Download to read offline
![Letter ofRecommendation-Daniel[1]](https://cdn.slidesharecdn.com/ss_thumbnails/2389a6a7-a2b2-475a-a205-f6612cf10caf-150802175911-lva1-app6892-thumbnail.jpg?width=640&height=640&fit=bounds)
Debrief Pres
- 1. UBC Biomedical Engineering StudentTeam International Medical Device Initiative Open Debrief Session
- 2. Acknowledgements For this DebriefEvent UBC APSC and EECE Dept. - Sponsorship Hannah Haghdadi - Catering, Name tags Brandon Kim - Refreshments, Poster Karen Woodward - Event Program Vivian Wong - Picture Slideshow Marcus Cheung - Poster Karla Rivera, Jenny Yang, Carol Fu - Event Setup and Preparation
- 3. Presentation Overview ● AboutUBC BEST ● Team Mission ● International Medical Device Initiative ● Trip Findings ● Future Directions ● Appreciation
- 4. Who are we? UBCUndergraduate students in Engineering, Business and Science who design and construct medical devices
- 5. Team Mission To buildmedical devices or systems that optimize the delivery of medical care and improve patient outcomes.
- 6. Executive Team Andrea Marshall CEO Co-Captain Julie Kerr COO Co-Captain Elizabeth Wicks CTO Co-Captain BrandonKim Software Lead Marysia Grzybowski Research Lead Harry Pigot Electrical Lead Georgia Grzybowski Mechanical Lead Muieen Cader Business Lead
- 7. Past and CurrentProjects ● Music to Movement (M2M) ● Ebola Aid - EMR System ● Peripheral Neuropathy
- 8. International Medical DeviceInitiative
- 9. Acknowledgements Our Generous Donors PaulGeyer CEO, LightIntegra Dr. Jim McEwen President, Western Clinical Engineering Ltd. Dr. Ken Spencer President, SpencerCreo Foundation
- 10. Acknowledgements Andrea Wink Jeannie Scarfe Dr.Marc Parlange Dr. Elizabeth Croft Dr. Leo Stocco Dr. Peter Cripton Andrea Walus Darla LaPierre Dr. Andre Ivanov Kevin Chaplin Dr. Bernie Garrett Dr. Helen Brown Jenny Reilly Dr. Phyllis Kisa Dr. Charles Laszlo Mike Crean ErinRose Handy Wendy McHardy Nathan O’Hara Vanja Bodor Florin Gheorge Marianne Black Lawrence Buchan Benjamin Horsman Dr. Charles Larson Dr. Richard Lester Jocelyn Conway Jason Carmichael
- 11. Why Uganda? Makerere UniversityBiomedical Engineering Program
- 12.
- 13. Uganda Mulago National ReferralHospital
- 14. Why Kenya? UBC Centerfor Excellence
- 15. Kenya Nanyuki County Hospital NyeriRegional Referral Hospital
- 16. Trip Objectives ● Gatherinformation on the context ● Identify medical challenges ● Build a framework for future collaborations and implementation
- 17. Project Goals ● Addressesan identified medical challenge ● Is sustainable and context appropriate ● Is designed through collaboration ● Optimizes health care practices ● Improves patient outcomes Develop a device that…
- 18. Findings ● Existing technologyand clinical challenges ● Donated equipment ● Maintenance, repair, and disposal Mulago National Referral Hospital, Kawolo District Hospital, Nanyuki County Hospital, Nyeri Regional Referral Hospital
- 19. Traction Mulago Hospital andNanyuki County Hospital
- 20. Phototherapy Mulago Hospital andNanyuki County Hospital
- 21. Fetal Heart Rate MulagoHospital and Nanyuki County Hospital
- 22. Mulago Hospital andNanyuki County Hospital The Oxygen Challenge
- 23. Surgical Equipment Nanyuki CountyHospital ● Forceps ● Retractors ● Diathermy ● Awl stabilizer
- 24. Suction Overflow Challenge MulagoHospital and Nanyuki County Hospital
- 25.
- 26. Microscope Phone Holder MulagoHospital
- 27. Ear Irrigation Nanyuki CountyHospital
- 28. Respiratory Rate Mulago Hospitaland Nanyuki County Hospital
- 29. Laboratory Nanyuki County Hospital(Kenya) Nyeri Regional Referral Hospital (Kenya)
- 30. Equipment Tracking Mulago Hospitaland Nanyuki County Hospital
- 31. Sustainable Donations ● NeedsAssessment ● Technical Considerations ● Follow Up
- 32. Current Equipment ● Maintenance ●Repair ● Disposal
- 33. Findings Summary ● Existingtechnology and clinical challenges ● Donated equipment ● Maintenance, repair, and disposal
- 34.
- 35. Thank you! Dr. JamesMcEwen, Mr Paul Geyer and Dr. Ken Spencer
Editor's Notes
- #2 Why we are here
- #3 Of trip assistance and team members
- #4 I think we should put this after Project slide and before where we were slide and we could have this slide as an overview of: 1. location 2. Collaborations 3. Findings 4. Future 5. Appreciation
- #8 Andrea does peripheral neuropathy Introduction of what the IMDI Project is: Describe Mission of Team/IMDI project - Build medical devices that optimize medical care and improve patient outcomes. This is the general mission of what we build on the team, but IMDI is focused on doing so on an international scale. Learning more about the what the medical challenges are in different environments.
- #9 Introduction of what the IMDI Project is: Describe Mission of Team/IMDI project - Build medical devices that optimize medical care and improve patient outcomes. This is the general mission of what we build on the team, but IMDI is focused on doing so on an international scale. Learning more about the what the medical challenges are in different environments. Andrea : talk about how this came to happen, how we got funding, how the idea was to go to Africa, why we decided to etc…. all the beginning stages portions
- #10 Of trip assistance and team members
- #11 Of trip assistance and team members
- #12 Andrea - Explain about how we met the Ugandan students and how we got in touch with COE
- #15 Andrea - explain where we went in Kenya and Uganda - focused on traction because so common Problems: - patients have to stay in bed for 1-3 months - causes bed sores and mentally and physically hard on patient - takes up valuable bed space - talked to ortho surgeon and challenges he mentioned in traction were similar also problem when actually setting up the forces on the leg - don't have any method to differentiate how want to pull bones in place depending on different types of fracture - don't know if for certain types of fractures you need to pull bones in certain way... Only one method for multiple different fractures
- #17 Blake - We went to Uganda and Kenya because we wanted to gain first hand experience of the context of the setting in terms of environmental, social, political, and economic factors. We wanted to speak to medical professionals in international settings about the medical challenges that they face, and see in person what healthcare professionals work with on a daily basis. We also wanted to build collaborations with people on the ground, so that we have ongoing support and feedback throughout the development of our device, to ensure that it is suitable for the setting.
- #18 Blake - The overall goal of the IMDI is to bring back ideas for our team to develop a medical device or system that addresses a medical challenge identified by a healthcare professional in Uganda and Kenya. We want this device or system to be context appropriate so that it will be sustainable moving forward. In terms of sustainability, we want it to be designed in collaboration with all of the contacts that we made in country. Ultimately, the device or system has to optimize medical professional’s ability to perform care, and improve patient outcomes.
- #19 Marysia (2mins) Context - whats exists Disclaimer: engineers, not telling people challenges,
- #20 Georgia (2mins)
- #21 Blake - Phototherapy is a treatment where UV light is emitted on patients with Jaundice. This helps reduce the level of bilirubin in the system by changing it into products that can be expelled by the body. This treatment was quite common in the Newborn Units of both hospitals. The main issue that was identified to us was not knowing the intensity of the UV light being produced. When taking blood samples, the baby and blood are removed from the light, so it is unknown what the bilirubin levels are under treatment. Many medical professionals identified this as an area of improvement. Also, UV light can damage patient’s eyes. One patient that we saw had to receive phototherapy for almost 3 weeks, and as a result, their skin was peeling due to the exposure to UV.
- #22 Andrea (2.5mins)
- #23 Blake/Marysia (3mins) Blake - One of the common issues that we saw between wards and countries was the need to split oxygen lines between patients. As there is a limited supply of oxygen, multiple patients are put on the same line. On the left you can see an empty saline bottle attached to the wall oxygen outlet in Mulago hospital. Needles with lines attached to them were then inserted into the bottle in order to distribute more lines to different patients. The issue with this is that the flow and oxygen saturation in each line is unknown. Some sort of device that could equally distribute flow to less critical patients without losses would be beneficial. On the right you can see a oxygen splicer that we saw in the Paediatrics ward in Nanyuki. This was the only one that we saw. Unfortunately, we were told it can only deliver 1 bar of oxygen to each patient, which is well below the 15bar that is necessary for critical patients. However, having a controllable flow meter for each line is a major improvement to the bottle and syringe method. Marysia - After talking with various physicians and nurses it became clear that another challenge regarding the delivery of oxygen to patients with oxygen cylinders is that there is little active monitoring of the level of oxygen left in the tank. The presence of bubbling in the humidifying bottle is often used, or mothers that notice
- #24 Georgia (2.5mins)
- #25 Blake (1.5 min) - Above are four different versions of suction machines that we saw while we were in Uganda and Kenya. The leftmost is a portable unit that we saw in many wards and theatres. Beside it is the device that is used for a wall outlet for suction. The two on the right are a manual and electrical suction that we saw, these were mainly used as backups if the others failed. The main issue that affected all of these devices and was alerted to us by engineering in both countries, was the overflow shut off prevention. If fluid is not monitored actively, the cannister can over flow. When this happens, the fluid can backflow and can cause damage to the system. To prevent this, there is a rubber stopper that floats in the fluid and clogs the tube if the fluid gets too high. The problem is that when this happens, the plug often doesn’t properly initiate, and the suction machine breaks, or it does work and becomes stuck in the suction rendering the device useless. A redesigned version of this shutoff, or an alert to change the cannister would prevent the constant failures.
- #26 Andrea (2mins)
- #27 Blake (1min) - Before going to Uganda, we organized a meeting with Dr. Andama and his research associate John. While there, we had the opportunity to meet with them about their project. They are working on a mobile app for assisting lab technicians with the diagnosis of malaria in a blood smear, as 30% of malaria diagnosis is not actually malaria. This brings in a host of problems including patients and hospitals paying for incorrect treatment, the initial illness not being treated, and the patient becoming resistant to malaria medication. They approached our team with a problem with their device used to hold the mobile device on the microscope, shown on the right above. This is their current prototype, but it has issues with easily adjusting to get the lens in focus for the app, and it can be quite finicky. They have asked us to redesign this piece on 3D software to send to them, so they can 3D print it in Uganda and use it for their research. We are excited to have been approached with a problem and to get started on the task.
- #28 Marysia (1mins)
- #29 Blake (1.5mins) - Another one of the challenges identified to us in both countries was the need for a respiratory rate device. Dr. David in paediatrics at Mulago first raised this challenge. As one of the vitals, it is crucial to actively monitor respiratory rate. Unfortunately, with limited personnel resources, it can often only be taken every 3 hours. Also, when children and babies are moving, it can be difficult to count the rise and fall of the abdomen, which is how respiratory rate is taken. Dr. David proposed a device that sits on the abdomen (as it has the greatest vertical movement) that can relay the respiratory rate to a passing nurse, and can alert a medical professional if the rate drops to an alarming level, or the tidal volume becomes too low, constituting shallow breathing.
- #30 Andrea (3mins)
- #31 Blake (2mins) - Our donors suggested that we not only look at technology and equipment but also gather information on the systems in place within the hospital. One such challenge within the hospital is keeping track of what equipment exists in each department, and the status of that equipment, if it is in need of servicing for example. This illustrated itself one day in paediatrics in Nanyuki when we were talking to Dr. Hauck about the equipment shortage. As the main diagnostician at the hospital, she stated that she needs an ECG and the hospital doesn’t have one. We had previously seen three ECGs in the Emergency Department, and mentioned this to Dr. Hauck, who was shocked that there was one at the hospital. Sharing of equipment between wards in Nanyuki is also common as many departments only have one device, and if it breaks, they need to take one from a different department. This can get confusing as to where broken equipment is, and who has the working equipment. In Uganda, the Makerere students had identified this as a challenge and are working on a possible RFID system to track equipment and personnel in the hospital. In Nanyuki, the lead engineer, George, had come up with a numbering code system to keep track of inventory and all locations. Unfortunately, as it was paper based, it didn’t work as planned, but he is still hopeful to try again.
- #32 Marysia/Georgia (5mins)
- #33 1 min
- #34 Marysia (2mins) Context - whats exists Disclaimer: engineers, not telling people challenges,