1. Olympic CFM 600 Cerebral Function Monitor Group 14 Brian Snelling, JP Day, Colin Compas

2. Project Description –Cerebral Functioning Monitor Machine Leads –EEG Reading Affected EMI ECG Physical Contact –Equipment Proximity

3. Device Description Cerebral Function Monitor –Continuously measures brain activity –Normal reading Between 10-40 μV Less than 20k –Detects Oxygen loss (HIE) Drug side effects Seizures –Used approx. once per month

4. Solutions Move other equipment –Frequencies too high –Proximity Remove ECG signal –Ranges Overlap Shield Device –CFM is Licensed and Approved –Device Already has Shield Shield Leads –Preliminary Testing –Options

5. CFM Tracings Normal tracing characterized by central band in the 10- 40µV range with a normal sleep wake cycle Abnormal tracing characterized by lower, narrow band of activity with spikes indicating burst suppression EMI can lead a normal signal to resemble the abnormal signal which can lead to misdiagnosis of a baby’s cognitive function. Normal tracing affected by EMI

6. Phantom Scans Phantom test 1 Phantom test 2 Phantom was a cantaloupe with a diameter of 14 in. and a weight of 2 lb. 4 oz.

7. Distance Data Noise values measured (µV) for 3-D distances of Medfusion Syringe and Fusion Pump for the shown experimental design.

8. Misdiagnosis Baby in need of treatment due to CNS injury due to hypoxia but the CFM reading is persistently over 10 µV and appears normal, disqualifying the baby for therapy –Failure to prevent brain injury Baby with no brain activity but in whom interference generates a wave –The baby is actually too severely injured to benefit from cooling yet because of a false signal would be cooled

9. Completed Work Isolated noise signal with melon –Collected Data –Used Medfusion Pump Met with Dr. Wikswo –Discussed lead shielding –Obtained shielding literature Contacted Ted Weiler –Head of R & D –Ruled out EMI causes –Will review our data Generated 3D noise graph

10. Current Work Use signal generator to simulate noise –Characterize noise signal Contact Olympic Medical –Send our data –Discuss lead shielding Obtain list of “problem” devices –Dr. Walsh –Olympic Medical Test “problem” devices –Record noise signals

11. Future Work Begin testing shielding devices –Copper Mesh –Composite Material Select lead shield Test in NICU setting Continue working w/ Olympic Medical

12. References Vries L, Hellstrom-Westas L. Role of cerebral function monitoring in the newborn. Archives of Disease in Childhood, 2007;27. Spitzer A. Neonatal Cerebral Function Monitoring. Neonatalogy Today, 2006;1:1-12. Gluckman P, Wyatt J, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multi-centre randomized trial. Lancet. 2005;365:663-70. al Naqeeb N, Edwards AD, Cowan FM, Azzopardi D. Assessment of neonatal encephalopathy by amplitude integrated electroencephalography. Pediatrics 1999; 103(6):1263–1271. Archbald F, Verma UL, Tejani NA, Handwerker SM. Cerebral function monitor in the neonate. II: Birth asphyxia. Dev Med Child Neurol 1984; 26(2):162–168. Greisen G. Tape-recorded EEG and the cerebral function monitor: amplitude-integrated, time-compressed EEG. J Perinat Med 1994; 22(6):541–546. Thornberg E, Thiringer K. Normal pattern of the cerebral function monitor trace in term and preterm neonates. Acta Paediatr Scand 1990; 79(1):20–25. Verma UL, Archbald F, Tejani NA, Handwerker SM. Cerebral function monitor in the neonate. I: Normal patterns. Dev Med Child Neurol 1984; 26(2):154–161.