1. Neonatal Chest Compression Device Courtney Gallagher Jillian Zeber Advisor: Dr. Walsh, Vanderbilt NICU

2. Problem Statement When performed in conjunction with operations of the neck and lower abdomen, there is limited space for manual chest compressions. Manual chest compressions require both hands to be wrapped around the chest. 2 occurrences at the Vanderbilt NICU this past year.

3. Project Goal Small, easy to setup device that will perform automatic chest compressions on a 0-30 day old infant for use in the OR during a simultaneous procedure.

4. Performance Criteria Small but adjustable to fit the size of the baby. Provide enough force for sufficient chest compressions to reduce the width to one third, 2 to 3 cm. Apply the 11-12 lbs of force directly below the nipples in the center of the chest. Verified with bathroom scale and free weights. Maintain a rate of 80-100 compressions per minute for blood pumping. Simple and easy to use by Dr. Walsh in the NICU

5. Force Required for Chest Compressions Applied Force (lbs)Adequate Compression 11.1Yes 11.6Yes 12.3Yes 13.1Yes 14.7Yes 18Yes 10.8No 10.1No 9.9No Desired Force Range: 11 – 12 lbs

6. Solution Proposal Solenoid Valve Electronic Timer Power Supply 15 cm 6-9 cm 2-3 cm Adjustable depending on size of the baby

7. Solution Proposal Solenoid Valve Electronic Timer Power Supply 15 cm 5 cm 4-6 cm Adjustable depending on size of the baby

8. Solution Proposal 3- WAY Exhaust Air Cylinder Air Compressor

9. Device Components Single-acting spring return pneumatic cylinder Air compressor with coil hose Solenoid valve controlled by electronic timer On/off time range: 0.1 s to 99 hr Power supply: wall outlet 1.1 inch diameter plunger to displace chest 2-3 cm Wheel-up cart supporting electronic components & air compressor Support structure: Currently: stand with base and adjustable arm Ideally: Swivel arm connected to side panel of GE OmniBed

10. Calculations Air Cylinder Specs Bore size: F = p A = p π d 2 /4 where F = force exerted (N) p = gauge pressure (N/m 2, Pa) A = full bore area (m 2 ) d = full bore piston diameter (m) F = 11 lbs = 50 N p = 100 psi = 689.5 kPa  d = 10 mm ≈ 7/16” Stroke length: > 3 cm with extra space  5 cm ≈ 2” Timer Settings 80/min90/min100/min Cycle Frequency (s -1 ) 1.3331.501.667 Cycle Length (s) 0.7500.6670.600 On/Off time (s) 0.3750.3350.300 On/Off time: Cycle Length = 1/Cycle Freqency On/Off time = Cycle Length/2

11. Factors Provide necessary but not excessive force (11-12 lbs = 5 kg) Materials that can be sterilized Comfortable Quick setup Potentially portable Safety Adjustable

12. Implementation of Factors into Design Sterilizing plunger and stopper with plastic drapes Dr. Walsh Vary force applied with the psi of compressed air applied to cylinder Variable rate with micro-timer Adjustable with flexible arm coming out of NICU bed

13. Evaluation Isabel in the NICU Simulation Lab Responds like an alive baby Provides vitals Can determine if chest compression are adequate

14. Previous Work Researched existing adult compression devices AutoPulse, Lucas, Thumper Established goals and criteria that must be met Discussed with advisors Measured force required to provide chest compressions Decided on a prototype design Pneumatic cylinder Researched and purchased materials to build prototype Pneumatic cylinder and Air compressor Solenoid valve, timer All necessary connections Tested simplified version of prototype Verified applied force was correct Ordered more parts

15. Current Work Finishing DesignSafe Getting in touch with GE contact Kent Meeks Building complete version of prototype Testing full prototype

16. Future Work After testing, make modifications and re-test Build flexible arm Test Make Demo Evaluate effectiveness against traditional method

17. References http://www.zoll.com/medical-products/cardiac-support- pump/autopulse/ http://www.zoll.com/medical-products/cardiac-support- pump/autopulse/ http://content.onlinejacc.org/cgi/content/full/44/11/2214/FIG2 http://www.omega.com/auto/pdf/SimpValvesguide.pdf http://www.gehealthcare.com/euen/maternal-infant- care/products/microenvironments/giraffe_omnibed/index.html http://www.gehealthcare.com/euen/maternal-infant- care/products/microenvironments/giraffe_omnibed/index.html http://www.engineeringtoolbox.com/pneumatic-cylinder-force- d_1273.html http://www.engineeringtoolbox.com/pneumatic-cylinder-force- d_1273.html