Novel Fiberoptic Intubation Trainer That Measures Time to Completion and Duration of Contact

Fiberoptic intubation is more accessible to many emergency physicians as disposable fiberoptic intubation scopes have been introduced in a number of emergency departments. Unfortunately, many current emergency physicians and emergency medicine residents have limited formal training on fiberoptic intubation. Because the skill of fiberoptic intubation differs substantially from traditionally taught laryngoscopy, frequent application of newly available fiberoptic intubation equipment may be limited by insufficient emergency physician confidence in their ability to use it.

The central objective is to build a device that mimics features of fiberoptic intubation so that emergency physicians can safely develop the skill of fiberoptic intubation prior to clinical use. Additional objectives are to measure the time an emergency physician requires to successfully navigate the simulated airway and to measure the duration of contact that the fiberoptic scope makes with the simulated airway.

A brief literature review was used to identify prior devices, including their features and limitations. One device highlighted slightly separated foam baffles placed in series with a hole in a slightly different location such that users had to navigate a maze while being timed (Williams 2009). Another generated a maze of PVC pipes to build the skill of navigation (Giles 2020). Neither of these measured fiberoptic scope contact with the maze or pipe.

A device was created with a maze of PVC and copper pipes, roughly in the dimensions and course of an adult airway. The device identifies when the scope enters the airway using an photosensitive diode, starting a timer. The device uses another diode when the scope reaches the end of the simulated airway, stopping the timer. Additionally, total time that the fiberoptic scope tip touches the "airway's" copper pipe is measured. Both results are displayed.

The tabletop demonstration will show attendees the device itself, highlighting its ability to measure both the total time of airway navigation and the total contact the fiberoptic tip makes with the simulated airway surface. The device itself is interesting. It uses a combination of PVC piping as a scaffold for a maze of electrically-conducting copper piping. The copper piping is used to facilitate measurement of fiberoptic scope contact with the simulated airway's surface. To allow for measurement of this contact, the tip of the scope has a small piece of copper tape connected to a wire that goes through the scope's working channel. Therefore, when the scope's tip touches the airway's copper piping, a circuit is completed to allow for measurement of contact time. The device also uses light-sensing diodes to identify the scope's entry to and exit from the airway, measuring the total time to completion. To make these measurements and display the results, a commercially available Arduino kit was programmed using already-available coding with minimal modifications. To the author's knowledge, use of the Arduino kit in procedural medical education is rare. One publication highlights its use for measurement of force against teeth during intubation (Patel 2025), but it has not been applied broadly to procedural medical education despite its potential. In particular, utilizing the Arduino kit could help quantify procedural skill acquisition in a number of core emergency medicine procedures. Therefore, even the application of the Arduino device to medical education and procedural skill acquisition could give attendees a new tool for future applications. Finally, one of the core goals of the device is to help learners--medical students, residents, and attendings--build the skill of fiberoptic intubation. In the future, the device will be used by unskilled and skilled users to identify whether the quantification of both airway contact and time-to-completion correlates with skill acquisition. The main hypotheses to test are whether skilled users have less total contact time with the simulated airway and whether skilled users require less total time to navigate the airway.