Tackling Single-Use Products_ Medical Laryngoscope

WildDesign Intern Design Sprint

Single-Use Mentality in the Medical industry

By Savio Mathew Mukachirayil

A high volume of landful and incintrated waste from single use devices are from the medical industry

research

Global market value is over

$11,000,000,000 for medical waste management

Poor Waste Management Has A Negative Impact On The Environment

Hazardous Materials Cannot Be Reused Or Recycled Single Use Devices

85%

30%

Packaging Tubes

Only

15%

Recyclable Laryngoscope is a common SUD found in one of the bins in the hospital Waste Is Incinerated The blade is mainly plastic but I found it in the When It's Put Inmetal bin. Bins containing mixed materials cannot be recycled.

The Wrong Bin It is made up of plastic, metal and electronics.

Laryngoscopes Laryngoscopes Syringes

Average Hospital Waste Is Non-Regulated

Waste Is From The Operating Room

...

Medical Waste Is Actually Harzardous

What is it used for?

Shines light and acts as a guide to perform edoscopy for Larynx, a part of the throat leading to the lungs.

Laryngoscope What is it?

A common single use device used by doctors in operation rooms to intubate the patient.

Why Laryngoscope?

"I saw lots of laryngoscope plastic blades in the metal sharps bin and this didn't make sense to me."

How is it used?

Helps the doctor locate the Larynx and guides the breathing tube for assissted ventilator breathing

User Journey Map

After opening, the blade is manouvered using its clear plastic packaing without making direct contact and is fixed onto the handle.

Laryngoscope comes packed with a battery and the blade is in a seperate packaging.

The handle is removed from the packaging.

The patient‘s position is adjusted to increase ease of procedure and decrease discomfort for the patient.

Having the battery already in the handle makes the process faster for me

The blade is carefully put into the throat making the Larynx visible.

Using their thumb and index finger they open the patient‘s mouth.

Not touching the blade helps me to maintain sterile practice

The type C battery is removed from the handle and is discarded. The handle is also discarded.

The LED in the handle turns on as soon as the handle is fixed to it.

Patient requires breathing assistance

Thoughts

The blade is seperated from the handle, and is placed into the metal sharps bin.

My view is blocked if the angle of the patient is not correct and can risk hurting the patient.

Using the side of the blade as a guide, the intubation tube is carefully placed into the trachea, establishing an open airway.

I have to grip the handle tightly and be careful inserting the blade into the throat, I do not want to cause discomfort

I have to be careful not to bash into the patient‘s teeth, it can cause discomfort or even break the teeth.

Without the tube the blade is removed from the patient‘s throat.

Throwing the battery away seems like a big waste but this needs to be done for the good of the patients. You do not want your battery to run out during a procedure.

Seperating the handle and blade is easy but it's not clear which bin to use when the materials are mixed. It‘s easier and safer to throw it in the hazardous waste.

Value Proposition Map: User

Doctor

Value Proposition Map: Doctor

Patient has successful airflow

Job

Intubate the Patient

Manouver the Laryngoscope safely

Easy to slide in the intubation tube

Gains

Has a good angle to luminate the throat

Can see the throat very clearly

Sterile & Clean No worry of contamination

Don't have to get very close to the patient

Sterile Practice

Quick to discard after use Feeling good about the work

Be mindful of time Help the Environment

Looking Proffesional

Easy to manouver into patient's mouth

Easy to assemble the blade and handle

Looking confident

Be mindful of patient

Unsure on which bin to use for certain components of different materials

Doesn't seperate the different materials on blade, takes too much time

Upset the patient Wasteful feeling if tooth breaks when throwing or bleeding in away after using Other important throat occurs it once e.g. jobs to do than batteries organising waste Unware of the properly, busy Don't want to quanitity of schedule waste that builds cause damage to environment up over time

Pains

Embarresed to ask everyone to categorise waste accuretly.

Patient could have a virus and user could catch it

Value Proposition Map: Doctor

Important Job

Patient has successful airflow

Job

Intubate the Patient

Manouver the Laryngoscope safely

Easy to slide in the intubation tube

Can see the throat very clearly

Intubate the Patient

Help the Environment

No worry of contamination

Easy to assemble the blade and handle

Unsure on which bin to use for certain components of different materials

Doesn't seperate the different materials on blade, takes too much time

Upset the patient Wasteful feeling if tooth breaks when throwing or bleeding in away after using Other important throat occurs it once e.g. jobs to do than batteries organising waste Unware of the properly, busy Don't want to quanitity of schedule waste that builds cause damage to environment up over time

Sterile Practice

Be mindful of patient

Looking confident

Be mindful of patient

Pains

Manouver the Laryngoscope safely

Sterile & Clean

Quick to discard after use

Be mindful of time

Essential Gains

Gains

Has a good angle to luminate the throat

Don't have to get very close to the patient

Sterile Practice

Feeling good about the work

Looking Proffesional

Easy to manouver into patient's mouth

Extreme Pains

Embarresed to ask everyone to categorise waste accuretly.

Patient could have a virus and user could catch it

Other important jobs to do than organising waste properly, busy schedule

Unsure on which bin to use for certain components of different materials Wasteful feeling when throwing away after using it once

Be mindful of time

Feeling good about the work

Looking Proffesional

Help the Environment

Insignificant Job

Patient could have a virus and user could catch it Unware of the quanitity of waste that builds up over time

Patient has successful airflow Upset the patient if tooth breaks or bleeding in throat occurs

Doesn't seperate the different materials on blade, takes too much time

Don't want to cause damage to environment

Sterile & Clean Can see the throat very clearly

Easy to manouver into patient's mouth

Has a good angle to luminate the throat Easy to slide in the intubation tube Easy to assemble the blade and handle Quick to discard after use

Embarresed to ask everyone to categorise waste accuretly.

Moderate Pains

No worry of contamination Looking confident Don't have to get very close to the patient

Moderate Gains

Value Proposition Map: Doctor

Gains Creators

Patient has successful airflow

Job

Intubate the Patient

Manouver the Laryngoscope safely

Easy to slide in the intubation tube

Gains

Has a good angle to luminate the throat

Can see the throat very clearly

No worry of contamination

Help the Environment

Easy to assemble the blade and handle

Ergonomic form for comfortable hold and manouver

Seamless to assemble

Seamless to dissassemble

Ergonomic form to hold and manouver

Reusable electrical components

Looking confident

Rechargeable light source

Be mindful of patient

Unsure on which bin to use for certain components of different materials

Doesn't seperate the different materials on blade, takes too much time

Upset the patient Wasteful feeling if tooth breaks when throwing or bleeding in away after using Other important throat occurs it once e.g. jobs to do than batteries organising waste Unware of the properly, busy Don't want to quanitity of schedule waste that builds cause damage to environment up over time

Pains

Reusable Laryngoscope

Easy to recharge Quick to discard after use

Be mindful of time

Easy to slide tube into the trachea

Fully sterile and safe to use

Sterile & Clean

Don't have to get very close to the patient

Sterile Practice

Feeling good about the work

Looking Proffesional

Easy to manouver into patient's mouth

Embarresed to ask everyone to categorise waste accuretly.

Patient could have a virus and user could catch it

Not required to dispose after every use, so no confusion with bins.

Reduced the amount of waste

Ergonomic form to not cause harm to patient Reduced waste being incinerated or going to landfill

Rechargeable powersupply Minimal variety of materials

Similar materials are used, less confusion for easier recycling

No electronic waste

Pain Relievers

Recyclable

Designinated area for intubation tube on Laryngoscope

Product

Value Proposition Map: User

Hospital

Value Proposition Map: Hospital

No worry of contamination with SUD

Gains Efficiently discard tools after use

Patient has successful airflow

Job

Sterile & clean practice

Healthy patient experience

Cost effective Long-term trust with patient

Confident staff Healthy staff experience

Make Profit Time efficient

Looking Proffesional

Effective services

Provide good instruments

Efficient services

Autoclaving (cleaning) machine are expensive

Don't want a bad reputation with the locals

Sterile Practice

Reduced disposal fees

Other important jobs to do than organising waste properly, busy schedule

laser marking (tracing) machines are expensive

Upset the patient

Pains

Don't want to cause damage to environment

Cleaning reusables takes time and addional staff

Value Proposition Map: Hospital

Important Job No worry of contamination with SUD

Sterile & clean practice

Healthy patient experience

Efficiently discard tools after use

Don't want a bad reputations with the locals

Effective services

Sterile practice

Patient has successful airflow Upset the patient

Long-term trust with patient

Make Profit Time efficient

Efficient services

Make Profit

Looking Proffesional

Autoclaving (cleaning) machines are expensive

Long-term trust with patient Laser marking (tracing) machines are expensive

Efficient services

Autoclaving (cleaning) machine are expensive

Don't want a bad reputation with the locals

Sterile Practice

Reduced disposal fees

Confident Staff

Cost effective

Effective services

Provide good instruments

Sterile & Clean practice

Cost effective

Confident staff Healthy staff experience

Essential Gains

Gains

Patient has successful airflow

Job

Extreme Pains

Other important jobs to do than organising waste properly, busy schedule

laser marking (tracing) machines are expensive

Don't want to cause damage to environment

Cleaning reusables takes time and addional staff

Healthy staff experience

Cleaning reusables takes time and addional staff Provide good intruments

Healthy patient experience

Upset the patient

Pains

Insignificant Job

Reduced disposal fees

Other important jobs to do than organising waste properly, busy schedule

Don't want to cause damage to environment

Moderate Pains

Time efficient

Efficiently discard tools after use No worry of contamination with SUD Looking proffesional

Moderate Gains

Value Proposition Map: Hospital

Gains Creators

No worry of contamination with SUD

Gains

Patient has successful airflow

Job

Sterile & clean practice

Healthy patient experience

Easy to clean after each use

Efficiently discard tools after use

Product Cost effective Long-term trust with patient

Confident staff Healthy staff experience

Seamless assembly and use

Make Profit Time efficient

Looking Proffesional

Good reputation, eco friendly

Minimal risk of contamination Mostly reusable laryngoscope

Long term savings, less new tools have to be bought frequently.

Subscription cleaning service

Effective services

Provide good instruments

Efficient services

Autoclaving (cleaning) machine are expensive

Don't want a bad reputation with the locals

Sterile Practice

Reduced disposal fees

Other important jobs to do than organising waste properly, busy schedule

laser marking (tracing) machines are expensive

Don't want to cause damage to environment

Cleaning reusables takes time and addional staff

Reduces landfill costs by reducing waste

Ergonomic form to reduce patient discomort

Upset the patient

Percieved as sustainable and caring institution by the locals

Not required to buy the expensive machines if service is hired externally

Comes back in new packaging and has unused appearance Reduced time spent on categorising waste Instrument used for a longer time

Not percieved as stingy

Pains

Pain Relievers

Patient

Value Proposition Map: Patient

Gains

Fast recovery Patient has successful airflow

Job

Good quality instruments being used Have sterile procedure

Cooperate with staff and hospital

Follow doctor's instructions

Having confident Long-term trust and comfortable with staff and/or workers hospital Feeling of safety Not spend much time in hospital

Be treated and feel better

Trust the health care institution

Feeling vulnerable

Discomfortable procedure

Want to go home earlier

Don't want to see a lot of blood

Feeling of embarressment

Don't want to cause damage to environment

Use of scary looking tools

Unfriendly staff

Pains

Recieving a sense of care

Value Proposition Map: Patient

Important Job

Job

Fast Recovery Feeling vulnerable

Follow doctor's instructions

Having confident Long-term trust and comfortable with staff and/or workers hospital Feeling of safety Not spend much time in hospital

Be treated and feel better

Trust the health care institution

Feeling vulnerable

Discomfortable procedure

Want to go home earlier

Don't want to see a lot of blood

Trust the health care institution

Feeling of embarressment Follow doctor's instructions, e.g. taking the correct medication

Having confident and comfortable workers Feeling of safety

Want to go home

Having sterile procedure Don't want to cause damage to environment

Cooperate wth Staff and hospital

Insignificant Job

Good quality instruments being used Not spend much time in hospital

Don't want to see blood

Use of scary looking tools

Pains

Recieving a sense of care

Unfriendly staff

Recieving a sense of care

Feeling of embarressment

Don't want to cause damage to environment

Unfriendly staff

Patient has successful airflow

Discomfortable procedure

Be treated and feel better

Good quality instruments being used Have sterile procedure

Cooperate with staff and hospital

Essential Gains

Gains

Fast recovery Patient has successful airflow

Extreme Pains

Use of scary looking tools

Moderate Pains

Long term trust with staff and/or hospital

Moderate Gains

Value Proposition Map: Patient

Gains Creators

Gains

Fast recovery Patient has successful airflow

Job

Good quality instruments being used Have sterile procedure

Cooperate with staff and hospital

Follow doctor's instructions

Having confident Long-term trust and comfortable with staff and/or workers hospital Feeling of safety Not spend much time in hospital

Be treated and feel better

Trust the health care institution

Feeling vulnerable

Discomfortable procedure

Want to go home earlier

Don't want to see a lot of blood

Minimum discomfort when going down the mouth

Seamless and easy to use

Minimum assembly required

Ergonomic form to reduce patient discomort

Don't want to cause damage to environment

Unfriendly staff

Pains

Minimal risk of contamination

Evironmentally responsible

Caring for environment

Recieving a sense of care

Feeling of embarressment

Use of scary looking tools

Seamless assembly and use

Discarded after each use

Brand new tool every time

Minimum variety of materials

Form decreases probability of cuts or damages being made Procedure made faster and easier

Pain Relievers

Ergonomic laryngoscope

Single Use Biodegradeable

Looks safe, soft design

Reduced damage to environment

Product

Redesign a laryngoscope which helps doctors very easily manouver comfortably into the patients throat and reduce the amount of incinerated plastic waste currently created.

Concept 1

Dissassembled for autoclave cleaning

Polished reflective metal

All parts completely re-used

Lightsource cannot be cleaned

Rechargeable lightsource

Seamless dissassembly

Prototyping Concept 1 Does an opened metal structure reflect enough light and luminate the pointed area well enough? Yes. The test piece is not curved and a curved structure can reduce the amount of light intensity, but its not polished, polishing it will increase the reflectivity.

Concept 1

Product-Use Journey Concept 1

The blade is attached to the 2nd component, fixing all components together.

The 2nd component is pressed and fixed onto the handle

The three cleaned components arrive in seperate plastic packagings The handle is pushed down onto the charger and attaches the lightsource inside

Without removing the tube, the laryngoscope is removed from the patient's mouth

The blade and tube is put into the patient's throat and is intubated

The blade, 2nd component and the handle is sent for autoclave cleaning

The handle is detached from the other components

The handle is pushed down onto the charger and the light source detaches and attaches onto the charger

Concept 2

Dissassembled for autoclave cleaning

Lightsource cannot be cleaned

Fibre optic connected to lightsource

Light from the fibre optic shines through the thin blade material

Three main seperate components

Blade made of (PLA) biodegradeable material

Prototyping Concept 2 Does enough light pass through the plastic material to luminate the area pointed at? Yes. The test piece is 3mm thick, making it thinner would allow a lot more light to pass through.The colour will be tinted by the colour of the medium it passes through.

Concept 2

Product-Use Journey Concept 2 The handle halves are closed keeping the lightsource inside.

The blade is brand new and the cleaned handle comes packaged. The lightsource is charged.

The handle is opened and pushed into the chargers and attaches onto the lightsource.

The optical fibre is pushed into the PLA blade and the blade fixes onto the handle.

Without removing the tube, the laryngoscope is removed from the patient's mouth

The blade and tube is put into the patient's throat and is intubated.

The handle is opened and sent for autoclave cleaning.

The blade is disposed.

The handle is detached from the blade.

The handle is opened and pushed into the charger and detaches the lightsource.

Concept 3 Small parts are hazardous Steam-bent wood

Single Use Phosphorescent material

Biodegradeable

Research Biodegreadble phosphorescent material is a technology still being developed.

Nyoka is a start-up developing the reusable and biodegradeable glow sticks by studying bioluminescence: self luminating living organanisms.

www.lightbynyoka.com (accessed 2020)

Since laryngoscopes are placed into the throat, it is important for safe chemicals to be used.

Concept 3

Product-Use Journey Concept 3

The handle and blade are attached together

The blade and tube is put into the patient's throat and is intubated.

The blade and handle are new.

Without removing the tube, the laryngoscope is removed from the patient's mouth

The blade is disposed.

The handle is detached from the blade.

Form I have decided to move forward and develop 'Cocept 2' as this currently has most potenital, cheaper than option 1 and the technology is more available than option 3.

The drill is very comfortable to hold and its shaped so that it naturally guides the user to hold it in a particular way. The largest dimension in the cross section of the handle is 60mm from one side to another side.

When the hand-drill is being used, it is kept in a stable position and is not in motion so comfortable and "almost locked" grip is neccessary When I held it upside down I noticed there was more stress on my forewarm and less on my biceps as more effort was required to grip the handle.

Ergonomics

01

How the laryngoscopes are currently held to identify areas of improvement for better ergonomics

02

05

03

04

06

07

The Laryngoscope is held in various positions, especially compared to the hand drill, good form-design should not restrict the freedom of rotation for the user in this case. Which means the form of the handle should have a minimal approach.

The height of the elbow and the angle at the wrist varies.

The position of the fingers and thump does not vary much.

The finger positions on images 01 and 07 seems lower and almost touches the blade. Images 01 and 07 is showing the laryngoscope being put in and out respectively. For this motion, a lower hold will allow more control as its closer to the centre of mass. So shifting the centre of mass away from the blade will allow more control from a higher position Holding the handle higher up will give you a higher range of motion for less discomfort compared to holding it lower.

Screenshots made from Dr. Gallagher's Neighborhood YouTube video.

Available https://www.youtube.com/watch?v=ZJtFb7lGPic&t=523s

Moodboard

Form Development Sketches

Ergonomics

An eliptical cross-section would provide most comfort whilst allowing easy manouvering and not limiting the range of motions for the user.

I did rough cuts to get a better understanding of dimensions, keeping in mind the diameter of a type C battery is 28mm for an approximate dimension for the light source.

The ideal dimensions are 30mm in width and 35mm in length.

Final Design Development

Final Design

Light shines through the blade but the light source makes no contact with the patient and is completely sealed allowing its reuse.

Seamless Assembly

1

2

3

4

5

6

User pushes the clips apart with their thumb

Guides

Soft edges for patient comfort

Guide for easy intubation

Guide for thumb and fingers for user comfort whilst allowing room for easy manouvering

Components

Hinge

Easy and cleanable reusable stainless steel body

Optical Fibre

Single-use disposal biodegradeable PLA blade Reusable Lightsource

WildDesign Intern Design Sprint

Single-Use Mentality in the Medical industry

By Savio Mathew Mukachirayil