1. Adjustable arm for an ultrasound probe during peripheral nerve block procedures Team Members: Sara Karle Michele Lorenz Emily Maslonkowski Ashley Matsick Client: Dr. Thomas Kloosterboer, Department of Anesthesiology, UW-Medical School Advisor: Ken Gentry, Department of Biomedical Engineering, UW-Madison

2. Intellectual Property Statement All information provided by individuals or Design Project Groups during this or subsequent presentations is the property of the researchers presenting this information. In addition, any information provided herein may include results sponsored by and provided to a member company of the Biomedical Engineering Student Design Consortium (SDC). Anyone to whom this information is disclosed: 1) Agrees to use this information solely for purposes related to this review; 2) Agrees not to use this information for any other purpose unless given written approval in advance by the Project Group, the Client / SDC, and the Advisor. 3) Agrees to keep this information in confidence until the relevant parties listed in Part (2) above have evaluated and secured any applicable intellectual property rights in this information. 4) Continued attendance at this presentation constitutes compliance with this agreement.

3. Overview  Problem Statement  Background + Motivation  Project Constraints  Design Alternatives  Matrix  Future Work

4. Problem Statement The goal of this project is to design an adjustable arm to hold an ultrasound probe, freeing up the hands of the doctor or technician to more easily perform peripheral nerve blocks.

5. Background + Motivation Anesthesia : eliminates perception of pain + sensations  General = circulates through bloodstream Involves analgesia, amnesia, loss of protective reflexes  Local = injected directly into site of procedure Smallest amount of anesthetic  Regional (Nerve blocks) = injected around nerve [bundle] Analgesia of region served by nerve(s) Retention of protective reflexes Interscalene nerve block (1)

6. Background + Motivation CONTINUED Motivation: Improve peripheral nerve block procedure Ultrasound image provides visual guidance - Increases success rate, anesthesia delivery - Decreases risk of nerve laceration, intravascular injection Multiple instruments handled during procedure - Ultrasound probe, needle, syringe, often catheter - Arm to hold ultrasound probe would free hands Brachial plexus nerve block (1) Sonosite probes (2)

7. Project Constraints The client has requested that the device be able to: Attach to Sonosite & GE ultrasound carts Hold probes of varying shapes/sizes Extend to far side of patient’s body Make fine adjustments at the probe end Exert desired force to obtain image Maintain position once placed Sonosite ultrasound cart (2)

8. Design Alternatives Cart Clamp Buckle Circular cuff Foam-lined Buckle closure Tighten via latch Strap Nylon band Angled brackets added to strap Pull to tighten Screw Circular cuff Foam-lined Tighten via nut/bolt Paluski.com image Grizzly Industrial image Google images

9. Design Alternatives Arm One member Ball and socket joint at cart end Long gooseneck Two members Horizontal + vertical extensions Medium gooseneck Multi (2+) member Numerous joints Greater number of possible positions Short gooseneck Goosenecks of various lengths

10. Design Alternatives Probe Holder Quick-release hand Foam-lined upper and lower jaws Squeezing jaws engages spring-loaded internal gear Position locked in place by pin Releasing pin allows spring to open jaws Foam plates Two foam-lined plates surround probe Held together by circumferential strap Probe holder will attach to the gooseneck via a ball-and-socket joint to maximize maneuverability.

11. Design Matrix Ease of operation StabilityUniversalityTOTAL (1-3)(1-4)(1-3)(1-10) Buckle clamp 3339 Strap clamp 2417 Screw clamp 1337

12. Design Matrix Ease of operation Storage Size WeightUniversalityTOTAL (1-5) (1-20) Single member arm 533314 Two member arm 444416 Multi (2+) member arm 254516

13. Design Matrix Ease of operation SizeWeightTOTAL (1-4)(1-3) (1-10) Quick-release hand 3339 Foam plates 2327 Final Design: Buckle clamp + Arm w/ 2+ members + Quick-release hand

14. Future Work  Determine hospital standards for medical equipment  Further define characteristics of components e.g. joint types, materials, dimensions  Observe demonstration of probe manipulation Better understand necessary range of motion  Test efficacy of individual components e.g. foam density, ball and socket joint resistance  Construction and testing of complete prototype

15. References (1)New York School of Regional Anesthesia. “Ultrasound assisted nerve blocks.” http://www.nysora.com/techniques/ultrasound2/ (2)Sonosite. “Micromaxx Transducers.”

16. Questions?