Paramedics project - Final report by Daan Hekking

innovation that matters

F INA L REPORT by Daan Hekking February 10, 2016

The paramedics project - Final report

Daan Hekking - Advanced Product Design 1

TABLE OF CONTENTS 1. Background

1.1

Project background

1.2

Historical review

1.3

Human centered design

2. Approach

2.1 Research

2.2

Design opportunity

2.3 Ideation

2.4 Conceptualization

2.5 Embodiment

3. Research

3.1

Investigative user research

3.2

Problem identifying

3.3

Visual Social Persona

3.4

Problem analysis

3.5

Ideation & role-playing

4. Design opportunity 4.1

Design opportunity

28 28

4.2 Electrocardiography

4.3 Paramedic

4.4 Patient

4.5 Ambulance

4.6 Hospital

4.7

ECG Electrodes

4.8

ECG Cables

4.9

ECG Paper result

4.10 LifePak 15

4.11 Display

The paramedics project - Final report

5. Additional research

5.1

Market research

5.2

Technology research

6. Ideation 46 6.1

Ideation sketches

6.2

Physical ideation

6.3

Ideation presentation

6.4

Chosen direction

7. Conceptualization

7.1

Wireles ECG-electrodes

7.2

Defibrillator base

8. Embodiment

8.1 CAID-Modelling

8.2

milling parts

9. CardiacStart

9.1 Overview

9.2

User interface

9.3

Defibrillator body

9.4

Defibrillator inside

9.5

Wireless ECG-electrodes

10. Reflection

11. References

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The paramedics project - Final report

inno va tio n tha t ma tters

CardiacStart is a new way of accurately acquire an electrocadiograph (ECG) of patients. The use of wireless ECG electrodes is making it able to acquire an ECG twice as fast. The self sensing electrodes are making existing wires useless, which results in a less busy workspace around the patient. The main body, which includes a defibrillator, has a detachable monitor. When there is a less severe case (priority 2), the paramedic can carry the light ECG monitor to acquire an ECG. By replacing the printer, which is used in the current situation to print ECGâ&#x20AC;&#x2122;s, with a screen, the weight can be reduced with 2 kg.

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The paramedics project - Final report

1. BACKGROUND 1.1

PROJECT BACKGROUND

The project has been executed in collaboration with the local ambulance station and the Norwegian medical appliance manufacturer Laerdal. In the ten week project Laerdal has given design feedback on the produced ideas and concepts. The knowledge and experience of the paramedics was used to gain insights and validate ideas & concepts. The project includes an intense two week user research & ideation phase,

a gradual move from simply transporting patients to hospital, to more advanced treatments in the field. In some countries, the paramedic may take on the role as part of a system to prevent hospital admission entirely and, through practitioners, are able to prescribe certain medica- tions, or undertaking ‘see and refer’ visits, where the paramedic directly refers a patient to specialist services without taking them to hospital.” (1)

concept phase and prototyping phase.

1.2

HISTORICAL REVIEW

The role of a paramedic has changed during the years. “A paramedic is a health care professional, predominantly in the prehospital and out-of-hospital environment, and working mainly as part of emergency medical services (EMS), such as on an ambulance. The development of the profession has been

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1.3

HUMAN CENTERED DESIGN

As described in the previous paragraph Project Background, intense user research has been done. The user research formed the basic of the design process because a Human Centered Design (HCD) approach was used during the project. IDEO describes the HCD process as following: ‘The reason this process is called “human-centered” is because it starts with the people we are designing for. The HCD process begins by examining the needs, dreams, and behaviors of the people we want to affect with our solutions.’ (2) During the two weeks of user research, several HCD based methods were used to investigate the needs, dreams and behaviours of paramedics.

The paramedics project - Final report

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2. APPROACH In this paragraph youâ&#x20AC;&#x2122;ll find the structure of the project. During the process, a humancentered approach was used. This resulted in a research phase with a following ideation phase. After validating ideas in the ideation phase, a concept was chosen and further developed during the conceptualization stage. The conceptualization was ended with a presenation to Laerdal Medical. During the embodiment phase, a final visual prototype was realised.

2.1

RESEARCH

The project started with extensive user research. This means four days of interviewing and shadowing at the Umea Ambulance station with a group of twelve students. After four days of user research and problem finding, a workshop was organised to indentify problems. Also a Visual Social Persona diagram (VSP) was created to gain a better understanding of the daily tasks and behaviour of a paramedic. After finding problems and creating a VSP, a role play has

2.2

DESIGN OPPORTUNITY

In the design opportunity phase, an interesting design direction was chosen. The chosen direction was based on the findings of the research. During this phase, more academic reports were looked into and additional market- & technology research was done. This resulted in a more in-depth design opportunity document. This report became the red wire through the project.

2.3

IDEATION

During the ideation, the design direction was to the full extend researched with sketches and sketch-models. The paramedics gave feedback on ideas during this phase and the ideas were presented to Laerdal.

2.4

CONCEPTUALIZATION

The conceptualization, which started after choosing a promising idea, focussed on formand function improvement. A keysketch was the endresult of this phase.

been executed. We, a group of four students including myself, were able to execute a

2.5

roleplay because of the generated ideas after

In the embodiment phase, this keysketch was

the problem finding phase.

EMBODIMENT

modelled in CAD and a final visual prototype was created by using different prototyping techniques.

The paramedics project - Final report

RESEARCH

DESIGN OPPORTUNITY

I D E AT I O N

C O N C E P T UA L I Z AT I O N

EMBODIMENT

Fig. 1.

Overview research

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The paramedics project - Final report

RESEARCH two weeks of user-, market-, and technology research has been done.

t h i s c h a p t e r , t h e r e s u lt s w i l l b e s h ow n and the chapter ends with a written design opportunity.

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Investigative user research

Problem identifying

VSP

Role playing

Problem defining

Design opportunity

Fig. 2.

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Overview research period

3. RESEARCH 3.1

INVESTIGATIVE USER

RESEARCH During the user research, interviews were held with the paramedics. According to the paramedics, it is a job where they get a lot of satisfaction. The fact that they can make a difference to people in need, keeps them motivated. Eventhough a lot of their equipment is not state-of-the-art, they are helping each other to make the best of it. Besides interviewing the paramedics, a second user research method has been used. Shadowing is a research method

whereby the paramedics will be followed for a specified time. In this case different paramedics were followed for ten hours in total. During these ten hours, the paramedics were observed and analyzed during the patient treatment. As described in the previous paragraph, one reason a paramedic became a paramedic is because of the caretaking part of the job. The caretaking part influences the paramedics in the way of approaching patients. They want to give as much comfort to the patient as possible and keep them calm during their treatment and care.

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Fig. 3.

The paramedics project - Final report

ECG Electrode placement

Fig. 4.

Registering the patient in LifePak 15

Fig. 5.

Shadowing the paramedic

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The paramedics project - Final report

3.2

PROBLEM IDENTIFYING

After interviewing and shadowing the paramedics at the local ambulance station in Umea, the data was analyzed in collaboration with three other students. The research was analyzed by dividing the findings in different categories; daily equipment, communication and information flow. These categories were covering all of the findings. The paramedics concluded that chest pain was the injury that occurred the most in the Vasterbotten region. Additional research shows that chest pain is the most frequent reason why people are calling the paramedics. In this case every second counts and the need of a fast analyze of the situation is therefore necessary to perform the next step of the treatment. The quicker a paramedic can analyze the situation of a patient, the quicker the paramedic can do second handlings such as Cardiopulmonary resuscitation (CPR) and/or defibrillation.

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3.3

VISUAL SOCIAL PERSONA

After gathering, analyzing and presenting the data from the user research, a visual social persona (VSP) was created. The VSP was used to visualize the social character of the paramedic. The gathered data was used to create insights in ‘one day of a paramedic’s

The paramedics project - Final report

life’. Paramedics liked it that not a single day was the same at the station. They never know what to expect, which also can affect them negatively. Overtime occurs weekly, which makes it difficult for paramedics to streamline their leisure activities directly after work.

Fig. 6.

Me in front of the sketched VSP

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3.4

PROBLEM ANALYSIS

Exploring session After presenting the VSPâ&#x20AC;&#x2122;s, different groups of students were formed to dig deeper in the problems of the paramedics. Every group, which consisted of four students, discussed the identified problems. All of the problems were written down, analyzed and rated by frequency and level of disturbingness.

The paramedics project - Final report

Clustering As described in the previous paragraph,

the problems were clustered with colours as

the problems were rated by frequency and

well. The problems were categorized in daily

level of disturbingness. The problems were

equipment, communication and information

ranked in a frequency-severity matrix. (3) This

flow. Every category had itâ&#x20AC;&#x2122;s own colour,

matrix was used to create a clear overview of

which made it easy to identify what category

problems that occur often with a high impact.

had the most problems.

Besides this classification model,

frequency

Fig. 7.

Frequency-severity matrix

High frequency

Low severity

High severity

Low frequency

Low severity

High severity

severity Daan Hekking - Advanced Product Design 1

Clustering

Already two criterias were chosen to select

selection phase. In this case every student in

ideas with, namely frequency and severity.

the group could select seven problems and

These two criteria made it easier to pick

mark these problem with a dot, which makes it

problems to solve. Besides this ranking

a total of 28 dots within our group on different

system, personal opinions and favours were

post-its. Some post-its had several dots,

intergrated in the selection process as well

which made it obvious to select that problem.

One of the criteria was specified by the

After discussing the different problems with

programme director. Every group had to

dots, the final seven problems were selected

present seven problems after the problem

and presented to the rest of the class.

The paramedics project - Final report

3.5

IDEATION & ROLE-PLAYING

Within the same groups, a braindump

The role play was organized to challenge

was organized to generate as much ideas

ourselves and express the concept in a

as possible regarding the seven selected

more visual way. During this process, a lot of

problems. Besides the seven problems that

extra problems were faced and solved. This

were selected in the group, five problems

resulted in a well through thought role play.

from other groups were added to create a wider view within the problems paramedics are facing. At the end, everey group of students chose a concept and prepared this concept to be acted in a role-play.

Fig. 8.

Role-playing during the research phase

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4. DESIGN OPPORTUNITY 4.1

DESIGN OPPORTUNITY

Chest discomfort is one of the most frequent and nuanced symptoms encountered in the Emergency Medical Service (EMS). (4) User research showed that paramedics were monitoring the heart rhythm (ECG) with the heavy LifePak defibrillator. Due to itâ&#x20AC;&#x2122;s heaviness, paramedics are not always taking the defibrillator with them to patients. After using the ABCDE and Triage method at the patient, the paramedics decide to bring the patient to the ambulance or bring the defibrillator to the patient. In case of chest problems or a cardiac arrest, every second is crucial. This makes time management important for the paramedic and patient. In what way can the paramedic obtain an accurate ECG as fast as possible?

Fig. 9.

The paramedics project - Final report

Attaching cables to electrodes

PRODUCT FLOW

pat ie nt

p aramedic

amb ulance

ho s p it al

Lif ePak

cardiac mon it orin g

d is p lay

E C G - p ap er

EC G-elect rodes

ECG-c ab les

PRODUCT FEATRES

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â&#x20AC;&#x2DC;S o me t i me s we have to ta ke the patie nt to t h e am bu la nce to m a ke a n E CGâ&#x20AC;&#x2122; Pa ra m ed ic , U m ea Ambu la n ce st at i on , week 01

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Fig. 10.

The paramedics project - Final report

Pad placement on body with 12-Lead ECG

4.2

ELECTROCARDIOGRAPHY

Besides the stethoscope, the

An ECG involves attaching 10 electrical cables

electrocardiogram (ECG) is the oldest and

to the body: one to each limb and six across

most enduring tool of the cardiologist. All

the chest. Every electrode is sensing the

the following information is based on the

electrical activity from one view of the heart.

book ‘ECG Interpretation: Made incredibly

By placing multiple electrodes at different

easy’. (5) In this chapter the technology

positions on the body, an accurate view of

of making an ECG will be explained.The

the electrical activity of the heart can be

heart’s electrical activity produces currents

conducted. These different views can help

that radiate through the surrounding tissue

paramedics, nurses and cardiologists to

to the skin. When electrodes are attached

accurately determine which part of the heart is

to the skin, they sense those electrical

malfunctioning.

currents and transmit them to an ECG monitor. The currents are then transformed in a graph which is displayed on the ECG monitor. These graphs, also called electrocardiographs, allows the nurse to monitor phases of myocardial contraction and to identify rhythm and conduction disturbances. A series of ECGs can be used as a baseline comparison to assess cardiac function.

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4.3

PARAMEDIC

User research showed that paramedics are more busy with preparing the ECG, then actual monitoring the patient. Attaching the pads and cables to the patientâ&#x20AC;&#x2122;s chest, arms and legs takes them around three minutes while monitoring of the patient is costing the monitoring device ten seconds. The display of the ECG is positioned on the right side of the patient, which is within an unergonomic reach length for the paramedic. The paramedic profession is a caretaking job as well. Attaching all the pads and cables does not feel like caretaking.

4.4

PATIENT

Within cardiac monitoring there are two types of patients. These are patients with a cardiac arrest and patients without. In the case with patients who are not suffering from a cardiac arrest, it is important to lay still to have the most accurate ECG results. Patients who are suffering from tremors sometimes need to be strapped since the tremors can influence the ECG result. Sometimes patients are becoming more nervous as the time passes since they donâ&#x20AC;&#x2122;t know what exactly is going on in the ECG-monitoring process.

The paramedics project - Final report

4.5

AMBULANCE

The ambulance car, or the private working space as the paramedics are calling it, is the place where the paramedics are preferably monitoring the patient. There are two reasons why the paramedics have this preference. The current defibrillator and defibrillator is too heavy to carry around, so paramedics prefer to bring the patient to the ambulance. In the ambulance all of the equipment is available and ‘within reach’. This is in contrast of the current trend in the paramedic profession. This trend says that paramedics are performing more medical care at the patient’s homes than in the ambulance.

4.6

HOSPITAL

When a patient is not stable enough to stay at home, the ambulance brings him/ her to the hospital. The transition of the patient between the ambulance and hospital is worth noticing. The cables which are attached to the ECG-electrodes will be de-attached from the ambulance monitoring device. The hospital will then attach their own cables to the ECG-electrodes, which will stay on the patient’s chest, and continue monitoring the patient.

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4.7

ECG ELECTRODES

At the moment, the paramedics in Umea are using ten ECG-electrodes (12-Lead ECG) to make up an ECG. The ten pads are divided by six on the chest, two on the wrists and two on the ankels. Besides the 12-lead ECG, a 3-lead ECG exists as well. These 3-lead ECG devices are mostly used in home environment and used for constant monitoring. The main difference between 12-lead and 3-lead ECG’s is the outcome. 12-lead ECG’s are designed for diagnostic use. The 12-lead ECG’s are showing the heart rhythm from more angles, which gives a bettter understanding of the heart rhythm. The 3-ECG’s are cheaper, more comfortable for the patient, less likely to be positioned wrong and the paramedic has more time to take care of the patient. The ECG-electrodes are staying on the patient’s body from the moment of monitoring untill a doctor at the hopsital decides to take them off the body due to rehabilitation. In case the patient has chesthair, this chesthair has to be removed with a razor. The paramedics are carrying this razor with them in their daily equipment bag. Additional research shows that inaccurate ECG-electrode placement can cause incorrent measurement. This can result in a series of wrong decision.

The paramedics project - Final report

4.8

ECG CABLES

The ECG cables are connecting the electrodes to the monitoring device. The cables are the connection between the monitor device & the patient and are transmitting the electrical activity. The cables are color-coded and a code is printed at the end of the cable. This code represent the position of the electrode & cable on the patientâ&#x20AC;&#x2122;s body. According the paramedics, the cables are not user friendly, as it can get nestled and break. The cable can pull the pad down as well, which results in a discomfortable experience. The cables are a distracting factor when measuring blood pressure and saturation as well.

4.9

ECG PAPER RESULT

When using the 12-lead ECG, the printer of the LifePak 15 will print 12 electrocardiographs. The electrical activity of every lead will be printed at this paper, which can be reviewed by the paramedic afterwards. The paramedic has to do this check manually and additional research shows that wrong interpretations can be made in this crucial phase. (4) To compare an old ECG with a new ECG, the two papers have to be held next to eachother to see a trend between two ECGâ&#x20AC;&#x2122;s.

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4.10

LIFEPAK 15

The paramedics in Umea are using the LifePak 15 which weighs 11.2 kg and includes a defibrillator, ECG-, SpO2-, spCO-, NIBP-, CO2-monitor and printer. The LifePak 15 is using the GSM-network to connect to the hospital. The scanned data, in this case from an ECG, can herewith be directly transferred to the hospital. Before sending the information to the hospital, the paramedic has to register the patient in the LifePak 15 with a turning wheel. Registering a patient takes around four minutes according the paramedics.

4.11

DISPLAY

The display of the LifePak 15 can be used to display up to three different waveforms. This could be three different ECGâ&#x20AC;&#x2122;s, saturation or blood pressure. The LifePak 15 is located next to the patient in the ambulances of the Umea region. Patients can see the display as well, which can affect them negatively according the user research. Patients are interpretating the results on their own, which could make them worried. In case the patient is worried, the heart will react and influence the electrical activity from the heart at that point.

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5. ADDITIONAL RESEARCH

5.1

MA RK ET RE SE AR CH

eries ZOLL X-s

LifePak 15

Defiguard Touch 7

Philips Heartstart MRX

O Defimonitor EV

Mindray Beneheart D3

The paramedics project - Final report

Defimax Biphasic

Philips Heartst art XL

More detailed information about market research can be found in the digital file ‘Appendices - The paramedics project’

‘

CardioAid 360B

C-8300 Nihon Kohden TE

Lifebot

US Defib E-heart

Cardiomax

Corpulus 3

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5.2

TE CH NO LO GY RE SE AR CH

cele Nymi Bra

iPhonECG case

Wireless ECG

RF-ECG

Plessey Epic

Isansys Li fecare

E-Motion ECG Mobile

CardioSecu

r Active

Kid ECG Intelesens Zensor

The paramedics project - Final report

More detailed information about technology research can be found in the digital file ‘Appendices - The paramedics project’

‘

h MD VitalConnect Healt

Plessey semiconductors

Gumpack wearable

Quardiocore

Baby therm

LifeLink (Behance)

ometer

Corventus Piix

Ready electrodes

E-motion ECG mobile

Holst centre

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The paramedics project - Final report

IDEATION The

ideation phase was executed

i n d i v i d u a l ly a n d l a s t e d f o r t w o w e e k s . w i t h i n t h e i d e at i o n p h a s e , a w e e k ly tutoring session was planned to streamline the process.

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6. IDEATION

6.1

IDEATION SKETCHES

During the ideation phase, sketches have been made to fully explore the potential within the writtin design opportunity. The sketches were used to communicate with classmates, tutors and even paramedics.

The paramedics project - Final report

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6.2

PHYSICAL IDEATION

Besides sketching on paper, which is generally associated with the ideation phase, mockups have been made as well. In this case, the mock-ups from the role-playing are being described as a physical ideation. A physical object within the ideation phase can enhance the communication process. Not only the physical models, shown on the right, were used during the role playing, they were also shown to the paramedics to validate these ideas.

The paramedics project - Final report

Fig. 11.

Paper mock-ups of wireless ECG-electrodes

6.3

IDEATION PRESENTATION

1. interchangeable wireless ECG electrodes Wireless pads saves time by not having to attach cables Battery life of wireless pads could form problems

2. sorted pads in external monitor Portable ECG monitor ideal for priority two, but not for priority one (they might need to defibrillate) **Portable ECG monitor could be used for saturation, blood pressure and so on.

3. semi-wireless ECG monitor The use of standardized materials saves money The cables will still be long because they have to reach the ankles as well

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6.4

CHOSEN DIRECTION

After presenting the generated ideas to Laerdal, the most promising idea was chosen and developed further. As the design

concept and embodiment phase. On the next page, a short summary is given about the chosen concept and how it fits within the three decided factors.

opportunity chapter describes, the product has to obtain an ECG as fast and accurate as possible. This means that time reducement, reliability and ergonomics are crucial in the development of the concept. These three factors were the red wire throughout the

Fig. 12. The paramedics project - Final report

Key-sketch of the chosen concept

The concept that is shown on the left side

the intergrated handle. The handle makes

is a defibrillator with a detachable ECG

it possible to carry the defibrillator vertically

monitor. The detachable ECG monitor is

instead of horizontally. Paramedics were

using wireless ECG electrodes to create a

facing problems carrying the defibrillator

less intrusive surrounding for the patient. The

horizontally. The manoeuvrability of the

detachable ECG monitor can be brought to

product has improved by carrying the

patients when there is a less severe chest

product vertically.

pain call (priority two). Reliability in wireless diagnosing Portability

The wireless ECG-electrodes will transmit

As described before, ergonomics are a

the electrical activity from the heart to the

crucial factor. In pre-hospital care and

portable ECG-monitor. This will save time by

in case of chest pain, every second

taking away ten steps (attaching cables to

counts. Research shows that paramedics

the ten ECG-electrodes). The new wireless

don’t always bring the LifePak 15 with

ECG-electrodes will have an intergrated

them when they’re having a priority two

LED. When the wireless ECG-electrodes are

call. Eventhough it’s a priority two call,

activated, every LED will then light up in a

paramedics do admit that there is a need to

different color. LED’s are intergrated because

obtain an ECG. By having a detachable ECG

the wireless ECG-electrodes are universal.

monitor, paramedics are able to easily carry

The paramedic will know with the different

monitoring equipment towards the patient.

colored LED’s what every wireless ECGelectrode is transmitting.

Mobility & stability One of the key elements of the product is

Fig. 13.

Product architecture of the wireless ECG-electrode Daan Hekking - Advanced Product Design 1

The paramedics project - Final report

CONCEPTUALIZATION In

the conceptualization several

methods have been used to take the presented idea to the next level.

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7. CONCEPTUALIZATION After presenting the chosen idea direction to Laerdal Medical via an audioconference, prototypes were made to specify dimensions, materials and details. The diagram below is showing the different steps in the conceptualization phase. The feedback of Laerdal was intergrated in this phase and the keysketch, shown in paragraph 6.4, was developed further. Within the conceptualization phase, more detailed physical models were built to improve the chosen direction.

KEYSKETCH include feedback

D I G I TA L F O R M / F U N C T I O N E X P L O R AT I O N

D E F I B R I L L AT O R

ECG-ELECTRODES

PROTOTYPING

CONCEPTUALIZATION

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D I S P L AY

Fig. 14.

Form exploration

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Fig. 15.

Fig. 16.

The paramedics project - Final report

Glueing the wireless ECG-electrode model together

Visibility of the disposable sillicon pad and electrical activity transmitter

Fig. 17.

Comparing the model with the current ECG-electrode

7.1

WIRELES ECG-

ELECTRODES To gain more insights in dimension Fig. 18.

Close up of disposable pad and electrical activity transmitter

and function, several prototypes of the wireless ECG-electrodes have been made. As shown in the descriptive texts at the bottom of every picture, the wireless ECGelectrode is using the same product architecture as the current ECGelectrodes. The wireless ECG-electrode exists of two parts. Part one is a disposable sillicon pad with a conductive gel and sticker at the bottom. The second part, in the pictures painted in red, includes the electronics that

Fig. 19.

Electrical activity transmitter clicks in disposable pad

will transmit the electrical activity of the heart.

Fig. 20.

Protective cover at bottom to protect glue and conductive gel

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The paramedics project - Final report

Fig. 21.

Role playing shown in four images

7.2

DEFIBRILLATOR

BASE During the conceptualization another role play was done to gain more insights into the usage of the defibrillator base. Two size variants have been made and tested with users. The use of a role-play resulted in an additional strap to easily carry the Fig. 22.

Two different size mock-ups of the defibrillator base

defibrillator around. The handle was mainly used to move the defibrillator base around in a short range.

Fig. 23.

Mock-ups of the wireless ECG-electrodes

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The paramedics project - Final report

EMBODIMENT The

embodiment phase focusses on

detailing the product in

CAD

physical

and into a

1:1

model.

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8. EMBODIMENT After the conceptualization phase, a decision was made to build the prototype 1:1. Autostudio Alias was used to model the product in 3D. The 3D file was used as a starting point for modelbuilding.

The paramedics project - Final report

8.1

CAID-MODELLING

As you can see at the pictures on the left side, the product has been modelled in Alias. To create a 1:1 model of this product, several modelbuilding techniques were used. During this process two different CNC milling machines, a handmill, drills and sanding machines were used.

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The paramedics project - Final report

8.2

MILLING PARTS

In total, the main body of the defibrillator exists of 14 parts. This includes the main body, the screen, handle, buttons, covers and a battery pack. 14 parts was the minimum amount of parts that could have been used to avoid undercuts and correct splitplines.

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Fig. 24.

Sanding the parts

Fig. 25.

Fig. 26.

The paramedics project - Final report

Parts prepared for primering

Overview of milled and sanded parts

Fig. 27.

Overview of milled and sanded parts

Fig. 29.

Mould making for sillicon pads

Fig. 28.

Close up of the handle

Fig. 30.

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Sillicon casting

The paramedics project - Final report

presenting...

i nnov ati on that matte rs

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The paramedics project - Final report

9. CARDIACSTART 9.1

OVERVIEW

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Strap attachment Release button ECG-monitor

Detachable ECG-monitor

Shock-resistant edge

Cover for pads

ECG-monitor

Wireless ECG-electrodes

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Handle with rubber feeling

Release button accu pack

Accu pack

Overview defibrillator body

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The paramedics project - Final report

9.2

USER INTERFACE

The user interface of the detachable ECGmonitor replaces the printer that is used nowadays because itâ&#x20AC;&#x2122;s using the same measurements as the printed ECG-paper. An integrated keyboard makes it able for the paramedic to fill in the patient details faster then the current situation. The keyboard can

also be used to write comments whose can be send to the cardiologist. Besides filling in patient details and reviewing the ECG results, the user interface includes software that supports the paramedic during CPR and breathing assistence. A CPR assistence bar that goes up and down, beeps and voice assistence are examples of the supporting software.

Daan Hekking - Advanced Product Design 1

The paramedics project - Final report

Daan Hekking - Advanced Product Design 1

9.3

DEFIBRILLATOR BODY

The main body of the defibrillator can be held vertically with an integrated handle during carrying. It includes two orange buttons which can be pushed to detach the ECG-monitor or the battery. There is an option to attach a strap to the main body as well. The strap can be attached above the orange button, shown below, and at the bottom of the product. For long distance walks or when the paramedic is busy with both hands, the strap is a usefull feature.

The paramedics project - Final report

9.4

DEFIBRILLATOR INSIDE

The detachable ECG-monitor can obtain an ECG and can provide CPR-assistence for paramedics, but it can’t operate the defibrillator. The buttons to operate the defibrillator with are hidden underneath a cover. Underneath this cover is a storage for the wireless ECG-electrodes and defibrillatorelectrodes as well. These electrodes can be placed in the cut-out you can see in the picture below.

will only see the buttons when he needs them. Hiding buttons will result in a more calm and less screaming product. Also the cover protects the buttons when the main body falls on the ground. The two buttons that are implemented are the ‘charge’ and ‘shock’ button. According to user research, these two actions, which can have a lot of impact, should stay manual with a press button.

Defibrillator buttons As described above, the buttons for the defibrillation mode are hidden under a cover. These buttons will only be visible when the paramedic opens te cover. The paramedic

Daan Hekking - Advanced Product Design 1

9.5

WIRELESS ECG-ELECTRODES

The wireless ECG-electrode exists of two parts which are visualized at the top picture on the next page. The part with the transmitter and electronics (1) is plastic and is a long-term use product. The pad (2) is a disposable sillicon part that is using a conductive gel at the bottom to receive the electrical activity better. Underneath the sillicon part, a plastic sheet protects the conductive gel and sensor (3). A click button is chosen because itâ&#x20AC;&#x2122;s used in the current situation, where it shows good conductivity. Fig. 31.

Activating pads The pads are activated when the plastic sheet is removed. When a second pad has been activated, the pads will start communicating with eachother to determine eachotherâ&#x20AC;&#x2122;s position.

The paramedics project - Final report

Pads will glow when activated.

Clicking pad The part with transmitter (1) can easily be clicked into the pad. Also the button makes it easy to detach this part from the pad.

Size reference The pad is 40 x 40 x 10 mm

Daan Hekking - Advanced Product Design 1

10. REFLECTION Working with a company is always a big drive to really push your limits and show what your capabillites are. During this project I enjoyed working with Laerdal Medical, who always looked with a critical eye towards everyone’s presentation. I believe that, with the help of Laerdal Medical and tutors, my concept was taken to a higher level. Besides the guiding part of the project, I learned a lot about modelbuilding. I haven’t believed in modelbuilding that much, until I started making this model myself. The process to understand how you should build up your model inspired me a lot. This is the part where I learned the most as well. This way of thinking makes you realize how producable your own product actually is. Above all I think the project was a lot of fun. The collaboration with the paramedics was rewarding and their feedback was incredible valuable. We, as a class, have created a strong and open collaboration with the paramedics and I’m proud of that. The fact that the paramedics were invited and came over to our presentations says enough in my eyes. I’m happy that I’m part of the class and that I’ve worked on this project!

The paramedics project - Final report

11. REFERENCES (1).

Degn. T (2015) Internal document. Used 21 November 2015

(2).

IDEO (2011) Human centered design: Toolkit (2nd edition)

(3).

Allen, C. (2004) Reducing uncertainty. Used 21 November 2015 https://www.fhwa.dot.gov/

publications/publicroads/04jul/06.cfm (4).

Rawshani, A., Larsson. A., Gelang, C., Lindqvist, J., Gellerstedt, M., Bang, A., Herlitz, J.,

(August 2014). Characteristics and outcome among patients who dial for the EMS due to chest pain http://www.sciencedirect.com/science/article/pii/S0167527314015101 (5).

Robinson, Joan M., Moreau, D. (2011) ECG Interpretation: Made incredibly easy (5th edition)

Wolters Kluwer (6).

Digiulio, V., (September 2015) Spot the STEMI #1 Used 22 November 2015. http://www.

ems12lead.com/2015/09/19/spot-the-stemi-1/

Daan Hekking - Advanced Product Design 1

The paramedics project - Final report

THANK YOU! If

you want to contact me about this

project, donâ&#x20AC;&#x2122;t hestitate to contact me!

daan_hekking@live.nl

Daan Hekking - Advanced Product Design 1