IMOVE—An Intuitive Concept Mobility Systems for Perioperative Transfer and Induction of Anaesthesia for Special Needs Children

Abstract

Children with autistic spectrum disorder (ASD) often exhibit uncontrollable disruptive behaviour during transfer to the operating room and operating table and at the induction of anaesthesia (sleep). This process often involves the physical restraining of children. These children are then lifted onto the operating table by healthcare staff after being anaesthetized. This predisposes children to fall risk and hospital staff to musculoskeletal injuries. We developed two concept mobility devices, IMOVE-I and -II, based on robotics systems comprising of restraint modules and multi-positional modality (sitting, supine, Trendelenburg). The aim was to intuitively secure children to facilitate the safe induction of sleep and ease of transfer onto operating tables upon sleep. IMOVE-I loads the child in standing position using a dual arm restraint module that is activated by trained healthcare staff. IMOVE-II loads the child in the sitting position by motivating the self-application of restraints. Opinions were obtained from 21 operating theatre healthcare staff with experience in the care of ASD children and parents with ASD children. The mean satisfaction rating of IMOVE-I was 5.62 (95% CI 5.00, 6.27) versus 8.10 (95% CI 7.64, 8.55) in IMOVE-II, p < 0.001. IMOVE-II is favoured over IMOVE-I in system operation and safety, ease of use and module functionality.

A concept mobility device with multi-positional configurations and child-kind restraint for safe perioperative transfer and induction of anaesthesia in children with autistic spectrum disorder – a cross sectional study

“…See Figure 1. This was developed as a collaboration between investigators from the paediatric anaesthesia department and biomedical engineers with input from parents with ASD children as well as multi-disciplinary healthcare professionals with experience in the care of children with ASD [12]. The mobility system is a multiposition con guration mobile chair-bed system with a restraining module [12,13].…”

“…Specialized design Mobility equipment A specialized mobility system (I-MOVE) is developed as a CONCEPT CHILD-KIND MOBILITY DEVICE to interest children and initiate child-machine interaction that includes sitting on it in the 'chair mode', selfapplication of the restraint module and assisted ambulation [12]. See Figure 1.…”

“…This was developed as a collaboration between investigators from the paediatric anaesthesia department and biomedical engineers with input from parents with ASD children as well as multi-disciplinary healthcare professionals with experience in the care of children with ASD [12]. The mobility system is a multiposition con guration mobile chair-bed system with a restraining module [12,13]. These positions are 'sitting' for preoperative sedation and induction of anaesthesia, 'supine' for airway management and transfer, 'lateral tilt' to aid lateral transfer onto the OT table, 'Trendelenburg' for oropharyngeal suctioning as part of airway protection [12].…”

“…The mobility system is a multiposition con guration mobile chair-bed system with a restraining module [12,13]. These positions are 'sitting' for preoperative sedation and induction of anaesthesia, 'supine' for airway management and transfer, 'lateral tilt' to aid lateral transfer onto the OT table, 'Trendelenburg' for oropharyngeal suctioning as part of airway protection [12]. These movements were activated via hand-held remote.…”

“…In our pilot study, parents of ASD children observed that perioperative transfer becomes unsafe and di cult when children becomes uncooperative. We developed a concept specialized child-kind mobility device in an attempt to meet the mobility needs of ASD children [11,12].…”