Multimodal Feature Analysis for Quantitative Performance Evaluation of Endotracheal Intubation

Abstract

Endotracheal intubation (ETI) is a crucial medical procedure performed on critically ill patients. It involves insertion of a breathing tube into the trachea i.e. the windpipe connecting the larynx and the lungs. Often, this procedure is performed by the paramedics (aka providers) under challenging prehospital settings e.g. roadside, ambulances or helicopters. Successful intubations could be lifesaving, whereas, failed intubation could potentially be fatal. Under prehospital environments, ETI success rates among the paramedics are surprisingly low and this necessitates better training and performance evaluation of ETI skills. Currently, few objective metrics exist to quantify the differences in ETI techniques between providers. In this pilot study, we develop a quantitative framework for discriminating the kinematic characteristics of providers with different experience levels. The system utilizes statistical analysis on spatio-temporal multimodal features extracted from optical motion capture, accelerometers and electromyography (EMG) sensors. Our experiments involved three individuals performing intubations on a dummy, each with different levels of training. Quantitative performance analysis on multimodal features revealed distinctive differences among different skill levels. In future work, the feedback from these analysis could potentially be harnessed for enhanced ETI training.