Cardiopulmonary resuscitation (CPR) training is one of the most common medical certifications, so people often assume it is easily accessible to everybody. This is far from the case.
According to the Christopher & Dana Reeve Foundation, nearly one in 50 people are living with paralysis, so choosing a career in health care may be daunting for some who have limited mobility. One of those people is Moscow resident Meagan Boll.
Boll is a tetraplegic — meaning she experiences impaired movement in all four of her limbs — so she has had to find a unique way to hone her CPR skills.
A second-year medical student in the Idaho WWAMI Medical Education Program, Boll uses a wheelchair, has limited motion in her arms and performs fine motor skills with a bionic glove. A spinal cord injury that caused her tetraplegia is also what got her interested in pursuing medicine.
“Being a tetraplegic in medical school requires a lot of resourcefulness,” she said. “With my injury, there are inherent mechanistic issues I have to work around.”
One of these challenges arose when students in Boll’s program were required to undergo CPR training in order to do certain types of clinical work. She said trying to maneuver her wheelchair around the CPR training manikin was awkward and that she couldn’t get enough mobility to achieve a full chest compression.
When Boll expressed her concern that she wouldn’t be able to complete the certification to UI WWAMI Medical Director Jeff Seegmiller, he had an idea for a solution.
Seegmiller reached out to four UI engineering students — Abdulrahman Almajnouni, Ahmed Al Nahab, Josh Sewell and Tyler Newman — to propose that they create and build an assistive CPR device for their senior capstone project.
To successfully perform CPR, the American Heart Association recommends exerting enough force on the base of the sternum to compress the chest 1.5 to 2 inches — which can mean exerting up to 100 to 120 pounds of force on an adult. When applied effectively, this force can lead to a cracked or broken rib.
To achieve proper compression in their design, the engineering student team tested the idea of using a method similar to a fingernail clipper and discussed several mechanical options. The design they landed on was a modernized version of the ancient “law of the lever” concept that proved force is amplified when transferred via a lever and a fulcrum.
The team’s first prototype clipped to the side of Boll’s wheelchair, requiring her to drive her wheelchair beside the victim and operate the wooden lever with one hand.
Since Boll’s finger mobility is limited, she suggested adding another handle to the design. The device was also upgraded to attach to the front of Boll’s wheelchair using a modified securement system. This allows her to push forward and operate a lever placed on the patient’s chest.
The lever-action augments Boll’s force to achieve necessary chest compression. Using a training manikin connected to a mobile application to record CPR performance, the engineering team verified their results and Boll’s successful use of the custom device.
Seegmiller said he hopes this project will pave the way for future innovations and changes to improve accessibility for all people who aspire to enter the medical field.
“Many technical standards required of people who apply to become medical professionals are barriers that shouldn’t be there,” he said. “There should be creative minds coming together to help any individual who dreams of becoming a health care professional to be able to accomplish their dream.”
In the medical profession, it is rare that a lone person will be performing CPR, as teams of medical personnel are normally frequent in emergency situations. Because of this, Boll said if anything, it is more important for doctors to be able to direct others through a CPR procedure than it is for them to be able to perform one autonomously.
Boll received her CPR assistance device last week, and she is currently practicing to improve her stamina and efficiency with it.
“People need to step out of the shadows and be willing to share their stories,” she said. “I’m really hoping other people with similar stories reach out to me to ask how I did things, so I can have a better answer for them than what I’ve gotten in the past.”
Ellen Dennis can be reached at (208) 883-4632 or by email at email@example.com.