A Language of Design for Healthcare Part 2: Design to Save a Life
I just learned about this from Nextdraft:
“When Olathe East High School students got their state-mandated CPR training this winter, freshman Seth Johnson couldn’t fully participate because of a broken collarbone. But he was paying close attention.
Two weeks after the training, Seth, his arm still in a sling from a lacrosse injury, helped his older sister, Claire, use CPR to save their dad when he went into cardiac arrest. Call it a hands-on follow-up lesson.
“Just do whatever it takes,” Seth, 14, said he learned. “Don’t be too scared to do CPR if it’s happening.”
Wow, now that’s a powerful story.
Have you ever been trained in CPR? Do you remember how to do it?
Years ago, Felicia Jackson’s 2 year old son stopped breathing because he was choking on a piece of candy in the car. She was a healthcare professional and actually had formal training in CPR, but in that moment of crisis she panicked:
“I froze”…“All my training went out the window.”
Her husband was able to clear their son’s airway to help him breathe again and he recovered, but Jackson was upset with herself for not being able to save his life.
This life-changing incident became the catalyst that would inspire Jackson to invent the CPRWrap, a truly innovative product with the potential to save countless lives because of its intuitive design.
What is the CPRWrap?
It’s a wrap made out of medical grade plastic, which provides step-by-step instructions on how to deliver CPR to an individual. In case your can’t remember how to do CPR, just follow the instructions, starting with the number 1.
Step 1:
Place the wrap on the body by lining up the markers for nipples on the wrap with the patient’s nipples.
Step 2:
Position and place your hands in that area between the nipples just as the diagram shows.
Step 3:
Push your hands down 2+ inches and release completely 30 times.
Step 4:
Just as the artifact instructs you to do, pinch the nose, tilt the head back, lift the chin, and breathe 2 gentle 1-second breaths into the mouthpiece.
Repeat:
Repeat steps 1–4 are until help arrives.
Not only does the CPRWrap guide the person performing CPR but it is made of a medical grade plastic and has a sanitary one-way mouthpiece to protect the individual from contacting bodily fluids. It also tells the individual to call 911 and send someone to look for an automated electronic defibrillator.
What’s even more brilliant is that CPRWrap has a child version and an infant version, with instructions that are tailored to these patient populations, because we know that kids are not just little adults!
Historically, the instructions for CPR were relegated to a written checklist of steps on a card somewhere, only to be lost and forgotten.
The genius of the CPRWrap design is that it maps the instructions directly on the body, focusing the user directly on the person in need, and providing explicit step-by-step instructions during a high stress life or death situation.
This is a great example of the language of design, which I define as design that is so intuitive that it simply guides the user to do the right thing, which in this case can save a life.
In addition to it’s innovative design, CPRWrap is also affordably priced at $14.99 a kit, available nationally at Walmart as well as on the CPRWrap website. Kudos to Felicia Jackson and her company for keeping the price of this innovation low so that the skills to perform CPR effectively can be democratized and many more individuals like the Kansas teenager can save a life.
But it’s not just lay individuals who need a language of design to save a life; the trained healthcare professionals need it as well!
For a child who is critically ill, how does a medical team figure out which doses of life-saving medications to give, to avoid giving a 10-fold overdose, and which equipment to use for resuscitation? For adults, it’s typically one size fits all, but for kids it all depends on knowing the weight of the child, a piece of information that is really difficult to obtain in the middle of an emergency situation. And even when the team has an estimation of weight, they have to perform some serious mental gymnastics because doses are measured in milligrams per kilogram for kids which then have to be converted to a volume based on the varying concentrations of medications (milligrams per milliliter) to draw up the right medication doses and choose the right-sized equipment.
Dr. James Broselow was a family physician who frequently worked in the ER treating critically ill children. As he describes:
“The system — estimating the weight, weight-based dosing, mgs per/kg, micrograms per kg, conversions to mLs, dilutions, equipment sizes, ventilator settings, missing critical equipment, fragile patients and stress — was a formula for disaster.”
“It was difficult for me to control my thoughts and emotions when a child’s life was at stake and having the family in the room kept me from retreating into my problem solving mode; their anxiety was contagious. I needed a more objective system to lean on, and so the idea of the Tape was born.”
Broselow therefore invented the Broselow tape in partnership with Bob Luten, an Emergency Medicine Physician, which is shown below:
The “tape” is essentially a color-coded tape measure that is laid out next to a child during an emergency. The child’s height measured by the tape is then used to approximate the child’s weight category, which is identified by a series of distinct colors. The red end of the tape is placed near the child’s head (“red to head”) and the color zone where the child’s heels line up designates the estimated weight of the child.
So for example, if the heels line up in the blue color zone, the weight of the child is estimated to be between 19 and 23 kg, and medical providers would follow the medication doses and equipment instructions for the blue color zone.
The language of design has extended beyond the tape, as there are now Broselow crash carts that use this color classification to store the right medications and equipment for a child of a given weight category.
Furthermore, there are even syringes with color markings to guide dosing of medications like epinephrine! Providers can just pull the syringe to the color (i.e. the blue line) to give the right amount of medication for that child. I think that’s pretty brilliant!
I want to acknowledge that a recent systematic review of studies using the Broselow tape has identified some limitations, but overall it’s a tool that is still widely used across the globe by clinicians, which I think is a testament to its utility and broad appeal using a language of design to support quick and safe decisionmaking.
The CPRWrap and the Broselow tape are compelling examples of why we need more of a language of design for healthcare!
What other examples of a language of design are you familiar with? Please share!
Here is a Twitter thread with Jose Gomez-Marquez regarding the definition of a language of design.
Check out my first post about a Language of Design: A Language of Design for Healthcare Part 1: Low Lego Literacy?
I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter!
Click here for information about creative commons licensing. Disclosures: T1D Exchange, Grant funding from Lenovo.
