1. Manual Ventilator Project Peter Ma, Richard Long, Matt Valaskey, Jimmy Fong Client: Michael K. Abernethy, MD, FACEP Advisor: Paul Thompson, PhD https://www.emed.wisc.edu/emedicine/web_images/agusta_dual_clouds_web.jpg

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3. Overview The product function is to modify the disposable manual ventilator (AMBU bag) to allow hands-free operation. This could be operated by foot or legs with the user in a sitting position.

4. Medflight Overview Have provided emergency care and transport for victims of crashes and disasters for over 20 years Have provided emergency care and transport for victims of crashes and disasters for over 20 years A specially trained team of physicians, nurses, pilots, and dispatchers A specially trained team of physicians, nurses, pilots, and dispatchers Fleet of three helicopters that work in a 225 mile radius of Madison Fleet of three helicopters that work in a 225 mile radius of Madison Respond to emergencies within minutes of receiving notice of a crash Respond to emergencies within minutes of receiving notice of a crash Carry in flight emergency equipment such as: ventilator, blood pressure and heart monitors, IV equipment, defibrillators and pacemaker equipment, emergency medicine and drugs. Carry in flight emergency equipment such as: ventilator, blood pressure and heart monitors, IV equipment, defibrillators and pacemaker equipment, emergency medicine and drugs.

5. Problem Statement Traditionally, AMBU bags operate as an inflatable Traditionally, AMBU bags operate as an inflatable bag by hand. To allow for the AMBU bag to be operated using legs or feet, an extension piece needs to reach the patient. Failure of the extension piece to adequately replicate the respiratory function of the traditional AMBU bag would result in the patients suffering from oxygen deprivation. Failure of the extension piece to adequately replicate the respiratory function of the traditional AMBU bag would result in the patients suffering from oxygen deprivation. Product should be able to tolerate traditional helicopter conditions.

6. Existing Manual Ventilation Devices Manual Ventilators: reusable (left) and disposable (right) www.ambu.com

7. Design Proposals Foot Bellow Model Foot Bellow Model Leg-Pump Model Leg-Pump Model Hinge Model Hinge Model

8. Leg-Pump Model Belt Attachment Belt Attachment Belt + AMBU bag Belt + AMBU bag Mounted to the thigh Mounted to the thigh Move the thighs to squeeze the bag Move the thighs to squeeze the bag Extension circuit from the bag to the valve Extension circuit from the bag to the valve

9. Advantages and Disadvantages of the Leg- Pump Model Advantages: Easy to install Easy to install No assembly time needed No assembly time needed Cost effective Cost effective Respiration requirements met because of original AMBU bag Respiration requirements met because of original AMBU bagDisadvantages:  Hard to control amount of airflow to patient  Non-intuitive motion  Extended tubing with a peep valve required

10. Leg-Pump Model

11. Hinge Model Squeezed by the movement of hinge Squeezed by the movement of hinge Hinge opens and closes by a foot pedal controlled motor Hinge opens and closes by a foot pedal controlled motor Rests on patient Rests on patient

12. Advantages and Disadvantages of the Hinge Model Advantages:  Applicable to every handheld respirator  Accurate because controlled mechanically  Does not require much extra space on the helicopter Disadvantages:  Difficult to stabilize on patient’s body  Increased pressure on patient  Requires more time to set up  Cost- Motor components

13. Hinge Model

14. Foot Bellow Model Utilizes foot bellows pump Utilizes foot bellows pump Ventilator circuit extension to patient Ventilator circuit extension to patient PEEP exhaust valve at the distal end of circuit PEEP exhaust valve at the distal end of circuit Oxygen reservoir at the pump/tubing joint Oxygen reservoir at the pump/tubing joint

15. Advantages and Disadvantages of the Foot Bellow Model Advantages Advantages  Intuitive pumping motion  No assembly time  Low cost  Efficient air flow  Permanent design Disadvantages Disadvantages  Learning curve  More storage space required  Pressure limiting mechanism needed

16. Foot Bellow Design (without extension piece)

17. Decision Matrix Design Feasibility Design Feasibility Cost Cost Ease of Use in Medflight Conditions Ease of Use in Medflight Conditions Reliability Reliability Expected Performance Output Expected Performance Output Comprehensive Design Comprehensive Design - Is the design practical and meet requirements

18. Design Matrix (Continued) 1 Design Feasibility 2 Expected Performance Output 3 Comprehensive Design 4 Reliability 5 Ease of Use in Medflight Conditions 6 Cost

19. Additional Information Possible additional features of prototype: Possible additional features of prototype: - Bag Reservoir -stores air to avoid bag from emptying - Positive-End Excretory Pressure (PEEP) Valve -controls end excretory pressure in lungs -Exhaust Valve -typical of most ventilators, releases carbon dioxide

20. Future Work Decide on Prototype Decide on Prototype Discuss Design Specifications as a team Discuss Design Specifications as a team Finalize Design Plans Finalize Design Plans Create prototype Create prototype Communicate with client at different stages of building process Communicate with client at different stages of building process Test Prototype (Standards, Performance) Test Prototype (Standards, Performance)

21. References Michael K. Abernethy, MD, FACEP Michael K. Abernethy, MD, FACEP –UW Medflight Flight Physician AMBU www.ambu.com AMBU www.ambu.comwww.ambu.com Instrumentation Industries, Inc. www.iierespiratory.com Instrumentation Industries, Inc. www.iierespiratory.com www.iierespiratory.com Manual Ventilation www.wikipedia.com Manual Ventilation www.wikipedia.comwww.wikipedia.com