BBMMEE 220000//330000:: BBIIOOMMEEDDIICCAALL EENNGGIINNEEEERRIINNGG DDEESSIIGGNN UUmmbbiilliiccaall CCoorrdd MMooddeell ffoorr UUmmbbiilliiccaall VVeeiinn CCaatthheetteerriizzaattiioonn TTrraaiinniinngg −− TTHHEE UUMMBBIILLIICCAALL TTEEAAMM –– PPRROOGGRREESSSS RREEPPOORRTT 1100 Friday, November 16 to Thursday, November 29, 2007 Clients: Advisor: DDrr.. JJuulliiee KKeesssseell PPrrooffeessssoorr BBrreennddaa OOggllee Department of Pediatrics Department of Biomedical Engineering 608‐417‐6236 (office) 2144 Engineering Centers Building 608‐265‐7000 (pager; code: 6318) 608‐265‐8267 / [email protected] [email protected] [email protected] SShhaarroonn BBlloohhoowwiiaakk Neonatal research laboratory 608‐ 417‐5780/ [email protected] Team Members: AAnnnn SSaaggsstteetttteerr PPaaddrraaiicc CCaasssseerrllyy Team Leader (Leadership & Progress Reports) Team Leader (Finance and Time Contributions) 507‐951‐8735 / [email protected] 507‐269‐9901 / [email protected] SSoonnggyyuu NNgg ((aakkaa KKeellvviinn)) AAnnggwweeii LLaaww Communicator BSAC 608‐770‐7855 / [email protected] 310‐804‐7028 / [email protected] TTiimmootthhyy BBaallggeemmaannnn BWIG 630‐903‐9811 / [email protected] IInniittiiaall PPrroobblleemm SSttaatteemmeenntt:: The American Academy of Pediatrics Neonatal Resuscitation Program (NRP) is required training for thousands of physicians and medical staff who attend the delivery of newborns. Placement of an intravenous catheter in the umbilical vein of the cord stump in a distressed newborn is one way to provide life saving medication and is a skill that is essential to the NRP course. Hands‐on training in the placement of an umbilical venous catheter has received increased attention and emphasis since the 2005 update of the NRP course. Currently, two models for hands‐on training are available. Some companies make newborn models for CPR that also have artificial umbilical cords (ex Laerdol). These models appear to inadequately mimic placement in a real cord and are very expensive. Alternatively, the American Academy of Pediatrics recommends using sections of an umbilical cord obtained after delivery. The cord section is placed in a glass baby bottle with part of the nipple cut off so the cord extends about 1/2 an inch from the top of the nipple. While this model has the advantage of using a real cord, the cord is secured poorly and thus does not adequately mimic placement in a newborn. My design idea is to make a support for real umbilical cords that would more closely mimic the umbilical stump of a newborn. The model could be made out of a material that might mimic the abdominal wall, such as ballistic grade gel, and might perhaps have two halves that clamp around a section of real cord. The model could mimic the curves of the umbilical vein after it enters the body, making placement more realistic. Ultimately, this model, which would best be quite inexpensive and disposable, could be marketed to the over 25,000 individuals in the US who teach NRP and would likely represent a vast improvement over the "baby bottle" model. RReevviisseedd PPrroobblleemm SSttaatteemmeenntt To construct a model optimized for use in the umbilical vein catheterization training program, a suitable method is to be devised to firmly hold a fresh umbilical cord in place. In addition, the model needs to accurately mimic the external texture and internal structure of the human neonatal abdomen. LLaasstt WWeeeekk’’ss GGooaallss:: Gel Approach 1) Experiments to determine if cold drying will increase the success of catheterization 2) More data points needed for the optimization of gel concentration Sphygmometer Approach 3) Shopping for better alternatives to substitute current blood pressure cuff 4) Experiments to miniaturize air cushion of baby oxygen mask (a continuous circular cuff) SSuummmmaarryy ooff AAccccoommpplliisshhmmeennttss:: EExxppeerriimmeenntt 11:: CCoorrdd PPrreeppaarraattiioonn CCoonnddiittiioonn TTeesstt ((NNoovv.. 1166tthh)) The Gel Approach Calculations revealed that some linear relationship exists between the tensile force and the cross‐sectional area of the cord. However, as there is only one data point for each concentration, the mathematical analysis was deemed unreliable. More data is needed to help determine the optimum concentration for the gel approach. As for the assessment of catheterization success, the results are tabulated below. It must be emphasized that only 2 cords were provided without indication of the proximal and distal ends. Apart from the inherent differences between cord sections, all controllable factors were kept constant except for their treatment methods. Note: Sections A2, A3, K2 and K3 were incubated at 2 degrees Celsius for 20 hours and 35 minutes. Cord Total Length (cm) A 33.3 K 24.5 Cord Section Location Along Cord Section Length (cm) Treatment Initial Mass (g) Final Mass (g) Catheterizable? A1 End 11.1 No treatment −−Yes A2 Middle 11.1 Cooled overnight / airtight 7.62 7.45 Yes A3 End 11.1 Cooled overnight / exposed 12.13 11.74 Yes K1 End 8.17 No treatment −−Yes K2 Middle 8.17 Cooled overnight / airtight 3.48 3.44 Yes K3 End 8.17 Cooled overnight / exposed 4.87 3.92 Yes It was apparent that all treatment
View Full Document
Unlocking...