Automated Syringe Dosing DeLorme J J Hanson E E Weisshaar C L Wentland A L BME 400 Department of Biomedical Engineering University of Wisconsin Madison December 8 2004 Advisor Willis J Tompkins Ph D Professor Department of Biomedical Engineering Abstract Many people especially elderly individuals have afflictions along with diabetes including poor eyesight tremors loss of dexterity arthritis and multiple sclerosis These disabilities make it difficult for patients to measure and administer medications with a syringe We have developed a device that electronically drives the plunger on a standard syringe reducing the dexterity normally needed with dosing a syringe We have constructed a prototype that demonstrates the feasibility of driving the syringe on a screw based system with a bimodal stepper motor In our next prototype the device will be handheld and lightweight We will incorporate a user interface consisting of a digital display and numerical keypad Syringe Dosing 2 24 Table of Contents Page Abstract 1 Table of Contents 2 Problem Statement 3 National Student Design Competition 3 Background 3 Current Products 5 Contacts 7 Design Constraints 7 Design Approaches 8 Design Evaluation 10 Our Chosen Design 11 Syringe Dosing Device Operation 12 Prototype 12 Construction of the Prototype 13 Syringe Dosing Device Advantages 14 Syringe Dosing Device Disadvantages 15 Syringe Calibration and Preliminary Testing 15 Future Work 16 Ethical Considerations 17 References 18 Appendix A PDS 20 Appendix B Expenses 24 Syringe Dosing 3 24 Problem Statement Our goal is to develop a syringe delivery device that uses standard 1 cc syringes BD Ultra FineTM Needles 1 and sets the dosage on those syringes within 0 01 cc accuracy This device should minimize the dexterity typically needed with dosing a syringe This device should be easy to use for elderly patients and those with poor eyesight Ideally this machine would be suited to patients who use syringes on a daily basis such as those suffering from diabetes Patients afflicted with maladies in addition to diabetes such as neuromuscular disorders and poor eyesight would also benefit greatly from this device National Student Design Competition This project is part of the 2004 2005 National Student Design Competition an undergraduate competition funded by the Rehabilitation Engineering Research Center on Accessible Medical Instrumentation 2 In conjunction with Marquette University Professor John Enderle of the University of Connecticut chairs the competition The competition is open to students predominantly in biomedical engineering and industrial design Student teams have a choice of three projects a weight scale a syringe dosing device or an ergometer all to assist patients of diabetes obesity paralysis and neuromuscular disorders At the University of Wisconsin Madison another team is working on an ergometer 3 while our team is working on a syringe dosing device Background Diabetes is one of the leading causes of disability in the United States causing dementia low testosterone levels in males excessive thirst frequent urination fatigue changes in vision blindness stroke nerve damage and the need for amputation 4 5 Diabetes is typically treated Syringe Dosing 4 24 with insulin injections where the amount of insulin is determined by eating habits exercise and ultimately a patient s blood glucose level While the changes in vision make it difficult for patients to see and set the dosage on the syringe elderly diabetes patients commonly acquire neuromuscular diseases albeit unrelated to diabetes Nevertheless these diseases make it difficult for patients to control syringes Type 2 diabetes is the most common form of diabetes affecting 18 2 million people in the United States alone This type is found in 9095 of the diabetes patients 6 Those most often afflicted with this disease are older people The Center for Disease Control 6 has predicted that the number of American diabetes patients will increase as Baby Boomers grow older and more sedentary Type 2 diabetes is characterized by a high blood glucose level a high insulin level and a resistance to insulin Figure 1 Contrary to type 1 diabetes Figure 1 Type 2 Diabetes In this disease users develop a resistance to insulin and therefore blood glucose levels rise 7 where insulin does not get produced in proper quantities type 2 diabetics cannot use their insulin effectively 5 A person with diabetes must take daily precautions to maintain optimal health These include healthy eating exercise and blood glucose testing Blood glucose testing will tell if the blood sugar levels are too low hypoglycemia or too high hyperglycemia 4 Irregular blood sugar levels can cause illness dizziness nervousness confusion fainting and or impaired judgment 4 Depending on the blood sugar level insulin may be administered Syringe Dosing 5 24 The injection procedure should be done as recommended by an endocrinologist and is as follows 8 1 Wash hands and area where injecting usually a fatty subcutaneous tissue area such as the stomach 2 Wash medicine bottle top with cotton ball and alcohol 3 Draw air into the syringe equal to the volume of fluid needed 4 Insert needle into medicine bottle and depress plunger pushing all air out of the syringe This action creates a vacuum and allows for easier and smoother filling and delivery 5 Invert medicine bottle and fill syringe making sure the needle is not exposed to air Air bubbles in the barrel will lead to an incorrect amount of medication 6 Once the syringe has been filled to the proper amount keep the bottle and syringe upside down and flick the syringe barrel This moves air bubbles that may have formed at the top of the syringe 7 Push the plunger to move the air bubbles into the vial 8 Check medication dosage 9 Insert needle into skin at a 90 degree angle and deliver medicine at a slow steady rate All medication should be released within 5 seconds 10 Dispose of needle properly It is evident that this is a complicated and involved procedure requiring a fair amount of dexterity in controlling the syringe and perspicacity in detecting bubbles This process should be simplified for the elderly and individuals with neuromuscular disorders and or poor vision Current Products Research was done on current devices available to diabetes patients Most diabetes patients administer insulin using either an insulin pump or a syringe An insulin pump like the Medtronic Figure 2 Medtronic MiniMed insulin pump A