BME 200 300 Biomedical Engineering Design Fall 2007 Project 33 Umbilical Cord Model for Umbilical Vein Catheterization Training MID SEMESTER REPORT October 23 2007 TEAM MEMBERS Ann Sagstetter Team Leader Padraic Casserly Team Leader Songyu Ng Communicator Angwei Law BSAC Timothy Balgemann BWIG CLIENT Dr Julie Kessel Department of Pediatrics UW Madison ADVISOR Professor Brenda Ogle Department of Biomedical Engineering UW Madison BME 200 300 BIOMEDICAL ENGINEERING DESIGN ADVISOR PROFESSOR BRENDA OGLE MID SEMESTER REPORT PROJECT 33 UMBILICAL Table of Contents Abstract 3 Problem Statement 3 Background Information Anatomy of the Umbilical System 3 Umbilical Vein Catheterization 4 Catheterization Training Current Products 4 Client s Requirements Design Constraints 5 Design Components 6 Ideas for Architecture 6 Design Matrix for Architecture 7 Ideas for Materials 8 Ideas for Stabilization Initial Stabilization Ideas 9 Evolution of Ideas after Consultation with Client 10 Design Matrix for Materials Stabilization 10 The Final Solution 11 Current Potential Difficulties About the Foam Support 11 About the Stabilizing Structure 12 About Other Components 12 Future Work 12 References 13 Appendix Product Design Specifications 14 Page 2 of 16 LAST UPDATED October 23 2007 BME 200 300 BIOMEDICAL ENGINEERING DESIGN ADVISOR PROFESSOR BRENDA OGLE MID SEMESTER REPORT PROJECT 33 UMBILICAL Abstract The goal of this design project is to develop a training model that mimics the human neonatal abdomen focusing primarily on the internal anatomical course of the umbilical vein and the external texture of the abdomen This model would be used for umbilical vein catheterization training incorporating real umbilical cords Currently there are two existing models in the market which have been deemed unsatisfactory one due to its price and the other because of inadequate mimicry of the umbilical cord placement in a newborn The purpose of this project is to bridge the insufficiencies of these devices by creating a design that will stabilize a real umbilical cord during the training procedure Problem Statement The American Academy of Pediatrics Neonatal Resuscitation Program NRP requires training for thousands of physicians and medical staff involved in 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 Catheterization training on a model can help to improve on this skill outside of the delivery room Developing a model that not only improves on negative aspects of the existing models but also meets or exceeds the positive aspects of those models will create a positive learning experience for trainees before the critical situation arises This means that the design model must mimic the umbilical vein path within an infant like the Laerdal model while being simple to prepare and compatible with an umbilical cord like the baby bottle model All this must be done while ensuring stability of the cord and maintaining a high safety level associated with the handling of human tissue and blood borne pathogens Background Materials ANATOMY OF THE UMBILICAL SYSTEM While in the uterus the fetus is connected to the mother through the umbilical cord and placenta The umbilical cord carries all nutrient and waste from fetal metabolism to and from the infant respectively The umbilical cord itself has an average length at term of 56 cm and is free to move with the baby The cord normally has three blood vessels running its length two arteries and a vein These three vessels and the allantoic duct are surrounded by the Wharton s jelly This gelatinous substance is composed mostly of hyaluronic acid and is rich in stem cells The small arteries spiral around the vein until the umbilicus of the fetus where they diverge The arteries are responsible for carrying deoxygenated blood away from the fetus while the vein brings oxygenated blood from the mother to the baby The umbilical vein is larger in diameter and has thinner walls compared to the umbilical arteries At the umbilicus the umbilical vein diverges from the arteries The arteries descend towards the legs and terminate at the femoral arteries while the umbilical vein ascends through the abdominal cavity to the portal vein of the liver which leads into the inferior vena cava At birth the umbilical cord is severed and clamped Specifically the umbilical vein and arteries collapse on themselves and eventually turn into ligaments The umbilical vein turns into a ligament extending from the umbilicus to the ligamentum venosum separating the two lobes of the liver Page 3 of 16 LAST UPDATED October 23 2007 BME 200 300 BIOMEDICAL ENGINEERING DESIGN ADVISOR PROFESSOR BRENDA OGLE MID SEMESTER REPORT PROJECT 33 UMBILICAL UMBILICAL VEIN CATHETERIZATION When a newborn infant is in critical condition it is often necessary to infuse medication as quickly as possible in order to save the infant s life The fastest way to do this is to start an intravenous line through the umbilical vein To do this a clinician must unclamp the umbilical cord and cut it down to 1 2 cm above the skin surface This ensures that the line inserted into the vein will meet minimal twisting as it passes into the abdomen A 5 or 8 French catheter is most often used because of the small umbilical vein diameter Before the catheter is inserted the clinician will wrap a small tie around the cord to stop any bleeding once the catheter is inserted When inserted the catheter enters only about 5 cm If the catheter is inserted too far it could pierce through the portal vein or make its way to the heart To check the orientation of the catheter the clinician draws back a small amount of blood into the syringe If no blood enters the chamber or if resistance is met then the clinician must attempt to insert the catheter again or fix the orientation This is to ensure that the catheter has not punctured through the wall of the vessel or that it is not suctioned to the side wall of the vessel An umbilical vein catheter should only be used as a temporary line this is due to many different reasons One reason is that the umbilical vein and cord begin to deteriorate after birth The weakened vessel could tear or fuse with the line if it is left inside for too long Another reason is that with the cord open to the environment an entryway is provided for bacteria and other pathogens Also septic shock can occur in severe cases CATHETERIZATION
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