250, DOI: 10.1080/10903129908958945.
  10. Kaybase study of the Chris Airway Monitor, 2011.
  11. Kaybase defines credibility as follows: “The target customer understands the technology behind it and hence knows the benefit promised is deliverable.”

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Dr. M. Christopher M.D. (Anaes)


Phone: : +91 9443412873, +91 9487410467

dr.chris.judith@gmail.com