Hack COVID Rotation Bed
This project aims to build a system that can be used to rotate a patient onto their front to ease breathing.
Goals
The goal of this project is to design a device that can work with existing hospital equipment to safely turn a patient while being operated by no more than 2 staff members.
Healthcare Need
This is the original request from our healthcare contact:
As you all know, those of us at MU Health Care are working hard to be as ready as possible for the inevitable surge of COVID patients. I’m reaching out for some equipment-related help. This is mostly for you brilliant and resourceful engineering folks and for those of you with engineering contacts.
One of the treatment techniques that seems to help COVID patients on ventilators is turning them face down in bed. This allows for better lung function. However, without specialized equipment for this, the process of turning requires many staff members (often 5-6) in full body contact with the patient. Given that full body PPE is unobtainable, this is not a safe situation for our staff. We used to have the device pictured in the attachments. For a variety of reasons, this device is no longer available. There are softer, fancier versions out there, but not available.
My ask is this: is there anyone willing and able to actually build similar devices? What we want is a contraption that one or two staff members that could slide a patient into and then rotate into a prone position.
More information from the 2020-04-09 MU Hack COVID Prioities:
Priority 6 – Stryker Frame – wedge patient rotating bed (Google “Stryker frame image”, these used to be common, but discontinued in use ~15 years ago)
- Quantity – depend on design – either 150 (all patients on vent) or 4 – one in each covid unit moved patient to patient
- Timeframe – immediate
- Duration – 6 months (could use forever if functional, don’t just prone for SARS-CoV-2
- Old equipment no longer manufactured – likely some in some warehouse – allows 1-2 provider prone positioning of patients, limit staff exposure
- Slide patient to turning frame (Drop side bars and slide patient. Sliding routine. Note, patient will NOT stay on frame, but returned to standard bed in this recommended approach)
- Rotate supine to prone or prone to supine (one person on team handles ventilator hookup at head. Straps keep patient in place)
- Slide back onto standard bed
- Incorporates slide board
- Standard stryker bed patient stays on the bed – likely to complex to mass produce (150)
- All intubated patients with SARS-CoV-2 currently going prone
- Moveable device from room to room to assist prone positioning teams
Roadmap
This is just a skeletal roadmap to get us started. It makes a lot of assumptions and will certainly be changed.
- Create more detailed mockups of all design ideas that can demonstrate all operations of the device.
- Refine mockups with feedback from medical staff.
- Work with medical staff to determine the best design to move forward.
- Finalize design for prototype.
- Build prototype and test with mannequin at the MU Med School.
- Refine design based on testing.
- Work with local manufacturers to build operational device.
- Use actual product or prototype to develop detailed operation and maintenance instructions.
Communication
Existing Products
There are several existing products that hospitals use to accomplish this task.
Stryker 965 Wedge Turning Frame
- Max Weight: 250 pounds
- Max/Min Bed Height: 33.5" / 46.5"
- One of the devices referenced by the healthcare contact
- Healthcare contact provided the Operations and Maintenance Manual.
- Source for the image on this wiki page.
Antia Med Wedge Spinal Operation Frame
- Max Weight: 160 kg
- Max/Min Bed Height: 760mm / 320mm
- One of the devices referenced by the healthcare contact
- Not much known about this besides some technical info
VENDLET V5S Patient Turning System
- A different design than the turning frames. Uses a fabric sheet on rollers to assist in rolling the patient.
- A video demonstration of the device
- Product page, includes videos demonstrating an occupied bed sheet change and other operations.
- Sales brochure
Design Ideas
A raw collection of design documents is available on CGW's Google Drive.
Rotating Wedge Frame
This design resembles the Stryker Wedge Rotating frame by using an anterior and posterior frame to "wedge" the patient in before rotation into a supine or prone position. The upper frame, not being used to support the patient, can then be removed.
Preliminary 3d mockup by David V
Preliminary 3d mockup by Brad C
Fabric and Roller Patient Turning System
This design resembles the VENDLET V5S product above but is not a full bed system. Instead, the rollers are mounted on an existing hospital bed to move the sheet and assist in rolling the patient. Quoting from Jeff Thiele on Discord:
Covid Patient Turning Bed
This system turns the patient by pulling up the fabric they are laying on. This is done by rolling the fabric onto a cylinder at the side of the bed. That fabric is also rolling off of a cylinder on the other side of the bed. The system is designed to be placed on an existing hospital bed The “turning bed” frame sits on top of the existing bed frame, with the original mattress on top of the turning frame. The hospital bed frame does not have to be modified. It may be necessary to take off the side rails, but I anticipate they would remain attached and in the down position. If side tails were needed the adjustment yoke and roll could be raised.
At each corner the frame has receptacles for the height adjustment yoke. The height is manually adjusted and secured by the spring-loaded pins. The turning rolls lie in the yokes and are held in by gravity. The open top of the yoke allows for tilt of the roll when the height is being adjusted. It also allows the roll to be removed and placed in the yoke of another bed, and the patient easily shifted between beds. Being able to easily remove the rolls and fabric means it would make sense to have extra sets available so the system could be quickly returned to use when the original set needed to be cleaned.
The turning rolls are turned manually with a removable crank handle which goes on the ¾ in hex head at the end of the roll. A 3/8 or 1/2 in ratchet socket or wrench could be used if a crank handle is not available.
I have not drawn in the rings which would go around the rolls and prevent them from sliding down the yoke if used when not level. I also have not drawn in the mechanism to secure the fabric to the roll. A fast and easy method is to put a thick seam or seam with rope in it at each end and have this held by a metal clamp which is screwed onto the roll.
In the drawings the rolls and yoke are at a “storage height”. To turn a patient or use them to shift the patient in the bed they would need to be raised.
The frame is made of 14 ga 1x2 inch steel tubing. The space within the tubing is a sandwich of ¼ in plywood with 1 ½ in foam insulation in the middle. The foam reduces weight and allows the use of thinner plywood. The top and bottom of the frame are covered with “tabletop” laminate. This provides an impervious surface which is easy to clean. This “sandwich” construction removes any “spring” effect from the hospital bed frame. The only “give” would be from the mattress (usually about 8 inches thick). An alternate would be to have laminate and plywood on the bottom, then 1 ¾ in of pliable foam, with this being covered by heavy vinyl covered fabric. This would provide some “give” under the mattress. It would also be harder to source materials for and build.
My thought was to use steel throughout s it is easier to source and weld than aluminum. Aluminum should also be hard anodized to prevent galling.
Jeff Thiele MD 4-6-20
Preliminary 3d mockup by Brad C
Acronyms and Abbreviations
- HCTF - Hack COVID Task Force. Umbrella organization created by MU Health Care to coordinate community response to COVID-19 pandemic.
- MUHC - Missouri University Health Care
- ENST - Engineering Novel Solutions Team (I believe we fall under here -ZZ)
