The 2013 Biomedical Engineering International Conference (BMEiCON-2013)

Design and construction The Low Cost Defibrillator Analyzer

N.Thongpance1, T.Kaewgun2, R.Deepankaew3
Biomedical Engineering Program, Department of Physics, Faculty of Science, Rangsit University
1

nthongpance@hotmail.com, 2thawat.kaewgun@gmail.com,

Abstract The objective of this research was to design and

construct of the low cost defibrillator analyzer. This research
has adopted the principle of voltage divider and standard
calibration curves of the relationship between the set of
standard output energy, the standard maximum voltage and
the standard maximum current versus the digital output of
them. The designed and constructed the low cost defibrillator
analyzer was composed of 3 main parts: 1) the input part
consisting of the paddle electrodes receptacle, 2) the signal
conditioner and processing part including voltage attenuator
circuit , surge protection circuit, and microcontroller ARM
Cortex M3 ,STM32F107VCT 6 for processing of energy, peak
voltage, peak current, pulse period and plotting the both
monophasic and biphasic waveforms and 3) the display part
consisting of LCD touch screen display for displaying the
energy value in Joule unit , peak voltage in Volt unit, peak
current in Ampere unit , period in millisecond unit and the
waveform of the unit under test. The testing results were
compared with standard defibrillator analyzer FLUKE Model
Impulse 6000D showed the waveform, accuracy and to value
measure can be highly related with the comparative devices.
The results of standard calibration for accuracy of the load
resistance and energy measuring by the laboratory of
Calibration Services and Environmental Analysis Department
,Technology Promotion Association (Thailand Japan) that
has been certified by the international ISO 17025 shown that
the average uncertainties of the 95 percent confidence level are
0.0053 Ohm and 1.2 joules respectively. The result of the
user satisfaction of 13 people found that the mean satisfaction
score was 3.8 out of 4. The production cost of the prototype is
25,000 baht.
Keyword: Low Cost Defibrillator Analyzer, Voltage Divider,
Standard Calibration Curve

I.

INTRODUCTION

Nowadays, Thailand has a policy to be the Medical Hub

of Asia. For the purpose that can be supported as the policy
above, the establishment where is related to the health care
has to be certified by the organization standards in the
national level and /or international level. One of the
important elements that is certified as stated acceptance is to
make an accurate medical equipment in use at all times by
giving priority to the maintenance of proper medical
facilities. One factor which is the main component in the
maintenance of medical instrument is testing and calibration
of medical devices for ensuring that the accuracy and
precision are standard in the measurement at all time.
Defibrillator is the medical instrument which is very
important for helping patients who have seriously heartbeat
disorders which called that ventricular fibrillation. The
general principles of this instrument are taking charge in the
capacitor and discharge the stored electric energy through
the electrodes and patients chest. This instrument can
stimulate the cardiac muscle to be back in normal. The
success rate depends on the value of the activation energy or
electric current can transmits through the chest to the cardiac
muscle. For the energy level that was kept as the same
defibrillator will be effective different stimulating of each

978-1-4799-1467-8/13/$31.00 2013 IEEE

ronanchit3@hotmail.com

patient because the patients have different of chest

resistance.
Most defibrillators are energy-based, meaning that the
device charges a capacitor to a selected voltage and then
delivers a prespecified amount of energy in joules as the
equation (1).
E = 0.5 CV2
(1)
E
C

is the electric charge which has a measure in Joule

is capacitance value of capacitor which has
measure in Farad
V
is the electric potential that charged in the capacitor
which has measure in Volt
When the energy reached to the patient, it will be reduced
by the equation (2)



Rpatient
Edelivered = E

Rpatient + Rinductor
E

(2)

is the energy that has stored in the capacitor

which has a measure in joule.
Edelivered is the energy that comes to the patient which has
a measure in joule.
Rpatient is the patients chest resistance (RL) which has a
measure in ohm.
Rinducto is the induction coil resistance (L) which has a
measure in ohm. [1]
Modern defibrillators, deliver energy or current in
waveforms. Energy levels vary with the type of device and
type of waveform. Several types of monophasic waveforms
have been used in modern defibrillators. In this waveform,
there is no ability to adjust for patient impedance, and it is
generally recommended that all monophasic defibrillators
deliver 360J of energy in adult patients to insure maximum
current is delivered in the face of an inability to detect
patient impedance.
Biphasic waveforms have recently been developed and
approved for marketing and clinical use. They are rapidly
replacing defibrillators which deliver monophasic
waveforms. Lower energy biphasic shocks cause less
myocardial injury and subsequent post-resuscitation
myocardial dysfunction thus potential improving the
likelihood of survival. Recommendations of the
International Liaison Committee on Resuscitation (ILCOR)
state that biphasic energies less than or equal to 200 joules
are as efficacious as escalating higher energy monophasic
shocks. [2]
The calibration of defibrillator is to calibrate the output
power from the device to the patient in accordance with the
setting values or not or exceed the standards set tolerances
or not. Nomally we use the defibrillator analyzer to calibrate
the flowed energy from defibrillator in joules and display
peak voltage, peak current and pulse width. For this
research, the designed and constructed the defibrillator
analyzer can be accomplished to test the performance as

well as the criteria. It supports the full ability operation of

defibrillator to save the critical patient.[3]

Figure 1 This block diagram show design and construction of the research

II.

MATERIALS AND METHOD

The main principle of this research is to reduce the

several hundred Joules , many thousand volts and high
electric current of a generated pulse from a defibrillator by
using the attenuation circuit voltage and
the surge
protection circuit transient. After that the signal was sent to
the analog signal conditioner circuits to make all pulses
signal are in the positive side and sent to ADC for
converting to digital signal. After that the digital signal was
sent to microcontroller for signal processing. In terms of
processing using equations of standard calibration curves of
the relationship between the
set of standard output
energy,the standard maximum voltage and the standard
maximum current to the digital output of them. The design
and construction of defibrillator can be described by a block
diagram as shown in Figure 1.
We can consider from the block diagram in the Figure1
and can explain the design and construction principle as the
following below;
A. The input part
The input part composes of paddle electrodes receptacle
for receiving the energy from defibrillator and pass through
to the signal conditioner part . This research used stainless
with its 4.72 x 10-7 Ohm resistance and it does not affect to
the loss of energy. Its including the size that can support to
all defibrillators paddle.

B. The signal conditioner and signal process part

The signal conditioner consists as the following detail;
1) The voltage attenuator
The voltage attenuator is the voltage divider circuit which
composes of 50 Ohm resistor connected in parallel with the
precision resistor networks 0.0625 Ohm. For the 50 Ohm
resistor that is represent the impedance of the human thorax
under high-voltage pulse conditions. The voltage attenuator
is connected to the IC protection SP720 to prevent the high
voltage pass through the voltage attenuator and
microcontroller.[4]
2) Non-Inverting Summing Amplifier
This research has used the non - inverting summing
amplifier to elevate the negative phase of biphasic pulse to
the positive phase in order to be able to convert the analog
signal to a digital signal, including for signal processing by
the ARM Cortex M3 microcontroller. [5]
3) The signal processing
The research has selected microcontroller ARM Cortex M3
STM32 F107VCT6. The analog-to-digital converter on this
microcontroller is 12 bit resolution. The sampling rate is
chosen at 27 MHz. In the part of program, the researcher
used C language to program the equation of relationship
between standard energy, standard maximum voltage and
standard maximum electric current and their digital output,
including plot graphs the relationship between the voltage
versus time of the signal measured both biphasic and
monophasic waveforms in the microcontroller. When the
processing is completed, it will send the data to display on
touch screen graphic LCD color by connecting through the
ADS7846 chip. For the processing signals of this research
can be described as follows the flow chart shown in Figure 2
and Figure3.
C. Display part
This research has used the touch screen graphic LCD
color module provides peak voltage, peak current, pulse
period, and the amount of energy delivered during a
defibrillator discharge. This LCD is configured to work in
10-bit mode.The graphic LCD module has a resolution of
320 x 240 pixels and displays both monophasic and biphasic
delivered current wave forms. This LCD module
communicates with the ARM Cortex M3 STM32
F107VCT6 microcontroller via an 10-bit data bus.

Figure 2. Shows the flow chart of monophasic signal processing program

Figure 3. This diagram shows biphasic signal programs flow

Table I

III.

The results of energy calibration.

RESULTS

The result of design and construction and the the

performance testing of the prototype defibrillator energy
tester has details as the following below;
The complete prototype of defibrillator, as shown in the
Figure 4.
A. The results of performance testing
The results of performance testing of the defibrillator energy
tester are as follow ;
1. Able to display of energy, peak voltage, peak current,
pulses period and waveforms on touch screen graphic
LCD
2. Able to use for testing energy of monophasic and
biphasic defibrillator up to 450 J with average
percentage error and precision of 0.23 percent ,99
percent and 0.39 percent,98 percent for monophasic and
biphasic defibrillator respectively when compared with
the defibrillator analyzer FLUKE Model Impulse 6000D.
3. Load resistance is 50 0.0053 Ohm.
4. The results of energy calibration by the Laboratory of
Calibration Services and Environmental Analysis,
Department
Technology
Promotion
Association
(Thailand Japan) that has been certified by the
international ISO 17025 shown that the uncertainty of
the 95 percent confidence level are shown in table 1
5. The production cost of the prototype about 25,000 baht.

Figure 4 The Proto Type Defibrillator Energy Tester

Applied Energy
(Joules)
2.1175
50.2485
100.7403
187.4813

UUC
Reading
(Joules)
2.63
50.53
107.62
191.14

Error
(Joules)

Uncertainty
( Joules)

0.5125
0.2815
6.8797
3.6587

0.064
0.66
1.4
2.5

B. Testing the satisfaction of the users

From the satisfaction survey of user of the defibrillator
analyzer with the workshop on the principle of testing and
calibration of defibrillator in the January - March 2013.
Furthermore, during March 7 -8, 2013, we arranged the
project to provide the technical services in biomedical
equipments for the Huahin hospital in this opportunity we
used the defibrillator analyzer to calibrate the defibrillators.
There were 13 participants answered a questionnaire.
Among these were satisfied with the average score was 3.8
out of 4 which is 94 percent. They also have suggestions on
how to improve the external appearance more attractive and
should be designed to provide the user with greater
durability.
IV.

DISCUSSION AND CONCLUSION

Nowadays, there are several defibrillator analyzers

commercial availably in market in Thailand and these
devices have well performances. However, the most of them
were imported from foreign country with high cost, more
complexity, and difficult to repair and maintenance. In
addition, if we use a technology imported from abroad
without researching and developing the technology for their
own use. We cannot be self - reliant and cannot compete
with other countries in the field of technology development.
These problems that occur today and will be more vital in
the future were concerned. Therefore, the research was
carried out by using the principle of voltage divider and
standard calibration curves of the relationship between the
set of standard output energy, the standard maximum
voltage and the standard maximum current to the digital
output of them. The defibrillator analyzer in this study was
aimed to assess a low cost device with high accuracy and to
be compatible to both monophasic and biphasic defibrillator.

The results of performance testing are indicated that it can

be used for testing energy of monophasic and biphasic
defibrillator up to 450 J with average percentage error and
precision of 0.23 percent, 99 percent and 0.39 percent, 98
percent for monophasic and biphasic defibrillator
respectively. The result of standard calibration for accuracy
of the load resistance and energy measuring by the
laboratory of Calibration Services and Environmental
Analysis Department ,Technology Promotion Association
(Thailand Japan) that has been certified by the
international ISO 17025 shown that the uncertainty of the
95 percent confidence level were 0.0053 Ohm and 1.2
joules respectively. Further more,for the satisfaction test of
the users who are related with medical instrument
application found that they has the satisfaction of utilization
average as 3.8 from full mark 4. Thats approximately
94.6% and the production cost of the prototype about 25,000
baht

ACKNOWLEDGMENT
The authors would like to thank you the 2 - V Research
Program for the year 2011 from the National Research
Council of Thailand for funding support this research. The
authors also would like to thank you Biomedical
Engineering Program, Department of Physics, Faculty of
Science, Rangsit University for supporting and providing
the facilities during to do this research until to achieve the
objectives.
V.
[1]

[2]

[3].
[4]

[5]

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[January 9,2012].
Testing and Calibration of Bio-Medical Equipment Available URL :
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