Neonatal Abstinence Syndrome: Detection and Intervention
Neonatal Abstinence Syndrome (NAS) affects an estimated 20,000 newborns annually with total treatment costs exceeding $800M. NAS is a condition caused by in-utero exposure to opioids, resulting in painful withdrawal symptoms including tremors, seizures, respiratory distress, and if untreated, death. Current assessment techniques are subject to practitioner bias, putting infants at risk for inaccurate dosage of pharmacological intervention and treatment plans.
The Pediatric Medical Device Institute, in partnership with the Virginia Tech Mechanical Engineering Department and Cambrian Design and Development, LLC, is developing an objective, quantitative tool for assessing symptoms of withdrawal. The device provides objective monitoring of tremors and respiratory rate, allowing physicians to avoid subjectively estimating severity of the infant’s tremors and providing accurate real-time feedback to aid in appropriate dosing of pharmacological interventions.
Global Assistance of Infant Resuscitation (Global AIR)
Physicians in developing countries face many challenges including an unstable electric grid, unsanitary conditions, and malfunctioning equipment, all of which contribute to alarming infant mortality rates in resource-poor areas. Global AIR (Assisted Infant Resuscitation) is a mechanical resuscitator that provides positive pressure breathing, continuous positive airway pressure (CPAP), and suction during the first critical moments of newborn care. Other systems require compressed air/oxygen and electricity to function, which are often unfeasible and too expensive to deploy in austere environments.
To optimize sustainability, the innovative design of Global AIR utilizes local resources, such as materials commonly found in hardware stores around the world. The device can be fabricated for under $100.00 and can operate independently of electricity.
During 2014, the Pediatric Medical Device Institute partnered with Carilion Clinic Roanoke Children’s Hospital and Virginia Tech Mechanical Engineering Department to demonstrate Global AIR in Malawi, Africa at eight collaborating hospitals. Design feedback was solicited from over 60 medical personnel, including clinicians and maintenance managers. Global AIR aims to deliver suction machines for small scale implementation to Malawi in 2016. Global AIR continues to consult with the collaborators from Malawi in order to ensure device is sustainable and able to be successfully deployed. Long term, Global AIR strives to employ a business-model that will function within the private sector businesses of Malawi.
Pediatric Electronic Device for Emergency Resuscitation
Pediatric Electronic Device for Emergency Resuscitation (PED-ER), an electronic display technology for the emergency room, has been developed to provide key procedures, dosing information, drug tracking features, and logging capability for first responders and emergency department applications. PED-ER provides more robust decision support by converting the Broselow Pediatric Emergency Tape to electronic content. PED-ER provides decision support in three main areas:
- Listing of equipment size appropriate for patient size
- Treatment algorithms for common emergencies such as cardiopulmonary arrest, burns, seizures, etc.
- Verification of medication selection via barcoding, automated calculation of appropriate medication close, and display of administered medications.
M. Coli Blue
Providing access to safe water in low and middle income countries remains a top international development priority. To ensure that water is safe for drinking, E. coli and total coli form counts need to be assessed. The traditional method is to take a water sample and incubate a dilution of the sample in a media and to manually count the colonies that grow. This count is prone to error and is time consuming to perform, especially when lots of samples are being processed. PMDI is working on a device to automate the counting of colonies. Using a low-cost computer vision system, an image of the incubated sample can be captured. Software can then count each of the colonies. The system is designed to be portable and battery-powered for field use.
Inspire: Respiration Rate Measurement for Diagnosing Pneumonia
Pneumonia in children five years and younger is diagnosed based on temperature and respiratory rate in resource limited environments, where diagnostic techniques that require electricity, such as x-rays, are often not available. Getting an accurate measurement of the respiratory rate can be difficult. Manual breaths counts are highly prone to errors and many other sensors are too costly or slow for large scale clinics. Misdiagnosis can have significant impact. Missing pneumonia prevents treatment, and treating a child for pneumonia with antibiotics who does not have pneumonia increases the prevalence of antibiotic resistant bacteria. Partnering with Cardinal Mechatronics, LLC, PMDI is developing a low-cost sensor to measure respiration rate for use in environments where access to an x-ray is not available. This sensor must be accurate, repeatable, and get a measurement quickly since many healthcare clinics in these environments will have a high patient-to-staff ratio. The device will also be developed specifically for use with children five years and younger.