ParaVR – Training VR for Paramedics

Virtual reality to train paramedics

Paramedics are set to be trained to carry out life-saving procedures using virtual reality technology developed by researchers at the University of Chester.

The technology enables paramedics to both ’see’ a virtual patient in a lifelike situation at the accident scene or in the back of an ambulance) and ‘feel’ the sensation of needle insertions.  The project with the Welsh Ambulance Services NHS Trust. The project is exploring how innovative techniques and technologies in computer graphics can be used in medical settings to help patients.

The ParaVR prototype uses VR head mounted display (HMD) and haptic interface to simulate lifesaving paramedic procedures.

ParaVR

2019 Named in Top 100 Lifesaving University Projects Listed in the top UK lifesaving innovations from UK research projects. Read News story Online

LifesaverAward

See UniversitiesUK Website

2018 Winner of Health Gadget Hack North Wales Connects, Glyndwr University HackAwardWinning £7,500 from Bevan Commission. “ParaVR – Virtual training simulator for ambulance paramedics.”

ERCP Simulator (Endoscopic Retrograde Cholangiopancreatography)

ERCP stands for ‘endoscopic retrograde cholangiopancreatography’. ERCP is a very useful procedure, as it can be used both to diagnose and to treat various conditions, such as:

  • Gallstones.
  • Acute pancreatitis – inflammation of the pancreas that develops quickly over a few days.
  • Chronic pancreatitis – inflammation of the pancreas that is more persistent.

Video of our developed ERCP Simulator with XRAY and Bile duct cannulation.

An endoscope is a thin, flexible telescope. It is passed through your mouth, into your gullet (oesophagus) and down towards your stomach and the first part of your gut after your stomach (your duodenum). The endoscope contains fibre-optic channels which allow light to shine down so the doctor can see inside.


Fig. 1. External view of the Stomach, Duodenum and Common Bile Duct in our developed ERCP simulator.


Fig. 2. Internal Endoscopic Camera View in our developed ERCP simulator.

 

Fig. 3. Rendering of the Liver, Duodenum and Bile Duct in our developed ERCP simulator

Fig. 4. Video of the internal organs rendered 3D graphics within our ERCP simulator.

A Demo version of the ERCP simulator is available to try online: https://neil.nvaughan.linux.studentwebserver.co.uk/ercp/

 

Orthopaedic Simulator

Hip Replacement – Orthopaedic VR Simulator

We developed a virtual hip replacement simulator for training surgeons.

Fig. 1. Hip Replacement Simulator with Oculus Rift, Leap Motion Hand Tracking and Google Cardboard.

Figure 1: [JPG]

The simulated surgery uses a haptic interface with the Geomagic (Sensable) Omni combined with the eMagin stereoscopic head mounted display (HMD). This simulates bone drilling, sawing, reaming and various orthopaedic tools.

Figure 2: [PNG]

This was interfaced with 3D printing technology which has capability to 3D-print metallic hip stem implants which can be custom made to fit individual patients from their CT scan data [1]. This was a novel aspect, not covered in the existing orthopaedic simulators shown in our published comprehensive review [2]. The simulator also assesses the accuracy of hip implant surgery [3], which provides feedback differentiating between novice/expert surgeons and to predict the risk of future hip dislocation or failure based on the placement accuracy.

Figure 3: [JPG]

Fig. 4. Video demo of the developed orthopaedic simulator.

Related Publications

[1] Vaughan N, Dubey VN, (2016) Hip replacement simulator for predicting dislocation risk, Intl. Design, Engineering & Technical Conference, Paper59286, Charlotte, USA. http://proceedings.asmedigitalcollection.asme.org/data/conferences/asmep/90681/v01bt02a044-detc2016-59286.pdf

[2] Vaughan N, Dubey VN, Wainwright TW, Middleton RG, (2016, Feb) A Review of Virtual Reality Based Training Simulators for Orthopaedic Surgery. Medical Engineering & Physics, 38(2), p59-71. (Impact 2.2) http://www.sciencedirect.com/science/article/pii/S1350453315002799

[3] Vaughan N, Dubey VN (2017, Sep) Virtual Hip Replacement Simulator For 3D Printed Implants, ASME Journal of Medical Devices, DMD2017-3496, 11(3). http://eprints.bournemouth.ac.uk/28213/1/DMD2017-3496.pdf

 

Epidural Simulator

Epidural Simulator 

A stereo graphics haptic simulator for epidural needle insertion has been developed [1] – see Figure 1.

The simulator in use.
Figure 1: Epidural simulator in 2010 with eMagin Stereo Head Mounted Display. [JPG]

The complex skills involved with administering epidurals, such as locating optimal insertion point and needle angle, can only be learned by practice. However it can be dangerous for novice anaesthetists to practice their first epidural procedure on real patients. This simulator provides a training scenario whereby novice anaesthetists can practice needle insertions.
Figure 2: [PNG]

A novel aspects is that the virtual patients are of adjustable body mass index (BMI) based on measured patient data [2]. Also the device enables experienced epiduralists to fine tune their epidural technique for obese patients, providing a platform to help experts train novices.

Figure 3: [PNG]

The virtual spine model can bend and flex with three degrees of freedom (DOF) and adapt to match the particular size shape and BMI of individual patients. The eMagin stereoscopic head mounted display (HMD) was combined with the Novint Falcon haptic device and custom pressure measurment wireless microcontroller devices [3]. A clinical trial measured the force during needle insertions from various BMI obstetric patients and used this for simulated haptic feedback.

Fig. 4. Video demo of the Epidural Simulator Software and Hardware.

Epidural Procedure

Epidurals are commonly used to provide pain relief during childbirth, for operations or to relieve back pain, but doctors currently have to rely on experience and clinical training to place the epidurals accurately.

With the increasing obesity epidemic in the UK and challenging patient population, clinical training itself may not be sufficient and there is a potential for complications if the epidural is not inserted accurately.

The epidural simulator developed by BU and Poole Hospital includes software which integrates information such as a patient’s height, weight body shape to present a realistic model for training and enhancing skill-learning for the procedure.

It also includes a pressure monitoring system, which is attached to the epidural needle and alerts doctors to help them detect the loss of pressure that occurs when the epidural space is reached.

By monitoring the procedure electronically, rather than relying on the experience of the doctor, this will improve patient safety. The ultimate aim is to have doctors use these devices in practice and trainees use it as a simulator as well. It will give them experience without them having to practice on a patient.

CoMPRE 2013 Faculty Meeting

CoMPRE 2013 Faculty Meeting

Winner, Best Poster 2012 Bournemouth University Post Graduate Research Conference

Winner, Best Poster 2011 Bournemouth University School of Design, Engineering & Computing Post Graduate Research Conference

IET Image Processing Conference 2012, publication accepted.

Related Publications

[1] Vaughan N, Dubey VN, Wee M, Isaacs R. “Advanced Epidural Simulator with 3D Flexible Spine and Haptic Interface.” ASME Journal of Medical Devices, Proceedings of DMD2012 Design of Medical Devices Conference, Minnesota. 2012. http://medicaldevices.asmedigitalcollection.asme.org/data/journals/jmdoa4/28022/med0601_017524.pdf

[2] Vaughan, N., Dubey, V. N., Wee, M. Y., & Isaacs, R. (2014). Parametric model of human body shape and ligaments for patient-specific epidural simulation. Artificial intelligence in medicine (AIIM) Journal (Impact 1.63 62(2), p129-140.) http://www.sciencedirect.com/science/article/pii/S0933365714001006

[3] Vaughan N, Dubey VN, Wee MYK, Isaacs R, (2014), “Device to accurately place Epidural Tuohy needle for Anesthesia Administration”, Mechanical Sciences Journa, Copernicus, Special Issue: Design of medical devices: creative solutions by young researchers, vol 5, pp. 1-6. http://www.mech-sci.net/5/1/2014/ms-5-1-2014.html

Smartphone App Device for Diabetic Tele-monitoring

Smartphone Device for Peripheral Neuropathy

Medical Condition
• Causes numbness, pain and weakness in limbs
• Affects 2.4% of the population (8.0% over 65)
• Seen in 66% of type 1 diabetes patients, 59% of type 2
• Commonly occurs in people suffering from cancer or diabetes, two of the most common diseases worldwide
• Rates are higher in third world countries due to leprosy, HIV, diabetes and toxins

POC Peripheral Neuropathy Device
• Smartphone device
– 3D-printed probe
– Uses smartphone vibration motor
– Smartphone app
– Uses GPS, Wi-Fi
• Wireless data transmission
• Encryption and cybersecurity designed-in
• Patent applied for

Device Use
• Point of care evaluation of vibration perception
– an indicator of nerve function
Step 1: Probe applied to region of interest
Step 2: Level of vibration perception recorded.
Step 3: Wi-fi & Bluetooth Data Transmission.

Improved Health Outcomes
• Enables patients to self-monitor at home without the need to travel to hospital for neuropathy assessment
• Innovates care pathways for patients receiving potentially neurotoxic chemotherapy
• Encourages patient engagement in managing their disease e.g. diabetes
• Allows more frequent monitoring for earlier detection of sensation loss, before irreversible damage occurs

Related publications:

[1] Vaughan N, Dubey VN, Hickish T, Cole C,(2016) Peripheral Neuropathy Point-Of-Care Testing (Poct) With Smartphone App , Intl. Design, Engineering & Technical Conference, Presentation, Charlotte, USA.

[2] Cole J, (2015) Mobile Device for Neuropathy, https://research.bournemouth.ac.uk/wp-content/uploads/2013/10/Mobile-Device-to-Detect-Neuropathy-in-Cancer-Patients-Prof-Jonathan-Cole.pdf