December 3rd, 2016

W. Cully Hession
Professor of Biological Systems Engineering
200 Seitz Hall
Blacksburg, Va 24061

Dear Dr. Hession,

The following document contains an analysis of potential solutions report for the Global
Assitance of Infant Resuscitation (Global AIR) senior design project. This report examines
design solutions for the four parts of our system: pressure generation, pressure storage, and
pressure delivery. The results of the design matrices will ultimately shape the final design for our
continuous positive airway pressure (CPAP) device. The report contains an introduction, a
description of the various decisions investigated, decision matrices, results of the analysis and
ranking of each potential solution, and a discussion of the future of our design project.

If further information is required, please do not hesitate to reach out to us.

Sincerely,

Abigail McCranie Elle Hoover

amccran@vt.edu ellen13@vt.edu
 Analysis of Potential Solutions
Global Assistance of Infant Resuscitation
(Global AIR)

BSE 4125 Comprehensive Design Project

Team Members:
Abigail McCranie
Elle Hoover

December 3rd, 2016

Introduction
The goal of Global-AIR is to build a mechanical CPAP to be used in the neonatal unit in
hospitals in Malawi, Africa. The constraints and criteria pertaining to this design are all based
around the safety of the child and the materials available to build this device. First, the system
must cost no more than $50 to build. The materials used to build the system must be found in
low income countries and the system must have a simple construction process. The positive
pressure output must not exceed 20 cm H2O and never drop below 5 cm H2O, in order to keep
the lungs properly inflated. The system should be durable, lightweight, and easy to clean. From
the given constraints and criteria, project background, and through meetings with people who
have resided in Malawi, a basic design solution was determined. The ideal system will be made
up of a combination of four main parts, including a pressure generation device, a pressure
storage facility, and a two part pressure delivery system.

Potential Solutions
Because the design solution has been broken down into four main parts which will
operate independently, each part will be analyzed individually, and then evaluated as a complete
system connected in series. The pressure generation device will operate by a foot pump in order
to free the hands of the operator. The pressure storage facility will be able to safely hold a
reserved amount of pressure, so that the device may run without the need for continuous constant
pumping. Finally, the pressure delivery system must provide continuous positive airway
pressure (CPAP) to keep the lungs inflated.

Figure 1: Overall CPAP design containing the four parts.

First, we will identify the potential solutions for the pressure generation device. This part
of the system must be operated by a foot pump. With this and location in mind, a few proposed
solutions were formulated. Initially, the idea of a bike pump seemed the simplest way to conquer
this problem. Foot bike pumps are available for purchase. However, the type of bike pump that
can be found in Malawi is operated by hand. An option to solve this issue would be converting
this standard bike pump into a foot pump. This pump would consist of a bike pump, a strong
spring, and a pulley connected to a pedal. When the pedal is pushed the string would run over
the pulley, pulling the spring, and raising the handle of the bike pump. When the foot is released
from the pedal, the spring would tighten, allowing the handle to compress back into the bike
pump, thus pumping air into the tank. Another solution for pressure generation is the accordion
pump. This device consists of two hand holds, a valve for entrance of air, a nozzle, and an
accordion like bag that compresses to push air through the front nozzle. The final solution being
considered for pressure generation is the bag pump. This pump consists of two parts, a bag and a
nozzle. When pressure is applied to the bag, air goes out. When pressure is released, the bag
fills again. This type of air pump is constantly used in the medical world for resuscitation. In
order to modify this as a foot pump device, the bag would have to be converted so it could lay
flatly on the floor to be operated by foot.
Next, we will analyze potential solutions for the pressure storage facility. The potential
solutions include a bucket, PVC pipe and fittings, a soccer ball, or a tire inner tube. A simple
bucket would be equipped to hold a large amount of pressure and can be found easily in Malawi.
PVC piping and fittings can be found in many different sizes and can be sealed to allow for
secure pressure storage. The soccer ball storage option comes from an article written about using
a soccer ball as a local material for a nebulizer in Honduras. Their design consisted of a bicycle
pump, two pump needles, plastic medical tubing, a soccer ball, air filter and a nebulizer/mask
connected in series. The soccer ball acted as a low-pass mechanical compliance filter to smooth
the time-varying pressure/flow pattern (Dzwonczyk 1). This article proves that the soccer ball
can be connected to similar parts we are using for our CPAP device, and could therefore
potentially be used to store pressure. This project has very similar design criteria to our system,
so it is a viable option to consider. Finally, a tire inner tube is being considered. A tire holds a
large amount of pressure when connected to a vehicle. If the tire can be altered in order to
connect it to the pressure generation and pressure deliver mechanisms, this could work to store
pressure.
Next, we will evaluate the potential solutions for the the pressure delivery system. The
delivery of pressure to the lungs will be facilitated by some form of a neonatal face mask. A
neonatal face mask is commonly used for CPAP devices and can be easily found in most
hospitals in Malawi. The other option being considered is modifying a mask to adapt to different
pressures. In order for the pressure to reach the face mask, a pressure regulator is necessary to
release the correct amount of pressure from the pressure storage facility.
Finally, in terms of a pressure regulator, we are looking at a two art set up. We want a
simple regulator to reduce the amount of pressure, and a second regulator to facilitate the set
pressure to enter the infants lungs. The options for the initial regulator that are currently being
considered are a chemistry funnel tap and a water hose faucet. The chemistry funnel tap would
be designed to connect to the pressure storage facility. It would reduce the pressure being
released and use a flowmeter device to adjust the flow rate delivered to the patient. The use of a
water hose faucet is also being considered. The faucet comes with an adjustment to allow for a
set amount of water, or in this case air pressure, to be released. With this scenario, a gauge would
need to be connected to ensure proper amounts of flow being delivered to the face mask. For the
second, set pressure regulator, we are looking into creating our own. However, we have just
recently started researching this possibility, and dont currently have any viable options.
Concurring this will be our next major step in the design process.
Ranking Method Procedures
The criteria for the design matrices were selected by carefully considering the project
goals, and determining which criteria are the most important for the system design.
Cost: Cost was given the second largest percentage of importance. The purpose of our project is
to provide a working system for low income countries. In order for this system to be affordable
for these countries, we must stick to a strict budget of fifty dollars per system.
Durability: Durability came in third for the largest percent. Durability is a vital factor to our
design because it needs to be able to run for days to keep the baby attached alive.
Local Materials: Local materials was given the largest percentage of importance within the
decision matrix because it is the most critical factor for our design. We are required to use local
materials, so that the final design can be easily made in Malawi without exhaustion of cost and
effort to import the materials.
Easy to Construct: Easy construction was another one of the criteria that came in the three way
time for third largest percent of importance. The CPAP needs to be easy to construct because we
will not be there to oversee the construction process, and we want the CPAP they build to be a
replication of the one we design.
Easy to Clean: Easy to clean is the final criteria in the three way tie for third largest percent.
Cleanliness of the device is important, because multiple neonates will use this device throughout
its lifespan. Each of the neonates needs a sterile CPAP, since they are prone to infection.
Easy to Transport: This criteria was ranked the least important. Although we would like for the
machine to be easily moved, to function as a CPAP it does not need to move when in use. This
would be more of a convenience for the Hospital to transport it from room to room.

Results of Analysis & Ranking

Each design solution was given a score between 1 and 5 based off of how well the
solution met the criteria, with 1 being the worst in that category, and 5 being the best in that
category. The score was then multiplied by a weight determined by the importance of the
criteria, and the scores were totaled.

Pressure Generation

Figure 2. Types of Foot Pumps

Table 1. Decision matrix for alternative solutions for pressure generation
Criteria Weight (out Foot Bike Modified Accordion Bag
of 100) Pump Bike Pump Pump Pump

Cost 20 1 2 4 5

Durability 15 5 5 2 1

Local Materials 25 1 5 4 5

Easy to Construct 15 5 5 5 5

Easy to Clean 15 2 2 1 3

Easy to Transport 10 5 5 5 5

Total - 275 395 350 295

Foot Bike Pump: The foot bike pump would be one of the easiest and most durable pump
options for pressure generation, because it would not need any modifications and would be
performing the function that it is made for. Although these criteria make it seem like the best
option, when it comes to cost and ability to find it locally, the foot bike pump falls short. The
foot bike pump is not easily found in Malawi and if special efforts were made to get a hold of
one, it would cost a lot of money. These two factors ended up causing the foot bike pump to be
ranked the lowest in the pressure generation matrix.
Modified Bike Pump: The modified bike pump ranked the highest on the pressure
generation matrix. The major Pros to this option are that it is easily found in the area, not many
modifications are needed to create an efficient bike pump so it should be durable and easy to
construct. The only major Cons are that it would be hard to clean and it falls on the pricier side
of pump options.
Accordion Pump: The accordion pump was the second highest scoring option in the
pressure generation matrix. It is also relatively easy to construct because it already functions as a
two way air pump. However, it would be one of the most difficult option to clean because it is
not easily opened. And it would not last long, since it was not created to be used regularly.
Bag Pump: The bag pump would be extremely accessible, since it is commonly used in
resuscitation in the hospital. The major difficulty in this option would be the ability to turn it
into a foot pump, because it is not made for this, the durability would be compromised causing
this option to get one of the lower scores in the decision matrix.
Pressure Storage

Figure 3. Types of Pressure Storage

Table 2. Decision matrix for alternative solutions for pressure storage.

Criteria Weight (out of Closed PVC and Soccer Ball Tire Inner
100) Bucket fittings Tube

Cost 20 5 5 1 2

Durability 15 3 5 3 3

Local Materials 25 5 5 4 5

Easy to Construct 15 5 4 4 4

Easy to Clean 15 5 4 1 1

Easy to Transport 10 3 4 5 5

Total - 450 460 290 335

Closet Bucket: The bucket was the second highest score on the pressure storage device.
The bucket would need no modifications to be a storage device, so it would be easy to clean and
extremely cheap. The determining factor that caused the bucket to score second is durability.
The bucket has the ability for the top to pop off under high pressures, and this is not a trait that
we want for the pressure device.
PVC with fixings: PVC with fixings was the highest scoring option in the pressure storage
matrix. PVC is extremely durable, cheap, and easy to find in Malawi. It ranked at least a 4 or
above in each category.
Soccer Ball: The soccer ball was the lowest scoring pressure storage device. The Soccer
Ball would not only cost a lot as a specialty good, but it would also prove hard to clean. The
only high scoring Pro it had, was that it would be easy to transport.
Tire Inner Tube: The tire inner tube scored mediocrely in the pressure storage matrix. It
is a material that is easy to find, however it would be difficult to clean.
Pressure Delivery

Figure 4. Types of Pressure Delivery

Table 3. Decision matrix for alternative solutions for pressure delivery

Criteria Weight (out of 100) Neonatal Face Mask Modified Mask

Cost 20 5 5

Durability 15 5 3

Local Materials 25 5 5

Easy to Construct 15 5 2

Easy to Clean 15 5 4

Easy to Transport 10 5 5

Total - 500 410

Neonatal Face Mask: The Neonatal Face Mask scored a perfect score in the pressure
delivery decision matrix. The face mask is already used by hospitals, so it is up to the health
standards needed for hospital use.
Modified Mask for Changes in Pressure: The modified mask for changes in pressure
scored lower, due to the perplexity of adding changing pressures. Not only will this be difficult
to implement, but it will compromise the ability to clean it and the masks overall durability.

Pressure Regulator

Figure 4. Types of Pressure Regulators

Table 4. Decision matrix for alternative solutions for pressure regulator
Criteria Weight (out of 100) Water Faucet Chemistry Funnel Tap

Cost 20 5 2

Durability 15 5 4

Local Materials 25 5 3

Easy to Construct 15 5 5

Easy to Clean 15 3 5

Easy to Transport 10 5 5

Total - 470 395

Both the water faucet and chemistry funnel taps are not final solutions for a pressure
regulator, these would only be able to regulate flow if pressure was to remain constant. After
examining existing pressure regulating solutions and finding that none of our current research
provided a solution that fell within the price and performance constraints, we have determined
that we will have to develop our own. This will more than likely have to be a two stage
regulator, one to reduce the high level of pressure released from the pressure storage facility, and
one to release the set amount of pressure safe to enter an infants lungs.

Creating Overall Options

To identify our options for a general solution, we decided to use the two best options
from the categories of pressure generation, pressure storage, and pressure delivery. For pressure
delivery, we decided all options would use the Neonatal Face Mask, since it got a perfect score
in the decision matrix, combined with either the handmade flow meter or the water hose faucet.
The option for the Pressure Regulator is listed as homemade for both, because we have not yet
decided how to integrate the faucet or the chemistry funnel tap into a dual pressure regulator.
With homemade as a placeholder for the final pressure regulator, the numbers from the pressure
regulator matrix were not counted towards the total in the general solution matrix.

Figure 5. Illustration of Option 1

Option 1 is a combination of:
Pressure Generation - Modified Bike Pump
Pressure Storage - PVC with fixings
Pressure Delivery - Neonatal Face Mask
Pressure Regulator - Home Made
We paired the modified bike pump and PVC with fixings together, since both of these options
scored high and both require minor modifications to pre-existing parts.

Figure 6. Illustration of Option 2

Option 2 is a combination of:

Pressure Generation - Accordion Pump
Pressure Storage - Bucket
Pressure Delivery - Neonatal Face Mask
Pressure Regulator - Home Made
We paired the accordion pump and the bucket together,since they were both easy to construct
and transport, and relatively low costing.

Choosing the General Solution

Table 5. General Solution Matrix
Criteria Weight (out of 100) Option 1 Option 2

Cost 20 12 14

Durability 15 15 10

Local Materials 25 15 14

Easy to Construct 15 14 15

Easy to Clean 15 11 11

Easy to Transport 10 14 13

Total - 1355 1300

 With Option 1, the creation of a CPAP using a modified bike pump, PVC with fixings,
and a neonatal face mask - scoring the highest on the solutions matrix, this is the route our team
will use to construct the CPAP. This design consists of the highest individually scoring parts in
their respective decision matrices, proving it to be the best option for the overall design.

Conclusion
After our research and meetings we have determined many design solutions for our
CPAP device. By evaluating each solution with the given criteria, we have determined the most
ideal potential solution. This will consist of a modified bike pump device, PVC piping and
fittings, and a neonatal face mask. Based off of the design matrices, this would be the best
combination for our system.
The next step in our design process is to finish researching pressure regulators to figure
out a viable solution to this part of the design problem. After this, we will begin building a
prototype for our system. The first prototype we build will consist of the parts in option one of
our general solution matrix. If, for some reason, this prototype is unsuccessful, we will consult
option two of the general solution matrix in order to proceed. In the end, we hope to have a
working prototype of our system in order to consult with hospitals in Malawi about possible
implementation of the system into local hospitals.

References
Dzwonczyk, R., Brockman, M., George, D., Hankins, N., Mchugh, M., and Soto, M. G. (2015).
A Method of Powering a Nebulizer Manually Using Parts Locally Available in
Honduras. 2015 IEEE Global Humanitarian Technology Conference (GHTC), 1-5.
Retrieved December 5, 2016, from http://ieeexplore.ieee.org/document/7343952