1. Pressure Sore Alleviation Device Senior Design Team P6203 Adam Hagerty Elizabeth Hampton Scott Keppel Brian Phillips Coordinator: Dr. Elizabeth DeBartolo Sponsor: Kristen Quinlan, ARC of Monroe

2. Outline ARC of Monroe Overview ARC of Monroe Overview What is a Pressure Sore? What is a Pressure Sore? Project Needs Project Needs Concepts Developed Concepts Developed Design, Analysis, and Build Design, Analysis, and Build Budget Budget Final Product Final Product ARC of Monroe Feedback (1 week of use) ARC of Monroe Feedback (1 week of use)

3. ARC of Monroe Overview Organization that has provided care to mentally/physically disabled patients for many years Organization that has provided care to mentally/physically disabled patients for many years They are looking for a way to relieve pressure sores on a single patient They are looking for a way to relieve pressure sores on a single patient Want device to function to eliminate need for the nursing staff to constantly be disrupting patient’s sleep for adjustment Want device to function to eliminate need for the nursing staff to constantly be disrupting patient’s sleep for adjustment

4. Project Team Goals Create device to alleviate pressure spots on clients body Create device to alleviate pressure spots on clients body Make it affordable to stay within budget Make it affordable to stay within budget Make it safe and reliable for all users (i.e. – Nursing staff and client) Make it safe and reliable for all users (i.e. – Nursing staff and client)

5. Problems Discovered Client has pressure sores Client has pressure sores Client has difficulty sleeping at night Client has difficulty sleeping at night Client is disabled and deaf Client is disabled and deaf ARC doesn’t have effective device to alleviate pressure sores without constant supervision ARC doesn’t have effective device to alleviate pressure sores without constant supervision

6. What is a Pressure Sore?? Develop due to constant pressure on an area of skin Develop due to constant pressure on an area of skin This reduces blood supply to the area This reduces blood supply to the area Causing Causing Cell death Cell death Breakdown of the skin Breakdown of the skin Development of an open sore Development of an open sore Picture Courtesy of www.WebMD.com

7. 4 Stages of a Pressure Sore Stage 1 Pressure Sore Stage 1 Pressure Sore Skin is red or discolored Skin is red or discolored Redness does not go away 30 minutes after pressure is removed Redness does not go away 30 minutes after pressure is removed Stage 2 Pressure Sore Stage 2 Pressure Sore Upper layer of the skin is broken Upper layer of the skin is broken Creates a shallow, open sore Creates a shallow, open sore Drainage may or may not be present Drainage may or may not be present Pictures Courtesy of www.WebMD.com

8. 4 Stages of a Pressure Sore Stage 3 Pressure Sore Stage 3 Pressure Sore Break in the skin extends through the second skin layer into fat tissue Break in the skin extends through the second skin layer into fat tissue Wound is deeper than in Stage 2 Wound is deeper than in Stage 2 Stage 4 Pressure Sore Stage 4 Pressure Sore Breakdown extends into the muscle and possibly down to the bone Breakdown extends into the muscle and possibly down to the bone Usually lots of dead tissue and drainage are present. Usually lots of dead tissue and drainage are present. Pictures Courtesy of www.WebMD.com

9. 1 Part of the Cure This device is only one part of the pressure sore problem This device is only one part of the pressure sore problem Although this device will alleviate pressure it will not cure a pressure sore, it is for prevention only Although this device will alleviate pressure it will not cure a pressure sore, it is for prevention only Healing of a pressure sore is done by two methods: Proper medical treatment and proper nutrition Healing of a pressure sore is done by two methods: Proper medical treatment and proper nutrition

10. Needs of Project Safe for user Safe for user Alleviate long-term pressure areas Alleviate long-term pressure areas Stay in budget (<$1500) Stay in budget (<$1500) Be waterproof Be waterproof Rotate through position settings Rotate through position settings Rotate at intervals Rotate at intervals Comfortable to user Comfortable to user Simple user interface Simple user interface Low/Easy Maintenance (repair) Low/Easy Maintenance (repair) Power source location Power source location Operate quietly Operate quietly Control interface location Control interface location

11. Specifications Sales Price: $1500 Sales Price: $1500 Supportable Weight (max): 300 lbs Supportable Weight (max): 300 lbs Number of times patient needs assistance during sleep period due to an issue with the device: <1 Number of times patient needs assistance during sleep period due to an issue with the device: <1 # of Cycle Patterns: 3-5 # of Cycle Patterns: 3-5 Duration of Each Cycle Pattern: 30-60 min Duration of Each Cycle Pattern: 30-60 min # Of Buttons on User Interface: 5 max # Of Buttons on User Interface: 5 max Life of Product: 7 yrs Life of Product: 7 yrs Selectable Duration for Each Cycle Pattern: 1-3 Selectable Duration for Each Cycle Pattern: 1-3 Size of Mattress (in 2 ): 54”x75” Size of Mattress (in 2 ): 54”x75” # of Main Components: 10 max # of Main Components: 10 max Distance to User Interface: 25 ft Distance to User Interface: 25 ft Distance to Outlet: 10 ft Distance to Outlet: 10 ft

12. Concepts Concept # 1 – Air bladder system Concept # 1 – Air bladder system Concept # 2 – Cylinder mechanism Concept # 2 – Cylinder mechanism Concept # 3 – Alternating track system Concept # 3 – Alternating track system Concept # 4 – Hinged mattress Concept # 4 – Hinged mattress Concept # 5 – Water bladder system Concept # 5 – Water bladder system

13. CONCEPT # 1: AIR BLADDER

14. CONCEPT # 2: CYLINDER SYSTEM

15. CONCEPT # 3: ALTERNATING TRACK SYSTEM

16. CONCEPT # 4: HINGED MATTRESS

17. CONCEPT # 5: WATER BLADDER

18. CONCEPT SELECTION CONCEPT # 1: AIR BLADDER CONCEPT # 1: AIR BLADDER Based on Pugh analyses Based on Pugh analyses Determined to be best suited for needs Determined to be best suited for needs

19. Design Guidelines MATTRESS MATTRESS 3 cycles for alleviation 3 cycles for alleviation 2 moving cycles 2 moving cycles 1 stationary cycle 1 stationary cycle Twin size section Twin size section Foam border to fill full size bed of client Foam border to fill full size bed of client Water proof mattress cover Water proof mattress cover

20. Cycles of Alleviation CYCLE 1 CYCLE 3 CYCLE 2

21. Air Cell Analysis Patient Statistics Patient Statistics W=115lbs. W=115lbs. H=56in. H=56in. Assuming 18in. wide patient Assuming 18in. wide patient Worst Case: Worst Case: (300lbs on 5 Tubes) Client Case: Client Case:

22. Pump Analysis Pump usage Pump usage Inflate and deflate 10 air cells Inflate and deflate 10 air cells The air pump must produce.23cfm to properly inflate the mattress in 20 minutes. The air pump must produce.23cfm to properly inflate the mattress in 20 minutes. Will use pump from Sentech (110V) Will use pump from Sentech (110V) Data Courtesy of www.sentechmedical.com

23. User Box Contains 4 lighted switches for cycle control Contains 4 lighted switches for cycle control Holds microcontroller, solid state relays, and other electrical components Holds microcontroller, solid state relays, and other electrical components Enclosure is safe for electrical devices Enclosure is safe for electrical devices Mounts to wall with ease Mounts to wall with ease

24. Pump Box Contains switch and power connection for pump Contains switch and power connection for pump Holds pump, 2 valves, 2 pressure sensors, and other electrical components Holds pump, 2 valves, 2 pressure sensors, and other electrical components Again, safe for electrical devices and easy mounting capability Again, safe for electrical devices and easy mounting capability

25. Foam Containment Foam used to surround and contain air cells Foam used to surround and contain air cells Foam purchased from www.efoamstore.com Foam purchased from www.efoamstore.com www.efoamstore.com Can be made in any shape for any specific application (aka bedding) Can be made in any shape for any specific application (aka bedding) Yellow foam is medium grade bedding foam Yellow foam is medium grade bedding foam Medium foam will compress approximately.75” Medium foam will compress approximately.75” Blue foam is firm grade bedding foam Blue foam is firm grade bedding foam Firm foam will compress approximately.25” Firm foam will compress approximately.25”

26. FINAL ASSEMBLY-MATTRESS Consists of 4 foam sides, 4 foam inserts, 1 foam base, and 10 air cells Consists of 4 foam sides, 4 foam inserts, 1 foam base, and 10 air cells

27. Electrical Analysis The controls are outside of the bedroom due to customer requirement The controls are outside of the bedroom due to customer requirement 4 lighted switches used to control the cycles 4 lighted switches used to control the cycles Sense pressure in air tubes Sense pressure in air tubes Open valves when the pressure is above the set level (discussed later) Open valves when the pressure is above the set level (discussed later)

28. Sensing Pressure Need to sense pressure around 20mmHg (up to 50 mmHg) Need to sense pressure around 20mmHg (up to 50 mmHg) This pressure sensor ranges from 0 to 51 mmHg which is perfect for this application This pressure sensor ranges from 0 to 51 mmHg which is perfect for this application Controller input needs to switch to high when at proper pressure Controller input needs to switch to high when at proper pressure V O -1.5=.09*R (Used this to determine resistor necessary for proper pressure switching point) V O -1.5=.09*R (Used this to determine resistor necessary for proper pressure switching point) www.honeywell.com

29. Comfort Analysis Used 20 mmHg as base point for analysis Used 20 mmHg as base point for analysis Adjusted Resistor from 6 ohms to 18 ohms where maximum comfort was experienced Adjusted Resistor from 6 ohms to 18 ohms where maximum comfort was experienced An 18 ohm resistor gave a voltage of 3.12 volts and an approximate pressure of 33 mmHg An 18 ohm resistor gave a voltage of 3.12 volts and an approximate pressure of 33 mmHg Start End Used this calculation to determine resistor needed to meet comfort level 1.5 V is the high/low trip point for the controller and.09A is the current of the controller

30. Opening Valves A solid state relay was used to open the valves with the 5VDC, 30mA signal the controller outputs A solid state relay was used to open the valves with the 5VDC, 30mA signal the controller outputs Relay, when signaled would allow a 12VDC signal to travel to the valve Relay, when signaled would allow a 12VDC signal to travel to the valve Two relays were used to control each valve separately Two relays were used to control each valve separately Figure Courtesy of www.norgren.com When 12 VDC is passed across valve, exhaust port is opened Valve closes when 12 VDC is removed Mattress pressure is regulated through these valves

31. Electrical Schematic

32. System Control BASIC stamp microcontroller BASIC stamp microcontroller Excellent for small control applications Simple programming language 16 I/O ports for connections This project used 8 ports

33. System Control Pin Assignments Pin Assignments Pins 0 and 1 were used for pressure sensors Pins 0 and 1 were used for pressure sensors Pins 3 and 4 were used for valve control Pins 3 and 4 were used for valve control Pins 10-13 were used for lighted switch control Pins 10-13 were used for lighted switch control

34. System Control Depending on switch selected program will select proper cycle time (30, 45, 60 minute cycles, or Full Inflate) Depending on switch selected program will select proper cycle time (30, 45, 60 minute cycles, or Full Inflate) If no switch is selected mattress will automatically full inflate If no switch is selected mattress will automatically full inflate If multiple switches are selected mattress will choose first switch If multiple switches are selected mattress will choose first switch These times are based on count commands within the program These times are based on count commands within the program To determine the proper count testing was performed on the system for each required time. To determine the proper count testing was performed on the system for each required time.

35. System Control Air pump is always on Air pump is always on System pressure is controlled by valves and pressure sensors as seen earlier System pressure is controlled by valves and pressure sensors as seen earlier When pressure in either cell cycle exceeds 33 mmHg, stamp input 0 or 1 is signaled to switch to high When pressure in either cell cycle exceeds 33 mmHg, stamp input 0 or 1 is signaled to switch to high This switch signals input 3 or 4 to switch high, opening the valve associated with it This switch signals input 3 or 4 to switch high, opening the valve associated with it This valve remains open for 5 seconds and then closes This valve remains open for 5 seconds and then closes If cycle calls for valve to be open, input 3 or 4 is left high to release pressure from the required set of air cells If cycle calls for valve to be open, input 3 or 4 is left high to release pressure from the required set of air cells Cycles rotate between the 3 patterns until new switch is selected and old switch is shut off Cycles rotate between the 3 patterns until new switch is selected and old switch is shut off

36. Budget Overview Budget Available = $1500 Budget Available = $1500 Total Cost of Project = $920 Total Cost of Project = $920 This project was under budget by $580 This project was under budget by $580

37. Final Product

38. Arc of Monroe Feedback Patient is sleeping uninterrupted throughout the night (4 Nights since installation) Patient is sleeping uninterrupted throughout the night (4 Nights since installation) Nursing staff says patient looks comfortable in mattress system Nursing staff says patient looks comfortable in mattress system No problems with mattress system recorded, all positive feedback! No problems with mattress system recorded, all positive feedback!

39. Recommendations for Future Work This device is made specifically for a 115 lb client leaving available the variable user side of this project This device is made specifically for a 115 lb client leaving available the variable user side of this project This device is only a prototype, making it for mass production would be another area to investigate This device is only a prototype, making it for mass production would be another area to investigate

40. Special Thanks This material is based upon work supported by the National Science Foundation under Award No. BES- 0527358. This material is based upon work supported by the National Science Foundation under Award No. BES- 0527358. The electrical enclosure for our pump, valves, and pressure sensors was provided courtesy of Fibox. The electrical enclosure for our pump, valves, and pressure sensors was provided courtesy of Fibox.

41. Disclaimer Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation.

42. References [1] www.sentechmedical.com [1] www.sentechmedical.com [2] www.parallax.com [2] www.parallax.com [3] www.efoamstore.com [3] www.efoamstore.com [4] www.neurocare.com [4] www.neurocare.com [5] www.caregiverproducts.com [5] www.caregiverproducts.com [6] www.medicalharmony.com [6] www.medicalharmony.com [7] www.medicalproductsdirect.com [7] www.medicalproductsdirect.com [8] www.therohogroup.com [8] www.therohogroup.com [9] www.sunrisemedical.com [9] www.sunrisemedical.com [10] www.invacare-ccg.com [10] www.invacare-ccg.com [11] www.medicalsupplis4all.com [11] www.medicalsupplis4all.com [12] www.webMD.com [12] www.webMD.com [13] www.foamorder.com [13] www.foamorder.com [14] www.airdimensions.com [14] www.airdimensions.com [15] www.norgren.com [15] www.norgren.com [16] www.fibox.com [16] www.fibox.com

43. Questions