CardiacStart - comforting patients and paramedics during stress
 
 

Why this project?

Chest discomfort is one of the most frequent and nuanced symptoms encountered in the Emergency Medical Service (EMS). "

Setup

A 10-week term project which was executed in collaboration with the Umeå Paramedics and supported by Laerdal Medical. Executed at the Umeå Institute of Design in Sweden, from October 2016 till January 2018. 

Opportunity

Paramedics monitor a patient's heart rhythm (ECG) with a heavy defibrillator. Due to it’s heaviness, in paramedics do not always take the defibrillator with them to patients. Patients often experience the process of obtaining an ECG as unpleasant, due to placing ten ECG-elctrodes and cables on a patient's body. Can one solution benefit both parties?

Result

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 defibrillator has a detachable monitor, which replaces the printer and paper, downscaling its overall weight.

 
 
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product ecosystem 

Who and what is involved in the diagnosis of a patient with chest problems?

The diagram on the right side shows the stakeholders who are involved in the cardiac diagnosis process (left side) and on the right side the product features the stakeholders are using. A human-centered approach was used due the paramedic's profession; giving care to people.

 

Chest discomfort is one of the most frequent and nuanced symptoms encountered in the Emergency Medical Service (EMS). (4) User research showed that paramedics monitor a patient's heart rhythm (ECG) with the heavy LifePak defibrillator. Due to it’s heaviness, paramedics do not always take 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. 

 

 

 

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what is it like to be a paramedic?

10 hours of shadowing and interviewing

In order to understand who is involved in what stage of the cardiac diagnosis process, two types of user research were used. Interviews were held with paramedics to understand their motives and opportunities. Besides interviewing the paramedics, a second user research method was 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. During these ten hours, the paramedics were observed and analyzed during the patient treatment. Check out the research movie that was created after shadowing and interviewing the paramedics for over ten hours. . In the first week of the project we, 12 first year master students of the Advanced Product Design program, visited the local paramedic station. After doing field and desk research, the following insights were found and used as a starting point for the ideation phase. 

 
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creative exploration

Visualising the initial ideas

Ideation sessions can be done in many ways. Educated as an industrial designer, sketching is in my case the quickest way to shape and visualise ideas. The sketches were made by hand, scanned in and later edited in photoshop. Digital tools, results are shown in the second and third picture, were used to quickly change form and proportion.

 
 

 

creative exploration

Learn by building and build upon learnings

Sketches are usefull till a certain extend. In many cases I tend to quickly prototype the most promising ideas. This will not only give me, but also other people around me a better base for discussions. Many of these quick prototypes were made with scrap material.

 
 

 

 

creative exploration

Building the final product

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.  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.  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.

 
 

 

 

introducing

CardiacStart - there when you need it

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 ECG’s, with a screen, the weight can be reduced with 2 kg.

 
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product architecture

A versatile main 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 and uses both hands, the strap is a usefull feature.

 
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operated by the paramedic

User interface

The user interface of the detachable screen replaces the printer that is used nowadays because it’s using the same measurements as the printed ECG. 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 which 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.

 
 

 

 

 

comforting the patient is key!

Reassuring ECG accuracy while comforting the patient

The wireless ECG-electrodes will transmit the electrical activity from the heart to the portable ECG-monitor. This will save time by taking away ten steps (attaching cables to the ten ECG-electrodes). Taking away the cables will result in a less busy workplace for the paramedic and few products that lay on the patient. It is a win-win situation where the patient becomes more relaxed and the paramedic has the execute fewer steps. The new wireless ECG-electrodes will have an intergrated LED. When the wireless ECG-electrodes are activated, every LED will then light up in a different color. LED’s are intergrated because the wireless ECG-electrodes are universal. The paramedic will know with the different colored LED’s what every wireless ECG-electrode is transmitting.

 
 
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components of the electrode

Product architecture

The wireless ECG-electrode exists of two parts. The part with the transmitter and electronics (1) is plastic and is along-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. A click button is chosen because it’s used in the current situation, where it shows good conductivity.

 

 

 
 

 

attach and detach

Use what the paramedics like 

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. User research showed that paramedics like this easy click and detach button. It's reliable, fast and is a fairly cheap solution.

 

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size of the wireless ecg-electrode

Keeping it as small as possible

The wireless ECG-electrode is 40 x 40 x 10 mm and has similar dimensions as the current ECG-electrode. The patient won't get bigger pads on his body and the paramedic can still carry portably carry the wireless ECG-electrodes.

 

 
 

 

 

Get rid of the cable hassle

Self sensing ECG-electrodes

Time management is crucial for paramedics, especially when a patient experiences chest discomfort. In every wireless ECG-electrode, a sensor is embedded that communicates with other activated wireless ECG-electrodes. This means all of the ten pads are communicating in the ecg-electrode placement stage of the cardiac diagnosis process with each other to determine their place on their body. Self sensing ECG-electrodes are needed in order to save seconds. It will take a paramedic longer to find the a specific ECG-electrode and place it on the body. 

 
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