Johns Hopkins undergraduates have built a device to enable critically ill intensive care unit patients to leave their beds and walk while remaining tethered to essential life-support equipment. The invention allows doctors to better understand whether carefully supervised rehabilitation, as opposed to continuous sedation and bed rest, can improve the recovery of intensive care patients.
Some clinicians believe that allowing ICU patients to get out of bed and walk could avert some of the muscle weakness, bedsores and depression that typically develop when these patients are confined to bed. Because such patients usually must remain connected to an artificial breathing machine, heart monitors and intravenous lines with essential medications, a simple walk down the hall could require four staff members to accompany the patient.
To reduce this staffing demand and improve this new ICU rehabilitation program, a physician at Johns Hopkins Hospital last year asked students in a biomedical engineering design team course to devise a mobility aid for ICU patients. Over two semesters, the students, supervised by faculty members and graduate students and advised by hospital staff, produced a device called the ICU "Mover" Aid.
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This device has two components: a novel mobility aid that combines the features of a walker and the safety of a wheelchair, and a separate wheeled tower to which important life-support equipment can be attached.
"The finished product is truly outstanding," says Dale Needham, M.D., an assistant professor in the division of Pulmonary and Critical Care Medicine at the Johns Hopkins School of Medicine.
Dr. Needham had challenged the students to produce a device that would meet three key criteria: First, it had to provide physical support for the patient during walking. Second, it had to safely house all necessary monitoring and therapeutic equipment for critically ill patients. Finally, it needed a safety backup system for patients who must immediately sit down because of fatigue or a sudden change in their medical condition.
The final version features a walker type framework similar to devices that frail or elderly people use to walk. Behind the patient, however, a fabric seat is attached to the frame so that if a patient is tired they can sit down. The seat can also "catch" a patient who abruptly collapses because of a medical problem. The seat is made out of a ballistic nylon so it won't rip. It is durable and easy to clean for infection-control purposes.
As a separate component, the prototype features a tower designed to accommodate two oxygen tanks and there medical devices: a cardiac monitor, IV pups to provide medications and a ventilator to support breathing. Despite all of the equipment attached to it, the "Mover" prototype was small enough to maneuver through the ICU's narrow hallways, although using it in the ICU patient rooms proved to be more challenging.
The device requires only two hospital staff members to accompany the walking patient, compared to four staff members with the earlier system. The student inventors and their faculty mentors have obtained a provisional patent for the device and are exploring commercial opportunities.
"With increasing interest in early therapies in the ICU setting to improve patient recovery, I think there is a strong commercial future for the Mover device," Dr. Needham says.