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11
2017

Win $500 for your Program with our Brainstorming Contest

By Brandi 6

Attention Residents!  We need your bright ideas!

This year for Resident Awareness Week we will be hosting our own Medical Make-a-Thon with 3D4MD and Medical Makers.

What will we make?  That’s where you come in!  Work with your colleagues, your teams and your patients to generate ideas that provide 3-D printable solutions to existing medical issues.

Some things to keep in mind while you create:

  • Who are you designing for?
  • What is the need you are designing for?
  • Why are those needs not being currently met?
  • Why is 3D printing a better solution than the traditional alternatives?

Your idea will be featured as one of the problems our Makers could solve during Resident Awareness Week.

The winning designs from the Make-a-thon will become part of a catalogue of crowd-sourced, free designs being used to benefit humanity across the globe and even into Space!  The winning designs of our Make-a-Thon will have the opportunity to be printed at the Mars Desert Research Centre.

Be a part of a global community making a difference right now.  Submit your design ideas in the comments section of this post to be considered.  The FIVE programs who submit the best ideas will each receive $500 in additional Plan Your Own Social funding!

Put your idea in the comment section below

author: Brandi

Comment
6
pvanstolk

Currently in Rheumatology, we use our own hands to assess our patients for metacarpophylangeal joint swelling and warmth when we are concerned about rheumatoid arthritis (RA). This is open to bias based on our pre-test probability of disease (history-taking), and the inter-rater reliability has been shown to be moderate at best. I am interested in the possibility of creating a device to accurately quantify the amount of joint swelling (eg. tissue distensibility) and warmth. This would enhance our ability to compare a patient’s response to therapy visit-to-visit, and to develop cut off points that could be used in RA diagnosis and monitoring. This device could be applied to the patient’s hand, and would eliminate the subjective component of this assessment. I believe this would be a significant leap forward, and benefit the 1 out of 100 people in the world that are affected by this debilitating condition.

rgolby

Emergency residents are required to gain competence in a variety of procedures to preserve life and limb and maintain these skills throughout their career. Given the diversity in the types of patient presentations to the ED, some procedures are practiced sufficiently through routine care. Others arise infrequently depending on the level of care your facility typically receives, and opportunities are further diluted when new trainees are present and want to attempt the procedure.

In the move to competency based medical education, entrusting residents to perform uncommon procedures should not rely on chance incidence of these opportunities. Chest tube placement is a skillset that is essential to the practice of emergency medicine; however, indications for this procedure occur in high-stress life-saving environments. A novice trainee can struggle with the motor skills required, and both slow pace or failure of any step can limit entrustment with future attempts.

We are proposing the development of a 3D printed model of the chest wall for residents in emergency medicine (with applicability to surgical, critical care, and anesthesiology residents) to refine the approach to this uncommon procedure. The current practice model involves individual sourcing of pig meat that is poorly secured and not representative of thorax consistency. This is neither cost effective or realistic, and typically residents in our program are exposed to this representation only once, early in training. A 3D printed solution of a chest wall with rib spaces and variable “tissue” consistency will re-inforce muscle memory and engrain procedural steps. It can be created as a single rib space and therefore an entire thorax does not need to be crafted. A thin membranous sheet of tissue could even be adherent to the medial aspect of the 3D chest wall to simulate piercing the pleural lining between rib spaces. Our vision is that there are ways to make a permanent rib structure whereby a multi-use sheath could be slid over top of the ribs and removed when that “tissue” has been penetrated a few times – thereby preserving some of the baseline 3D structure (bony framework). With the addition of straps and a kevlar wall (which we have found can work for other critical procedure practice) we could even attach this bony architecture with removable chest wall sheath to real people to practice on – with penetration through the membranous “pleural membrane” having 2cm of dead space before terminating at the kevlar wall. This would allow replication of the control required when entering the thorax (failure being actually striking that wall through the membrane and deadspace). The size of this print will keep costs low – potentially less than pig materials where food products are wasted almost immediately. When true chest tube needs to be placed, residents will have procedural confidence to proceed with staff entrusting that their residents have had adequate exposure in the lab to this life saving practice.

I am a resident posting on behalf of the UBC – Fraser – FRCPC Emergency Medicine Program (located at Royal Columbian Hospital)

abrezar

Other suggestions include hearing aids, glasses (and cases) and dentures which are often forgotten at home before coming to the hospital and can contribute to deliriums.

frostgeoff

Hey,

I’m a physiatry resident and one of the biggest problems we face is accurately and consistently grading muscle strength on a physical exam. We ask our patients to resist the force we apply on their muscles, and then subjectively rate the strength of the muscle based on the patient’s ability to pull against us. While this is a vital physical exam skill, it has been demonstrated time and again that the results are simply not reliable. Often different examiners will assign different strength grades for (presumably) the same effort. The same examiner may even grade the same patient differently from session to session. We seek a device that interfaces between the physician and the patient that will:
A) Not inhibit normal muscle strength testing
B) Output a muscle strength grade based on the patient’s best effort
C) Calibrate its output (either immediately or through a companion manual/app) to the patient’s age and sex (it is well known that elderly patients have weaker muscles, but this does not necessarily mean the weak muscle is pathological, so a grading scale that is normative to age and sex would be essential to differentiate pathological from non-pathological).
D) Be a flexible tool that can be used in all the major muscle groups tested in a screening neurological examination.

Posting on behalf of the Physiatry Residency Group at Vancouver Coastal Health

frostgeoff

Hi RDoBC,

Another suggestion from Physiatry:

We are starting to use ultrasound machines extensively in our practice. We use ultrasound for both diagnostic tests and interventional procedures. In short, ultrasound skills are becoming essential to physiatry practice. When using ultrasound to guide injections, we persistently run into a nagging problem:

One of the accepted ways to visualize a needle under ultrasound is to hold the long axis of the needle parallel to the long axis of the ultrasound probe. The user then slowly advances the probe under the skin, all the while visualizing the needle using the ultrasound machine. Sadly, the long axis of the ultrasound probe takes a very narrow slice of space – perhaps no more than a millimetre or two. As a result, it is technically very challenging to keep the needle in the ultrasound probe’s visual window. Often, trainees find it bedeviling to even visualize the needle with the machine, let alone follow the needle down it’s intended path. As a result of this persistent issue, we are seeking:
A) A device that interfaces with the injection needle and the ultrasound probe, such that the movement of the needle is always visible in the long axis of the ultrasound image.
B) The device will not permanently change the probe in any functionally meaningful way, as the probe must be available for use in diagnostic tests.
C) The needle shall not be restricted from moving in the plane of the ultrasound’s long axis (still able to move in the 2D plane seen on the ultrasound image).
D) The device will not be so cumbersome as to prevent or significantly change current injection practice; unless the proposed change is an improvement on current technique.

We can provide pictures to better explain this problem if needed!

Written on behalf of Physiatry at Vancouver Coastal Health

ariyliu

My idea is for anatomical pathology program at UBC/VGH.

3D printing is a versatile tool that allows customization of tools in tackling surgical specimen for processing. We receive specimen from appendectomies to sarcoma resection involving limbs, internal organs and other soft tissue components. 3D printing allow us to build tools to effectively take sections for processing into slides and allow pathologists to make diagnoses that impact patient management and provide prognostic information.

Our tools of trade include but are not limited to sharps for cutting, cassette organization and slide filing. 3D printing can create dual blade knives to help us create 3mm sections to fit into the cassettes. This prevents us from further disruption of the specimen when making the sections. A cassette holder tool can also be made to prevent loss of slide order and prevent mislabelling of cases. Our paper slide trays can also be replaced with reusable holders that are safe for transport and protect the slides from breaking or being lost.

One of the biggest issues for pathology residents is sharp needle injuries. This is the result of pinning specimen for better orientation of the specimen and better sections. My proposal would be to use 3D printing to create a platform with screws as pinning and holding specimen while the specimen fixes in formalin. This will protect residents and other technicians and assistants from suffering the consequences of needle injuries such as infection.

I believe 3D printing will allow us to improve our efficiencies at work and also help medical education. Specimen cannot be fixed and showcased readily to medical students or to the general public. Scanning and 3D printing specimen can help in medical education and improve health literacy in the general public. Showing a lung cancer infiltrating the lymphatic and blood stream, exhibiting what fractures look like can help people outside medicine to appreciate the complexities of cancer and other medical illnesses.

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