What is the need you set out to address?

Our need focused on a way to empower front-line health workers to resuscitate newborns with birth asphyxia more easily and effectively. I was motivated to tackle this need by several experiences. First, when I was pretty young, I saw my mother resuscitate a 12-year-old boy. He collapsed and was gone. But, with a few minutes of resuscitation, he came back to life. That left a powerful impact on me. The second was when I was an intern in the labor room, where I experienced firsthand the anxiety when a baby is about to be born; but what if they don't breathe? That worry can be an overwhelming emotion. Finally, as I started looking into the space, I realized that babies who go through birth asphyxia may become disabled for life. I found that particularly heart wrenching, especially given that one or two minutes of effective resuscitation could prevent all of that misery. 

"…I realized that babies who go through birth asphyxia may become disabled for life. I found that particularly heart wrenching…"

What key insight was most important to guiding the design of your solution?

As a resident, I was trained in the technique of resuscitation. There’s a triple maneuver that you have to do with one hand – head tilt, chin lift, jaw thrust. That same hand also has to perform the E and C clamp technique. That’s where two fingers hold the ventilator mask over the nose and mouth in the shape of a C while the bottom three fingers hold the jaw firmly in the shape of an E so that the oxygen mask fits snuggly without any openings around the edges. That's a lot for someone to achieve with just one hand. The other hand is used to do the bagging, which means squeezing the hand-held device that delivers positive pressure ventilation through the mask. 

In some ways, it was an obvious realization that if the second hand was free to help with the technical maneuvers and clamping, then maybe resuscitation would be easier and more effective. When my team and I started to look into it, we found in the literature that was actually the case. In one study, having two hands available was shown to reduce mask leakage by 50%. But this study was done with a second operator taking care of the bagging. It confirmed our assumption, but we had to figure out how we could make this happen with a single operator.

How does your solution work?

NeoBreathe is the world’s first and only pedal-operated resuscitation device. The use of a foot pedal to deliver the positive pressure ventilation to the mask frees the operator’s second hand from the task of bagging so it can now be used for positioning the patient and holding the mask with both hands. This reduces leakage by 50%, as we expected. 

With two hands, the grip on the mask becomes much more stable, so pressure and volume become more stable too. And our device includes a reusable manometer that allows the operator to observe pressure levels in real time. Along with our proprietary pressure control technology, this makes the procedure safer for the baby. 

Using suction to clear the airway can be another important part of resuscitation. But, depending on where the resuscitation is performed, suction may not always be available. For that reason, we integrated suction into our device so that functional suction will be available no matter what. 

With regard to field suitability, the device works without the need for electricity or a source of compressed air. These features further decrease risks and improve operator confidence. 

Avijit Bansal demonstrating the NeoBreathe technology (image credit: Vishal Koul for Outlook Business Magazine).