Relaxx Doctors, Nurses and Patients…

Here is a …

Solution for your (I.V. solution) Problems…

Low level Intravenous Fluid Level Indicator for Hospitals

SISHU GRIHA MONTESSORI & HIGH SCHOOL

Bangalore, India

Project code: EN 1TD027

Age Category: 1

Subject Category: Engineering Team

1}

Nishanth. V. Kumar - Class VII

1

2}

Krishna. V. Betai - Class VII

TABLE OF CONTENTS

SYNOPSIS Page

INTRODUCTION Page

METHODOLOGY Page

EXPERIMENTS Page

DISCUSSION Page

CONCLUSION Page

REFERENCES Page

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ACKNOWLEDGEMENT Page

Synopsis

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Objective:

Intravenous fluid administration is a very common treatments given for

problems ranging from dehydration,infections and loss of blood.In a

developing country like India, with these problems present very

commonly,this treatment modality is used day in and day out.. This

fluid meant to save patients from the verge of death, if not kept

under a constant watch, it may endanger the patient’s health and

sometimes also life.

In India, the ratio of Nurse to Patient is very poor. The discrepancy

becomes all the more obvious and important in situations where a few

patients need simultaneous attention of a nurse. A familiar scenario

is when 4-5 patients are on I.V. fluids, the fluid bottle getting

empty with no nurse nearby and /or an uneducated attendant.

This can lead to a lot of complications like blood regurgitating

towards the fluid bottle(due to negative pressure),block in the I.V

tube and needle necessitating repeating the injection and most

important AIR EMBOLISM which can be fatal also.

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We did a lot of study on the internet and also spoke to a few

doctors.We learnt that major hospitals use an infusion pump for this

purpose which costs anywhere from Rs 35,000/- to Rs 50,000/-

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The Aim of our project is to:

Find a simple and Cost effective solution to the I.V. fluid

administration problem which may be of serious concern.

Create a relaxed environment for the Patients, Nurses and Doctors.

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Origin of the Idea:

We learnt that one of our teacher’s relative had been on I.V.

fluid and when the empty bottle was not replaced immediately, he had

to be re – injected and also suffered a severe infection which made

him seriously ill. This problem had been discussed in the science club

and a model based on pulleys had been made to tackle this problem.

We saw that model and we felt that it was not easily

Implementable. We felt it was for a noble cause and were curious to do

something towards solving the problem. Our small studies and

researches grew up into this project.

Hypothesis

A low cost, simple and portable device can be designed that can

trigger audio & visual alarm for indicating low level of IV fluid

Impact

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This device can create a friendly environment in the hospitals

making the patients feel comfortable. Any patient will say, “Oh, now

that this device is there I need not worry about the I.V. fluid bottle

so, I can sleep PEACEFULLY.” The nurses and doctors will also be

relieved as they need not keep a constant watch over the fluid level.

Materials requiredAn Intravenous fluid administration set(Drip Set), I.V. fluid

stand, I.V. fluid bottle, P.C.B. circuit which senses low fluid

levels, wire, probes, etc.

Methodology and experimentation

Step 1: Initially we thought of a pressure sensor which could sense

the pressure dropping as the fluid level decreases, triggering an

alarm.

Step 2: Due to the unavailability of pressure sensors, we switched to

the idea of using a laser light and a light sensor. This also had a

few technical problems and we thought of the present idea.

Step 3: We first devised a soft copy of every thing including the

circuit and showed it to our guide who asked us to go ahead with the

idea.

Step 4: Our parents made the P.C.B. circuit (with us being keen

observers) according to the instructions given in a particular book

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Electronics for fun by Suyash Dake and modified it a little bit. The

device now only had an L.E.D. indicator and it was connected to two

needles {syringe needles} as probes.

Step 5: We took our model to two hospitals – M.G.A. hospital & Deepa

hospital and displayed it there to the doctors and the nurses who

kindly listened to our explanation and gave us their feedback. They

also gave us some valuable suggestion about that there could be

infection through the needle and we had to maintain thorough sterility

if we had to implement our idea.

Step 6: We made new probes which were attached to plastic pieces in

which the wires could go through

Step 7: We made the final model. PICTURE ENCLOSED.

Step 8: We spoke to many prominent doctors of Bangalore about the

model and its uses. REPLIES ENCLOSED.

DATA INTERPRETATION

FUTURE SCOPE OF THE PROJECT

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€ Alternative solution to avoid insertion of probes inside the

bottle

€ Study the effects, if any, of the current passing through the

different IV fluids

€ Low battery indicator

€ Speak with manufacturers of IV administration sets regarding

small modifications in the set whereby the insertion of probes,

fixing the probe unit to the set can all be avoided.

€ Speaking to the Government about this so that it can be used in

Government Hospitals even in remote areas.

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Introduction

In a developing country like India there is poverty, illiteracy, lack

of proper hygiene and the awareness about it. These lead to many

medical problems. The common ones are:

€ Gastroenteritis leading to Dehydration due to loss of fluid.

€ Severe Infections leading to dehydration due to poor intake, cough,

vomiting etc.

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€ Severe Anaemia due to malnutrition and accidents that necessitate

Blood Transfusion.

A very common method of treatment for these is the administration of

Intra venous Fluid. It is used as treatment for:

€ Loss of Body fluid

€ Loss of blood

€ Administer medicines like Antibiotics, Iron, and Proteins etc.

€ This fluid administration is LIFE SAVING. However improper

administration can lead to a lot of problems - MORBIDITY and

MORTALITY in medical terms.

For e.g. If the fluid bottle gets empty and not replaced

immediately, there

can be:

€ Blood regurgitating towards the fluid bottle (due to

negative pressure)

€ Block in the needle necessitating repeating the

injection

€ Block in the drip set esp. pediatric necessitating

replacement of the set.

€ Air and Thrombo embolism which can be fatal.

€ Infections

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Methodology

Step 1: Initially we thought of a pressure sensor which could sense

the pressure dropping as the fluid level decreases, triggering an

alarm.

14

Step 2: Due to the non availability of pressure sensors, we switched

to the idea of using a laser light and a light sensor. This also had a

few technical problems and we thought of the present idea.

Step 3: We first devised a soft copy of every thing including the

circuit and showed it to our guide who asked us to go ahead with the

idea.

15

Step 4: Our parents made the P.C.B. circuit (with us being keen

observers) according to the instructions given in a particular book

How Parallel Connection Helped in This Project

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Series Connection

Parallel Connection

Switch is closed when probes are inside the IV fluid

In Parallel Connection, LED glows when switchis open (Low IV fluid level)

Electronics for fun by Suyash Dake and modified it a little bit. The

device now only had an L.E.D. indicator and it was connected to two

needles {syringe needles} as probes.

Step 5: We took our model to two hospitals – M.G.A. hospital & Deepa

hospital and displayed it there to the doctors and the nurses who

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kindly listened to our explanation and gave us their feedback. They

also gave us some valuable suggestion about that there could be

infection through the needle and we had to maintain thorough sterility

if we had to implement our idea.

We visited Deepa Hospital, K.R. Puram, Bengaluru.

Here we met Dr. Vishalakshi M.B.B.S, M.D. (O.B.G.) and the Nurses.

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We also visited M.G.A Hospital, Marathahalli, Bengaluru.

Here we met

€ Dr.M.G. Pradyumna M.B.B.S, M.D.

€ Dr. Madan .S. M.B.B.S, M.S.

Step 6: We made new probes which were attached to a porcelain piece in

which the wires could go through.

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Step 7: We made the final model.

PICTURE ENCLOSED.

Step 8: We spoke to many prominent doctors of Bangalore about the

model and its uses. REPLIES ENCLOSED.

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Opinion

noel maran to me

) Reply

Dear NishanthYou are doing an interesting study ,,just afew clarification 1. how do you ensure the sterility of probes of the circuit inserted in the IV bottle.2. Are there any chances of the fluid dripping from the point of insertion.3. Will the probe require a external fixture to keep itself in place. Apart  from these clarification it seems to be feasible study. All the bestSusan(Associate Professor St.John's College of Nursing)

nandakumar.jairam@columbiaasia.com to me

) Reply

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Dear Nishanth, Great thought process. I have one question, the probes will have to be inserted into the IV bottle this can be a threat to sterility, please think this over. I willbe happy to help and advise you. Regards Dr N K Jairam Medical Director Columbia Asia Hospitals. Sent from BlackBerry® on Airtel

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Conclusion

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CONCLUSION:

€ Intravenous fluid administration is a very common medical

practice.

€ Failure to maintain safe levels of IV fluid can be a major health

risk.

€ There is no cost effective device at present to monitor IV fluid

levels.

€ We have devised a simple, compact, mobile, cost effective and

practical model that can achieve this goal. Being battery

operated it does not depend on power supply which is very erratic

and not dependable in small towns and rural areas.

€ The entire model cost us Rs 200/- only. A ten bedded hospital can

have one unit per bed for Rs.2000/- only.

Limitations of this project

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1) Introduction of probes into the iv fluid can jeopardize sterile

conditions unless performed very meticulously

2) The probes if repeatedly poked can cause leakage of the fluid.

3) At present the probe unit needs some support to hold in place.

Annexures

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1)Comparative Data

Health manpower (per 100,000 population) across some

countries  Physicians Nurses Midwives Pharmacists

Australi

a 249.1 774.8 60.2 72.1Canada 209.5 1009 91.2 79.7China 164.2 104.2 NA 29Cuba 590.6 744.2 NA NAIndia 59.7 79.1 47.4 52.7

SriLanka 42.8 79.1 41.9 4.5Thailand 30.1 161.7 NA NA

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UK 166.5 496.6 43.3 58.9USA 548.9 772.6 NA 68.8

2) Nursing Services in India have expanded considerably since Independence. Along with this expansion a diversification in nursing services in the medical care field has also taken place. Great imbalances in the manpower situation can be noticed as far as nursing is concerned. As compared to the developed countries, the nurse's populationratio in India is not adequate. In India there is one nurse to 2250 people while in the developed countries the number of people served byone-nurse ranges from 150 to 200.Even developing countries like Indonesia, Kenya, Srilanka and Thailand have a better nurse populationratio. The nurse patient ratio, however, varies form 1:5 to 1:60 or 1:1000 in different Institutions.(Press Information Bureau,Govt of India)

3)Thrombo Embolism

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Pathway for Embolism

4)Air Embolism

infant IV:An infant isadministeredan I.V. for dehydration and it was installed incorrectlyThe animationshows the procedure and the outcome of the air embolism.

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5)Nursing Status. A New England Journal of Medicine study documented that improved RN-to-patient

ratios reduce rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding, and other adverse outcomes. (NEJM, May 30, 2002)

. The Massachusetts Department of Public Health reports medical errors and complaints at

hospitals have increased by 76 percent in seven years. (DPH Division of

Health Care

Quality.)

More than 195,000 patients die needlessly every year in our hospitals from a series of complications directly related to poor nurse staffing, according to a

study released in May 2004. The authors attributed the majority of these deaths to

"failure to rescue" (which refers to nurses' failure to promptly assess and treat

conditions that develop in a hospital), bedsores, postoperative sepsis and post-

operative pulmonary embolisms. (Health Grades, 2004)--JAMA.

Each additional patient pernurse was associated with a7 percent increase in mortality. The difference between four to six and four to eight patients per nurse would be accompanied by 14 and 31 percent increases in mortality.

-Journal of the American Medical Association (JAMA)–Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction (October 2002)

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Tthe above graph depicts clearly the importance of the Nurse-Patio

ratio.As increasing the nurse-patient ratio in our country may not be

easy,any measure to make their work load is welcome.Ours is one such

attempt.

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