A Mechanical Rate-Controlled Electricity-Free Medication Infusion Device for Low- and Middle-Income Countries

Abstract Continuous intravenous (IV) medication delivery is an integral part of patient care due to the increased dose precision and more immediate concentration of medication in the bloodstream as compared to alternative methods. However, this standard of care is often inaccessible in low- and middle-income countries (LMICs). Based upon a clinical needs assessment conducted in the Emergency Department at a teaching hospital in Ghana, we identified a need to create a more accessible device to provide rate-controlled infusion of medication. In this paper, we discuss the development and initial preclinical testing of a mechanical, rate-controlled medication infusion device, intended for use in LMICs. The proof-of-concept prototype presented in this paper was iteratively designed, fabricated, and tested. The prototype includes mainspring, escapement, variable transmission, and lead screw subsystems that allow for rate-controlled infusion of medication without the use of electricity. We conducted initial verification testing to assess the potential for success of this proof-of-concept prototype. Our initial testing results are promising and suggest the need for continued development of the mechanical rate-controlled medication infusion device. Based on our testing results, we outline priority areas for continued device iteration and testing, along with future considerations for implementation in Ghana and in other LMICs. The design and initial testing presented in this paper demonstrate the potential for an innovative, context-appropriate medical technology to address critical healthcare delivery challenges in resource-constrained environments worldwide.