BBMMEE 220000//330000:: BBIIOOMMEEDDIICCAALL EENNGGIINNEEEERRIINNGG DDEESSIIGGNN UUmmbbiilliiccaall CCoorrdd MMooddeell ffoorr UUmmbbiilliiccaall VVeeiinn CCaatthheetteerriizzaattiioonn TTrraaiinniinngg −− TTHHEE UUMMBBIILLIICCAALL TTEEAAMM –– PPRROOGGRREESSSS RREEPPOORRTT 44 Friday, October 5 to Thursday, October 11, 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 infant abdomen.LLaasstt WWeeeekk’’ss GGooaallss:: - Brainstorming on ideas and materials. - Revise PDS. - Team Building: Write ups. - Final Version of Design Matrix. - Meet with client to discuss our brainstorming results and final idea proposals. - Start Oral Presentation and Mid-Term Paper Preparations SSuummmmaarryy ooff AAccccoommpplliisshhmmeennttss:: -- Design Matrix The team reorganized the design challenges to 3 main elements: architecture, stabilization and materials. Architecture includes the general size and structure of the model, the design and location of the blood reservoir(s), the course of the cord, etc. Stabilization deals with fixing the umbilical cord to the model to preventing slipping into and out of the model. The general consensus is to fix a stabilizing structure on the umbilical cord before attaching it to the gel (ie. the "abdomen"). Hence this project challenge can be broken down into 2 complementary parts: cord-level stabilization and gel-level stabilization. The cord-level stabilizing structure serves mainly to prevent interior and exterior slipping of the cord, while the gel-level stabilizing structure fixes the cord-level structure onto the gel. Materials has to do with selecting the appropriate substance for the gel and other components of the model, and designing the mold to make the gel. The photos in Appendix A depict the brainstorming process. Architecture: The design criteria for the architecture element are usability (whether the model is user-friendly), reproducibility (whether it can be easily mass-produced, ie. manufacturing complexity), fixability (whether it is easy to backtrack when mistakes are made, ie. repair), availability (whether the components can be readily obtained) and functionality (whether it serves all the required functions). All criteria are considered equally important. The design criteria are abbreviated as follows in the remaining text: - U = usability - R = reproducibility - X = fixability - A = availability - F = functionality Model 1 cuts the body of the model into anterior and posterior halves. The posterior half is to be made of a red, hard, transparent material, while the anterior half serves as the "abdomen". The biggest advantage of this model is that trainees are able to see the depth of catheterization through the posterior half, so that no blood reservoirs are needed. However, the team
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