Due to a large number of redundant degrees of freedom (DOFs), the hyper-redundant manipulator shows outstanding dexterity and adaptability in avoiding the obstacles in confined space. In this paper, a hybrid obstacle-avoidance method of spatial hyper-redundant manipulators is proposed, with both efficiency and accuracy considered. The space around an obstacle is classified into safe, warning, and dangerous zones. A two-level protection strategy is then addressed to handle the obstacle-avoidance problem from qualitative (i.e., pseudo-distance based on super-quadric function) and quantitative (i.e., Euclidean distance based on practical geometry function) perspectives, respectively. The only condition for switching between the two-level protections is the value of pseudo-distance. Then, a modified modal method, which is a trajectory planning method, is presented to plan the collision-free trajectory of the manipulator by maximizing the minimum pseudo-distance or Euclidean distance in different zones. Some parameters, including the arm-angle parameters and the equivalent link length parameters, are defined to represent the manipulator configuration. They are adjusted to avoid the obstacle, singularity, and joint limit. The simulations of 12-DOF manipulator and an experiment of 18-DOF manipulator verify the proposed methods.

Introduction: In confined-space airway emergencies, prehospital personnel may need to perform cricothyrotomy when conventional airway techniques cannot be utilized or have failed. This study is a prospective, cross-over, randomized controlled trial that compares two widely-known techniques using two commercially available kits.

Methods: Twenty residents at Palmetto Health Richland Department of Emergency Medicine participated in the study. Their performance was assessed using the time required to placement and correctness of placement for each device. The residents performed the procedures on an Air-Man™ manikin that had been situated in a confined space. The residents also indicated which kit they would prefer in a confined-space, emergency airway situation.

Results: All of the devices were placed in the airway. The mean time to placement for the Melker™ and Quicktrach™ kits was 108.5 seconds and 23.9 seconds, respectively. This yielded a mean difference of 84.5 seconds, which provided a t-statistic of 8.88 (p < 0.0001). There was no evidence of a carry-over effect (p = 0.292) or a period effect (p = 0.973). All residents preferred using the Quicktrach™ kit.

Conclusions: Use of the Quicktrach™ kit resulted in the fastest time to placement, was placed correctly in the airway, and was preferred by each of the residents. Its small, simple, and sturdy design, with few parts and easy manipulation, allow the Quicktrach™ to be a valuable option in prehospital situations involving confined spaces. The Melker™ kit, with its many parts, and need for greater manipulation, is not as easily utilized or preferred in a confined space scenario.