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Pushpa Final Corrected Report

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    MTech. 1st

    stage Project Report, Dept. of Electrical Engineering, IIT Bombay, October 2010

    Arm Simulator for Blood Pressure Measurement

    Pushpa Gothwal (09307054)

    Supervisor: Prof. P.C. Pandey

    Abstract: Arm simulator is a device for simulating behavior of the arm for testing and

    calibrating a noninvasive blood pressure meter. It can also be used as an instrument aid

    in teaching the healthcare professionals to correctly use a blood pressure meter. The

    objective of the project is to design and build a low cost artificial arm for BP

    measurement using Koroktoff sound as well as Ossilometric method. For generating

    Koroktoff sound or pressure pulses in arm, 8 bit PIC microcontroller is used. Theses

    sounds or pulses are generated based on the BP parameters set through an external

    control panel, and in response to time varying pressure under the cuff as dynamically

    sensed by a pressure sensor. Korotkoff sound is generated using a digital-to-analog

    convertor (DAC). In the first stage of the project, microcontroller based simulator

    circuit is bread-boarded and a program has been written which can be used for setting

    the values of systolic pressure, diastolic pressure, heart rate, arrhythmia, and pulse

    volume within their respective pre-specified ranges.

    1. IntroductionMeasurement of blood pressure (BP) is the most commonly used tool for assessing a patients

    cardiovascular system. It gives certain important information about patients abnormal blood

    pressure such as hypertension (high blood pressure) and hypotension (low blood pressure).

    Abnormal blood pressure is also known as a silent killer, because the condition generally

    does not have any symptoms. Therefore it is very important to regularly monitor the blood

    pressure. For accurate reading of blood pressure, the measuring instrument should be tested

    and calibrated. Testing of blood pressure instrument is very difficult with living subject

    because pressure level may become different at different times. Also, pressure reading varies

    depending upon the certain physiological factor such as sleep, body position, smoking,

    emotional state, etc. Taking multiple readings of the same subject to test the precision of the

    instrument or for comparing readings from two instruments may leads to change in the BP

    value. Hence, this method of calibration is tedious, time consuming, and unreliable. The

    purpose of this project is to develop a low cost microcontroller based arm simulator which

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    can be used for simulating blood pressure reading over full clinical range along with different

    types and rates of heart beat.

    2.

    Physiology of the Heart

    Cardiovascular system consists of the heart and the blood vessels that circulate blood

    throughout the body. The blood transports nutrients and oxygen to tissue and removes the

    carbon di oxide and waste product from it. Heart is a muscular organ which pumps the blood

    throughout the body. The heart consists of four chambers, left atrium, left ventricle, right

    atrium and right ventricleas shown in Fig. 2.1 [1]. Right atrium has sinoarterial node which

    generates the impulses and atrioventrical node (AV) conduct those impulses. Blood enters

    into the right atrium through two venacova, superior venacova (which leads from the bodys

    upper extremities such as head and neck) and inferior venacova (which leads from the bodys

    lower extremities). The incoming blood fills the right atrium and the coronary vein also gets

    emptied into the right atrium. When the right atrium is full, it contracts and forces blood

    through tricuspid valve into the right ventricle. When ventricular pressure exceeds atrial

    pressure the tricuspid valve closes and pressure in the ventricle forces to open the semilunar

    pulmonary valve. By opening the pulmonary valve, pulmonary artery circulate the

    deoxygenated blood into the lungs. In the lungs red blood cells are recharged with oxygen

    and give up carbon di oxide. The oxygenated blood enters into the left atrium through

    pulmonary vein and then it is pumped via mitral valve into the left ventricle by the

    contraction of arterial muscle. When the left ventricle muscle contracts, it closes the mitral

    valve. Build up of pressure in the ventricle forces the aortic valve to open. Then the blood

    flow in aorta from ventricle circulates inside the whole body .This cycle of blood circulation

    is repeated with beats of the heart [1].

    Cardiac cycle is the sequence of coordinating events which take place during heart

    beat. Each cardiac cycle consists of two major periods- systolic and diastolic. Systolic is

    defined as the period of contraction of heart specifically ventricle muscle. Diastolic is the

    period of dilation of the heart chambers as they fill with blood. Various changes occur in

    different chamber of heart during each heart beat.

    http://en.wikipedia.org/wiki/Left_atriumhttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Right_atriumhttp://en.wikipedia.org/wiki/Right_atriumhttp://en.wikipedia.org/wiki/Right_ventriclehttp://en.wikipedia.org/wiki/Right_ventriclehttp://en.wikipedia.org/wiki/Right_ventriclehttp://en.wikipedia.org/wiki/Right_atriumhttp://en.wikipedia.org/wiki/Right_atriumhttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Left_atrium
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    Fig.2.1 Labeled diagram of heart [1]

    Fig.2.2 Various events during cardiac cycle [5]

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    3.Blood pressure measurement techniquesBlood pressure is measured either using invasive (direct) or non-invasive (indirect) methods.

    For routine clinical measurement, indirect method is preferred over direct method. It this

    method, The skin need not be punctured for taking the BP reading. It is a less accurate

    method because the pressure is measured indirectly and it also depends on patient position. It

    is generally measured with the patient sitting quietly and comfortably with the back support

    for five minutes and the arm is supported at the level of the heart. The patient should not take

    any caffeine or drugs or smoking before the readings. Direct method give accurate blood

    pressure measurement but it requires catheterization, hence it is not used for routine clinical

    measurement. This method is used in intensive care unit (ICU) and coronary care unit (CCU)

    for continuous monitoring of blood pressure. Noninvasive instrument includes the (i)

    auscultation method, (ii) ossilometric method, (iii) ultrasonic method, and (iv) tonometry

    method.

    3.1. Invasive Method (Direct)

    For taking direct measurement, a catheter or a needle type probe is inserted directly into the

    area of interest through arteries or vein [3]. Two types of catheters are available. One of them

    is the catheter tip probe in which the sensor is mounted on the tip of the probe. In this

    pressure exerted on the sensor is converted into proportional electrical signal. The other one

    is fluid filled catheter probe where pressure is exerted by fluid filled column to the external

    transducer, which converts the pressure into the electrical signal. The electrical signal is then

    amplified and processed to give systolic, diastolic, and mean pressure value and visualization

    of pulse contour.

    3.2. Noninvasive Method (Indirect)

    (i) Auscultation Method:

    This method is also known as sphygmomanometer method for indirect blood pressure

    measurement. The blood pressure is measured using an inflating cuff with squeeze bulb,

    mercury manometer, and stethoscope as shown in Fig. 3.2.[3]. The cuff is wound around the

    arm (which should be at about heart level) and a stethoscope is placed on the brachial artery.

    The cuff is inflated to a pressure above the systolic pressure so that flow of blood is occluded.

    The cuff is deflated slowly, and stethoscope is used to listen the sound from the artery. The

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    point at which sound is heard known as the systolic pressure. This sound arises because the

    blood flow is converted from laminar to turbulent form. The pressure below the sounds

    disappear is the diastolic pressure. this sound arises because blood flow is converted into

    turbulent form to laminar form. When the pressure is below the systolic pressure, but above

    the diastolic pressure, a clear tapping sound is heard with the heart beat. The sounds are heard

    in five phase- (i) initial 'tapping' sound (cuff pressure = systolic pressure), (ii) sounds increase

    in intensity, (iii) sounds at maximum intensity, (iv) sounds become muffled, and (v) sounds

    disappear. This technique does not require any expense. However, it cannot be used in noisy

    environment. In this technique mechanical error can get introduced e.g. mercury leakage, air

    leakage, obstruction in the cuff etc. It does not give accurate results for infants and

    hypotensive patients.

    Fig. 3.2 Auscultation method for indirect blood pressure measurement [3]

    (ii) Oscillometric Method

    The ossilometric method works on the same principle as the auscultator method but it does

    not use stethoscope as shown in Fig. 3.3. When the cuff pressure is in between the systolic

    and diastolic pressure, each cardiac cycle causes a small change in the cuff pressure, which

    has the appearance of oscillations. These oscillations, caused by the blood flow in artery

    below the cuff, are sensed using a pressure transducer. The appearance and end of the

    oscillation indicate the time at which the cuff pressure shows the systolic and diastolic

    pressure. The readings are not affected by high environment noise such as emergency andclinical room. The method can be used to reliably measure the mean arterial pressure. In this

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    method, excessive movement of patient or vibration during measurement may result in

    inaccurate reading.

    (a)

    (b)

    Fig. 3.3 Oscillometric method of blood pressure measurement (a) Cuff placement

    (b) Oscillation in cuff pressure [3]

    Fig. 3.3 (b) shows that oscillation in cuff pressure. The point of maximum oscillation

    corresponds to the mean arterial pressure. The point at which oscillation begins to increase

    rapidly is known as the systolic pressure and the mean arterial pressure at which oscillation is

    decreasing rapidly is known as the diastolic pressure.

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    (iii) Tonometry Method

    As shown in Fig.3.4, this method uses a flat plate to compress the surface of the skin directly

    over a superficial artery, supported from below by a bone (radial artery). An arterial rider,

    cylindrical in shape, senses the radial stress of the artery by means of a sensor array. Effect of

    skin tension in vertical direction is set to zero by the side plate. The arterial rider strain gauge

    sensor detects the arterial pulsation. For estimating pressure, force is divided by contact area

    of arterial rider. This method is non-invasive and non-painful and can be used to monitor

    blood pressure continuously. It has relatively high cost and the wrist movement of patient may

    gives inaccurate reading.

    (iv) Ultrasonic Method (Doppler method)

    Doppler sensor is used to detect motion of the blood vessel to determine blood pressure as

    shown in Fig. 3.5. A compression cuff is placed over the arm with 8 MHz transmitting and

    receiving crystals [4]. Ultrasound source transmits signal on the blood vessel and the

    reflected signal is transduced by the receiving crystal, and then amplified. The reception of

    reflected signal indicates the closing and opening of artery. Frequency difference between

    transmitted and reflected signal is proportional to the blood velocity and velocity of wall

    motion. For the cuff pressure between diastolic and below systolic pressure, the blood vessels

    open and close with each heart beat, because artery pressure oscillates between cuff external

    pressure. As the cuff pressure further increases, the time between opening and closing artery

    Fig.3.4 Tonometry method for blood pressure measurement [4]

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    Fig. 3.5 Ultrasonic method for indirect blood pressure measurement [4]

    decreases until they coincide. The reading at point is known as the systolic pressure. The cuff

    pressure futther decreases, the time between opening and closing artery increases until they

    coincide. The reading at point is known as the diastolic pressure. This method can be used in

    noisy environment and it can be used with infant and hypotensive subject. Movement by the

    patients change the alignment between the sensor and vessel thus the reflected signal does not

    give correct reading.

    4. Blood pressure simulatorA BP simulators is used to test and calibrate the BP monitor by assessing the repeatability

    and stability. In clinical environment, simulators are used as part of the quality assurance in

    for quick testing of BP monitors [8]. Two basic type of simulator have been developed, limb

    simulator and waveform simulator as shown in Fig. 4.1. A limb simulator models the

    artificial limb (arm). Waveform simulator generates pressure waveforms. Arm simulatoris in

    the form of inner cylinder filled with water and K-sounds are generated by transducer. An

    outer layer of water is in flexible form that transmits the sound waves to pressure cuff and

    transducer. A waveform simulator generates Ossilometric waveform, which is fed into the

    cuff tubing of the tested monitor. The most commercial available simulators are BP Pump 2

    and Cufflink by Fluke Biomedical, SmartArm and AccuPulse by Clinical Dynamics, QA-1290 by Metron and SimCube SC-1 by Pronk Technologies. The simulators suffer from a

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    number of disadvantages such as, large size, lack of flexibility in settings. Hence for the

    measurement of blood pressure under different cardiovascular condition, a compact portable

    BP simulator is needed.

    4.1 Calibration

    Accuracy of blood pressure measurements is dependent upon the deflation rate. For

    calibrating any instrument, pressure gauge reading is compared with a standard mercury

    sphygmomanometer and T connector is used between gauge and instrument. Any offset error

    if found should be corrected. For finding how much offset is needed, apply the cuff to the

    simulated arm. Set the simulator systolic pressure to 150 mmHg and set the diastolic pressure

    to 70 mmHg. Proceed with a simulated blood pressure measurement. Note the differencebetween the gauge and the simulator reading. Example, if the blood pressure reading was

    taken and the sound started at 148 mmHg, and then the offset is +2 mm. If the sound started

    at 152 mmHg, the offset is2. For diastolic pressureif sound stopped at 72 mmHg, the offset

    is2 or if the sound stopped at 68 mmHg, the offset is +2. [10]

    Fig. 4.1 Two basic types of simulator for testing of BP measurement (a) limb simulator,

    (b) waveform simulator [8].

    4.2 Earlier work

    An arm simulator for blood pressure measurement was reported by Glover in [6]. It uses

    ossilometric method for blood pressure measurement. Generation of simulated pulse is shown

    in Fig. 4.2. Pulse rate, systolic pressure, and diastolic pressure for the simulator are selected

    by user. The cuff gets inflated by the pump in the monitor, till the brachial artery gets

    occluded. The cuff is deflated in steps by valve located in monitor. Applied cuff pressure isdetected by transducer located in monitor. The transducer converts the pressure signal into

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    electrical signal. This monitor contains the amplitudes of detected pulses and stores them

    along with corresponding value of cuff pressure. This data is then reviewed and the pressure

    level at which maximum pulse amplitude has occurred is determined. The cuff pressure is

    also applied on both side of a diaphragm located in pulse chamber. The cuff pressure is

    further applied on pressure transmitter of the simulator which converts it into electrical

    signal. This signal is then given to both procceser and control circuit which control the valve

    opening and closing. Output of the processer is fed to electrical pulse generator which

    produces pulses at selected rate and varying amplitude depending upon the cuff pressure

    created by monitor. In this way, blood pressure reading is simulated. When processer

    activates pulse geneartor, it supplies pulse signal to valve control circuit for closing the valve.

    Processor always gets current value of cuff pressure along with preset value of systoic,

    diastolic, and mean atrial pressure, then it computes the required pulse amplitude according

    to the line equation. Pulse rate genearted is determined by the set heart rate.

    Fig. 4.2 Block diagram of blood pressure simulator arm [6]

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    5. Design approachIn the block diagram as shown in Fig. 5.1 the microcontroller is the central control unit of the

    simulator. For a very compact design, the microcontroller should have sufficient

    programmable ROM, data RAM, parallel I/O ports, UART, and a programmable

    timer/counter for handling all the operations without requiring additional chips. Arm

    simulator will be in the form of a cylinder. The cuff containing the transducer is placed

    surrounding the cylinder and the transducer kept between cuff and cylinder converts pressure

    variations to voltage. The voltage corresponding to the pressure variation is given as input to

    the amplitude calculator, which also takes as input the following parameters systolic pressure

    (SP), diastolic pressure (DP), and the mean atrial pressure (MAP). These parameters are input

    through a keypad. The entire scheme can be implemented using microcontroller with on chip

    ADC and DAC. The pressure variations are given as input to the ADC of the microcontroller.

    The program converts these pressure variations into varying amplitude pulses which is

    converted to sound using an appropriate audio module.

    Fig. 5.1 Block diagram of the arm simulator

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    Fig. 5.2 K-sound amplitude as a function of cuff pressure

    5.1 Hardware block of the simulator

    In the first stage designed the simulator circuit, shown in Fig. 6.3, consists of keypad and LCD

    interfacing with the microcontroller. The microcontroller PIC16F1936 is used for processing

    purpose. It use has resulted in a simple circuit because it has on chip like DAC, timers, ADC, etc.

    Microcontroller uses timer to generate pulses which vary with the beat rate selected by user.

    Minimum beat rate is 20 beats/ minute and maximum beat rate is 150 beats/ minute and it varies in

    steps of 5 beats/ minute. Port pins PC.4PC.7 of microcontroller are connected to up, down, left,

    and right keys respectively.

    Pressure

    sensorMicrocontroller

    Keypad LCD

    DAC out

    Pulses

    ADC in

    Fig. 5.3 Block diagram of simulator

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    5.2 Pin assignment of the microcontroller

    A 28 pin microcontroller IC (MCP16F1936) has been used for the testing of the simulator

    circuit. The user interface unit consists of four keys and a 16x2 LCD. The LCD is interfaced in

    four bit form to reduce the no. of port pins. The pin assignment is given in Table 4.1 and is also

    shown in Fig. 6.3. The display unit has option to change mode of operation, systolic pressure,

    diastolic pressure, heart rate, arrhythmia, and pulse volume. There are four keys increment,

    decrement, left and right. Key 1 and 2 are for selecting the parameter and key 3 and 4 are to

    change the selected parameter value. Choices available for the different parameters selection

    are listed below:

    Systolic pressure- 0230 mmHG, increase or decrease in step of 5, with default value as

    120.

    Diastolic pressure- 0140 mmHG, increase or decrease in step of 5, with default value as

    80.

    Heart rate- 20150 Beats/minute, increase or decrease in step of 5.

    Arrhythmia- 04, increase or decrease in step of 1.

    Pulse volume- 51, increase or decrease in step of 1.

    Table 5.1 Assignment of pins for various functions on the microcontroller

    Port Pin Function

    PA.1PA.4 LCD data pins

    PA.5 Enable of LCD

    PA.6 RS of LCD

    PA.7 RW of LCD

    PB.1 Square wave

    PB.2 Non periodic pulse

    PC.4 Increment key

    PC.5 Decrement key

    PC.6 Left key

    PC.7 Right key

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    PC.0

    PA.6

    EN

    PC.3

    PA.7

    PC.2DB 5

    DB 6

    DB 4

    RS

    DB 7

    DB 1

    DB 0

    VSS

    VEE

    VCC

    NC

    NC

    NC

    NC

    10 k

    330

    PC.1

    11

    12

    13

    14

    9

    10

    PB.0

    PB.1

    PB.2

    PB.3

    PB.4

    PB.5

    PB.6

    PB.7

    PA.5

    PA.4

    PA.3

    PA.1

    RW

    PA.2

    PA.0

    NC

    NC

    NC

    NC

    NC

    NC

    NC

    NC

    NC

    DAC out

    PC.7

    PC.6

    PC.5

    PC.4

    VPP

    VDD

    VSS

    VSS

    U2

    S4

    S3

    S2

    S1

    7

    6

    5

    3

    4

    2

    1

    21

    22

    23

    24

    25

    26

    27

    28

    18

    17

    16

    15

    19

    8

    14

    13

    12

    11

    6

    4

    10

    9

    8

    7

    3

    2

    5

    1

    20

    GND

    GND

    GND

    GND

    C2= 0.1 F

    LCDD

    I

    SPLAY

    JHD

    162A

    5 V

    R1

    R2

    R3

    R4

    R5

    R6

    R3= R4= R5 = R6= 10 k

    PIC16F1936

    DB 3

    DB 2

    NC

    NC

    NC

    5 V

    R7

    10 k

    ADC in

    GND

    Fig.5.4 LCD and Keypad interfacing with microcontroller

    5.3 Software

    The functioning of keys and LCD display are controlled by software. The simulator has two

    modes of operation: (i) Definition mode (ii) Operating mode. In definition mode all the keys

    are active and we can select and change all the five parameters. The user can select or change

    the mode and parameters following the algorithm as given below.

    1. Start.2. Default operation mode is definition mode; user can go to operation mode by

    pressing key1 or 3.

    3. Check for key press.4. In definition mode all the parameters can be incremented or decremented by pressing

    key 1 or 3.

    5. In operating mode, key 1 and 3 will not work and it generates non periodic pulsewave according to heart beat. Check for key press.

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    6. If key is pressed then do work accordingly. If left or right key is pressed then select the parameter, go to step 3. If up or down key is pressed then increment or decrement selected parameter

    respectively, go to step 3.

    7. Display current setting on LCD for the user.8. Go to step 3.

    6. Summary and future workWe are designing a microcontroller based low cost portable arm simulator, which pressure

    pulses will simulate. First stage includes study of the earlier method of simulating pressure

    pulses, available products of arm blood pressure simulator. A designed is simulator in which

    user can select the specify parameter and change the parameter value by keypad and generate

    the varying amplitude of the K-sounds in response to variation in the sensed pressure. For

    testing purpose pulses are output in place of K-sound. The output of pressure sensor was

    simulated by a potentiometer.

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    `

    Appendix: BP simulator

    1. No 600 blood pressure simulator Arm [15] - This arm uses Auscultation method for

    measuring blood pressure. It also simulates the palpation of the radial pulse, and varies

    systolic and diastolic pressures from 0300 mm HG in two mm increments, variable

    amplitude of sound heard, sound jack for group listening, auscultatory gap setting, and heart

    rate settings.

    2. (i) BPT-001 Blood Pressure Simulator [16] - This Blood Pressure Simulator simulates

    the five Korotkoff phases. It cost is 795$.It also provides the following features-

    Systolic and diastolic settings

    On or off of ausculatory gap

    Adjust volume

    Adjust pulse rate

    (ii)BPK3-001 Blood Pressure Training Arm - This arm designed for training the procedureof NIBP measurement with an electronic trainer. Its cost is 940$. It also provides the

    following features Palpable antecubital pulse

    Blood Pressure Trainer with LCD guided operation

    Systolic, diastolic, heart rate, and auscultatory gap are programmable.

    Representation of both systolic and diastolic pressures

    Indication of gauge reading as pressure is increased ordecreased

    Adjustable volume

    3. NASCO Life/form Blood Pressure Simulator (lf03204) [11] - The NASCO Life/form

    Blood Pressure simulator is programmed to demonstrate the 5 Korotkoff phases, including an

    auscultatory gap, which can be heard during auscultation of a subject, while measuring the

    subjects blood pressure. This simulator digitally records the pressure sound by varied pulse

    rate and volume. It also provides the following features

    Calibration of simulator

    Setting of palpation

    Extra speaker to hear korotkoff sound

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    Setting of systolic pressure, diastolic pressure, pulse rate, and pulse volume.

    4. SimCube NIBP Simulators [13] - Simcube NIBP Simulators are compact, handheld,

    affordable and easy to use. It simulates real-life oscillometric pulses by varying both the size

    and shape of the wave as cuff pressure changes. It also provides the following features

    It providesNIBP Simulations forAdult, Neonatal, hypertensive, and hypotensive subject.

    Digital Manometer

    12-lead ECG: 10 different Heart Rates, synchronized with NIBP

    Respiration: 3 rates, plus a sequence of 7 different rates

    Pacer Simulation

    Peak Detect- For checking overpressure limits in 0.5 mmHg steps

    Leak Test Mode- It measures leak rate of a NIBP monitor, cuff, and hose

    Automated Alarm Test Mode- Tests heart rate alarms

    5. Non-Invasive Blood Pressure Simulator (Rigel 311c) - It uses ossilometric waveforms

    for accurate calibration of NIBP monitors. It provides graphic representation of the inflation

    and deflation process. It displayed/ measured following parameters dynamic NIMP cuff

    pressure waveform, measurement time ( in seconds), maximum inflation Pressure (in mmHg

    typical), inflation time, inflation Rate (mmHg/sec), minimum Pressure, deflation time,

    deflation Rate. It also provides the following features

    It provides NIBP Simulations forAdult, Neonatal

    Digital Manometer, Leak Test

    6. Non-Invasive Blood Pressure Simulators (1000 series) [13] - The Model NIBP-1000

    Series is a family of Microprocessor based, High Precision Non-Invasive Blood Pressure

    (NIBP) Simulators. The units are small, easy to use and have multiple features to fit many

    different applications. The NIBP-1020, offers ECG waveforms that are full QRS and

    respiration waveforms that look real. The NIBP-1030 offers Invasive Blood Pressure,

    Temperature, Arrhythmias and a Leak Rate test mode. The graphics display not only provides

    multiple screens that give the pressure digitally in mmHg, but also offers views of the plot of

    the overall pressure or a close-up of the BP waveform. This model comes in different series

    with more features. The following are highlights of some of the main features

    NIBP(1010) -

    Large graphics display with cursor selection of options and setup of parameters Full range manometer

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    Adult, neonatal, hypertensive and hypotensive modes

    Digital pressure envelope offset

    Optional peak pressure detect with simple reset

    Digital calibrationno pots to turn

    Flash programmable

    NIBP(1020)- It provide all the basic model features plus:

    Ecg output with full nsr waveform

    Sinusoidal respiration simulation

    Ecg test waveforms

    Pace waveform

    Optional peak pressure detect with ecg alarm test

    Ecg syncronized with blood pressure

    NIBP (1030) - It has all the 1020 model features plus-

    Synchronized invasive blood pressure output

    Static Invasive blood pressure simulation

    Leak rate test

    Ecg arrhythmia waveforms

    Ecg arrhythmia sequence

    7. Cufflink Noninvasive blood pressure analyzer [10] - This Analyzer uses oscillometric

    method for simulation and generate BP waveforms for seven adult, five neonate, and 5

    arrhythmias. The different systolic/diastolic pressure gradients simulate a physiological range

    of normal, hypotensive, and hypertensive adult or neonate patients. An internal pump

    pressurizes the NIBP system under test. Use the Analyzers digital manometer instead of a

    mercury column for doing pressure measurements. The Analyzer facilitates overpressure

    testing of NIBP monitors by automatically detecting and displaying the overpressure point.

    The Analyzer has the following standard features:

    Dynamic oscillometric noninvasive blood pressure simulation

    Automated static pressure measurements, leakage testing, and relief-valve testingFive automated NIBP testing autosequencesFive arrhythmia selectionsAdult and neonatal NIBP selectionsAdjustable heart rate values

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    8. BP Pump 2 Non-Invasive Blood Pressure Simulator and tester [10] - This simulator

    include multi-purpose test instrument for use with oscillometric Non-Invasive Blood Pressure

    Monitors (NIBPMs). The Tester provides dynamic blood pressure simulations, static

    calibration, automated leak testing, and pressure relief valve testing. The following models

    are available:

    (i) BP Pump 2L (Basic Model)

    (ii) BP Pump 2M (High-Accuracy Model)

    The model has the following key features

    Pressure leaktesting on cuff, tubing, and connections

    Relief valve testing on the patient monitor

    Pressure gauge measurements

    Pressure source capability

    NIBP simulations including adult, neonate, arrhythmias, and respiratory artifacts

    Auto sequences with optional reports

    Internal Adult and Neonatal Cuff simulation

    ECG synchronization with non-invasive output

    External wrist cuff simulations

    \

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    References

    [1] K. Sembulingam and P. Sembulingam, Cardiovascular system,Essential of Medial

    Physiology, 5th ed., New Delhi: Jaypee, 2010, pp. 500-504.

    [2] C. Guyton, Physics of blood, blood flow, and pressure: Hemodynamics, Textbook of

    Medical Physiology, 7th ed., Philadelphia: saunders, 1986, pp. 206-209.

    [3] Handbook of Biomedical Instrumentation, 2nd ed., Tata McGraw Hill, New Delhi, 2009,

    pp. 218-227.

    [4] J. G. Webster,Blood pressure and sound,MedicalInstrumentation Application and

    Design, 2nd ed., Boston, USA: Houghton Mifflin company, 1992, pp. 394-401.

    [5] J. J. Carr and J. M. Brown, Physiological pressure and other cardiovascular

    measurement,Introduction to Biomedical Equipment Technology, 4th

    ed., Delhi: PearsonEducation, 2001, pp.234-245.

    [6] W.Glover and R. Medero,Arm Simulator for an Ossilometric blood pressure monitor,

    U.S. Patent 4,464,123, August 7, 1984.

    [7] K. Ruiter and W. W. Ruiter,Compact Ossilometric blood pressure simulator, U.S.

    Patent apl. 20100076713, 30 June, 2008.

    [8] G.Gersak, A. Zemva, and J. Drnovsek. (2009, October) A procedure for evaluation of

    non-invasive blood pressure simulators. Med Biol. Eng Comp.[online].47(12), pp.1221-

    1228,Available: http://www.springerlink.com/content/351052r33660n551/fulltext.pdf.

    [9] F. Leo and Jr. Costello,Ossilometric Noninvasive Blood Pressure Simulator, U.S.

    Patent 5,027, 641, July 2, 1991.

    [10] Fluke Biomedical, Cufflink NIBP analyzer Available online :

    http://assets.fluke.com.cn/evtmanuals/bppump2_omeng0000.pdf.

    [11]Nasco Life/form, LF03204U blood pressure simulator, Available online:

    http://www.enasco.com/pdfs/lf03204.pdf.

    [12] Clinical Dynamics , AccuPulse NIBP Simulator Available online:

    http://www.clinicaldynamics.com/pdfs/NIBP/AccuPulseSpecSheet.pdf.

    [13] PronkTechnologies Inc., Sim cube NIBP simulator, Available online:

    http://www.pronktech.com/simcube-nibp-simulator-pronk.htm.

    [14] Rigel medical,BP-SIM Handheld NIBP Simulator Available online:

    http://www.rigelmedical.com/products/nibp_simulators.asp.

    [15] Simulaids, No 600 Blood Pressure Simulator Arm Available online:

    http://www.simulaids.com/PDF/BloodPressureSimulatorArm.pdf.

    http://assets.fluke.com.cn/evtmanuals/bppump2_omeng0000.pdfhttp://www.enasco.com/pdfs/lf03204.pdfhttp://www.enasco.com/pdfs/lf03204.pdfhttp://www.pronktech.com/simcube-nibp-simulator-pronk.htmhttp://www.rigelmedical.com/products/nibp_simulators.asphttp://www.simulaids.com/PDF/BloodPressureSimulatorArm.pdfhttp://www.simulaids.com/PDF/BloodPressureSimulatorArm.pdfhttp://www.rigelmedical.com/products/nibp_simulators.asphttp://www.pronktech.com/simcube-nibp-simulator-pronk.htmhttp://www.enasco.com/pdfs/lf03204.pdfhttp://assets.fluke.com.cn/evtmanuals/bppump2_omeng0000.pdf
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    [16] Pinnacle technology group, BPT-001 Blood Pressure Simulator Available online:

    http://www.pinnacletec.com/pdf/pinnacle_catalog.pdf.

    1

    2

    CON3

    J3

    1

    2

    CON3

    J3

    AGND

    A3V3

    DGND

    C16

    100uFC17

    0.1uF

    C18

    0.1uFC19

    100uF

    C20

    0.1uFC21

    100uF

    C15

    100uFC14

    0.1uF

    C13

    100uFC110.1uF

    C12

    0.1uF

    C10

    100uF

    R2

    0 0hm

    R2100K

    R210K

    R2

    0 ohm

    IN OUT

    GND

    IN OUT

    GND

    IN

    GND

    Vout

    Vout

    GND

    Vout

    VoutIN

    D3V3

    1

    1

    3

    3

    2

    2

    2

    4

    2

    4

    1

    1

    3

    3

    D5V

    A5V

    LM7805

    LM7805

    LM1117

    LM1117

    U3 U4

    U5 U6

    BAT

    http://www.pinnacletec.com/pdf/pinnacle_catalog.pdfhttp://www.pinnacletec.com/pdf/pinnacle_catalog.pdf

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