Test Game Tech Wiki - User contributions [en]

Inclusive & Accessible Tech

2023-06-30T17:15:28Z

Srafferty: /* Plug-and-play Inputs & Accessories */

== Adaptive Hardware/Modifications ==

* [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller]
* [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo]
* [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller]
* [https://testwiki.childsplaycharity.org/wiki/3D_Printing#Adaptive_Equipment List of 3D printable resources]

== Plug-and-play Inputs & Accessories ==
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* [https://warfighterengaged.org/shop Warfighter Engaged: Custom Adaptive Equipment]

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

Inclusive & Accessible Tech

2023-06-30T17:13:31Z

Srafferty: /* Adaptive Hardware */

== Adaptive Hardware/Modifications ==

* [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller]
* [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo]
* [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller]
* [https://testwiki.childsplaycharity.org/wiki/3D_Printing#Adaptive_Equipment List of 3D printable resources]

== Plug-and-play Inputs & Accessories ==
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* https://warfighterengaged.org/shop

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

Inclusive & Accessible Tech

2023-06-30T17:13:11Z

Srafferty: /* Plug-and-play Inputs & Accessories */

== Adaptive Hardware ==

* [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller]
* [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo]
* [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller]
* [https://testwiki.childsplaycharity.org/wiki/3D_Printing#Adaptive_Equipment List of 3D printable resources]

== Plug-and-play Inputs & Accessories ==
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* https://warfighterengaged.org/shop

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

Inclusive & Accessible Tech

2023-06-30T17:12:42Z

Srafferty: /* Adaptive Hardware */

== Adaptive Hardware ==

* [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller]
* [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo]
* [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller]
* [https://testwiki.childsplaycharity.org/wiki/3D_Printing#Adaptive_Equipment List of 3D printable resources]

=== Plug-and-play Inputs & Accessories ===
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* https://warfighterengaged.org/shop

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

Inclusive & Accessible Tech

2023-06-30T17:10:47Z

Srafferty: /* List of 3D printable resources */

== Adaptive Hardware ==

[[3D_Printing#Adaptive_Equipment|test]]

=== [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller] ===

=== [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo] ===

=== [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller] ===

=== [https://testwiki.childsplaycharity.org/wiki/3D_Printing#Adaptive_Equipment List of 3D printable resources] ===

=== Plug-and-play Inputs & Accessories ===
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* https://warfighterengaged.org/shop

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

3D Printing

2023-06-30T14:19:21Z

Srafferty: /* Adaptive Equipment */

Inclusive & Accessible Tech

2023-06-30T14:18:15Z

Srafferty:

== Adaptive Hardware ==

=== [https://www.xbox.com/en-US/accessories/controllers/xbox-adaptive-controller Xbox Adaptive Controller] ===

=== [https://blog.playstation.com/2023/01/04/introducing-project-leonardo-for-playstation-5-a-highly-customizable-accessibility-controller-kit/ Playstation Project Leonardo] ===

=== [https://stores.horiusa.com/flex-controller-for-nintendo-switch/?showHidden=true Nintendo Switch Hori Flex Controller] ===

=== [[3D Printing|List of 3D printable resources]] ===

=== Plug-and-play Inputs & Accessories ===
* [https://www.logitechg.com/en-us/products/gamepads/adaptive-gaming-kit-accessories.943-000318.html?&utm_source=Google&utm_medium=Paid-Search&utm_campaign=Dialect_FY23_Q4_USA_GA_G_DTX-LogiG-Core_Google_na&gclid=EAIaIQobChMIj_Syyfng_QIVlIlbCh08rAR0EAAYASAAEgK3cfD_BwE Logitech Adaptive Kit]
In partnership with Microsoft, Logitech developed the Logitech Adaptive Kit as an inclusive bundle of plug-and-play accessories to use with the Xbox Adaptive Controller. These multi-use switches are compatible with other adaptive hubs that support 3.5mm inputs.

* [https://www.ablenetinc.com/switches/ AbleNet Inc. Switches]

* [https://www.marblesoft.online/switches-and-accessories/ Marblesoft Switches and Accessories]
* https://warfighterengaged.org/shop

== Web Resources ==
* [https://ablenetinc.zendesk.com/hc/en-us/categories/360004948372-Switches AbleNet Assistive Technology Knowledge Base]
* [https://learn.microsoft.com/en-us/training/paths/gaming-accessibility-fundamentals/ Microsoft Learn: Gaming accessibility fundamentals]

== Panels & Talks ==

Volunteers

2023-06-27T16:03:28Z

Srafferty: /* Fliers */

=== Needs and Uses ===
Volunteers can be helpful in day to day tasks and let a Game Tech focus on higher acuity needs or projects. While each hospital program has a unique volunteer recruit/screening process it can be helpful to express certain "skills sets" that would be useful for a Game Tech Volunteer (GTV) vs a typical volunteer, including experience in troubleshooting basic technology and interest/knowledge in current gaming trends. Below are examples of current programs uses of their volunteers.

* Game Kart inventory/maintence
* "Lower priority" (e.g. coping well but bored) bedside sessions
* CCTV support including flier handouts, hosting, or camera work
* Playroom/Teen room supervision and transportation

=== Recruiting ===
Due to daytime shifts, most hospital volunteer programs are primarily composed of college students and retirees. While anyone can have tech knowledge and gaming interest, it tends to be more common in the younger demographic. It can be helpful to speak to your hospital's volunteer department and explore how they are recruiting from this demographic. Are they reaching out directly to local colleges? Attending recruitment fairs common at the start of semesters? These can be easy ways to either attend in person or share fliers/documentation that goes into more detail about becoming a GTV in your hospital.

There also may be current volunteers in your hospital that have interest in tasks a GTV would help with. However it is important to speak with your volunteer department or the volunteer supervisor about sharing or adjusting the volunteers role. Volunteers, particularly good ones, can be hard to find, so you don't want to get the reputation of poaching excellent volunteers.

=== Training and Supervision ===
Each hospital has different standards in training, but if your GTV will be doing unique tasks, you will likely be training them to some extent. Providing documentation volunteers can keep can be helpful as a reference materiel for them in the future and being able to shadow yourself or another volunteer can help them feel more comfortable navigating the medical space and introducing self and resources. See resources section for examples of training assets.

While supervising your volunteers, it is important to provide guidance in the form of referrals. Keeping a running list of patients that would benefit from interactions or reaching out to child life or other peers can help give your volunteers direction, particularly during their first few shifts. More importantly by having the volunteers be independent, you can see other patients or work on projects without having to "babysit". Referral lists are also help for statistic both for keeping metrics and contact tracing if infection control issue arise.

=== Resources ===

==== Volunteer Descriptions ====

==== Training ====
[LINK TO HOSTED PDF OF LURIE MANUAL]

==== Fliers ====
[[File:Lurie Children's Recuirt Flier (Front).png|center|thumb|Lurie Children's Recruitment Flier (front)|304x304px]]
[[File:Lurie Children's Recuritment Flier (back).png|center|thumb|Lurie Children's Recruitment Flier (back)|304x304px]]

Volunteers

2023-06-27T16:01:26Z

Srafferty: /* Training */

=== Needs and Uses ===
Volunteers can be helpful in day to day tasks and let a Game Tech focus on higher acuity needs or projects. While each hospital program has a unique volunteer recruit/screening process it can be helpful to express certain "skills sets" that would be useful for a Game Tech Volunteer (GTV) vs a typical volunteer, including experience in troubleshooting basic technology and interest/knowledge in current gaming trends. Below are examples of current programs uses of their volunteers.

* Game Kart inventory/maintence
* "Lower priority" (e.g. coping well but bored) bedside sessions
* CCTV support including flier handouts, hosting, or camera work
* Playroom/Teen room supervision and transportation

=== Recruiting ===
Due to daytime shifts, most hospital volunteer programs are primarily composed of college students and retirees. While anyone can have tech knowledge and gaming interest, it tends to be more common in the younger demographic. It can be helpful to speak to your hospital's volunteer department and explore how they are recruiting from this demographic. Are they reaching out directly to local colleges? Attending recruitment fairs common at the start of semesters? These can be easy ways to either attend in person or share fliers/documentation that goes into more detail about becoming a GTV in your hospital.

There also may be current volunteers in your hospital that have interest in tasks a GTV would help with. However it is important to speak with your volunteer department or the volunteer supervisor about sharing or adjusting the volunteers role. Volunteers, particularly good ones, can be hard to find, so you don't want to get the reputation of poaching excellent volunteers.

=== Training and Supervision ===
Each hospital has different standards in training, but if your GTV will be doing unique tasks, you will likely be training them to some extent. Providing documentation volunteers can keep can be helpful as a reference materiel for them in the future and being able to shadow yourself or another volunteer can help them feel more comfortable navigating the medical space and introducing self and resources. See resources section for examples of training assets.

While supervising your volunteers, it is important to provide guidance in the form of referrals. Keeping a running list of patients that would benefit from interactions or reaching out to child life or other peers can help give your volunteers direction, particularly during their first few shifts. More importantly by having the volunteers be independent, you can see other patients or work on projects without having to "babysit". Referral lists are also help for statistic both for keeping metrics and contact tracing if infection control issue arise.

=== Resources ===

==== Volunteer Descriptions ====

==== Training ====
[LINK TO HOSTED PDF OF LURIE MANUAL]

==== Fliers ====
[[File:Lurie Children's Recuirt Flier (Front).png|center|thumb|Lurie Children's Recruitment Flier (front)]]
[[File:Lurie Children's Recuritment Flier (back).png|center|thumb|Lurie Children's Recruitment Flier (back)]]

Volunteers

2023-06-27T15:44:23Z

Srafferty: /* Resources */

=== Needs and Uses ===
Volunteers can be helpful in day to day tasks and let a Game Tech focus on higher acuity needs or projects. While each hospital program has a unique volunteer recruit/screening process it can be helpful to express certain "skills sets" that would be useful for a Game Tech Volunteer (GTV) vs a typical volunteer, including experience in troubleshooting basic technology and interest/knowledge in current gaming trends. Below are examples of current programs uses of their volunteers.

* Game Kart inventory/maintence
* "Lower priority" (e.g. coping well but bored) bedside sessions
* CCTV support including flier handouts, hosting, or camera work
* Playroom/Teen room supervision and transportation

=== Recruiting ===
Due to daytime shifts, most hospital volunteer programs are primarily composed of college students and retirees. While anyone can have tech knowledge and gaming interest, it tends to be more common in the younger demographic. It can be helpful to speak to your hospital's volunteer department and explore how they are recruiting from this demographic. Are they reaching out directly to local colleges? Attending recruitment fairs common at the start of semesters? These can be easy ways to either attend in person or share fliers/documentation that goes into more detail about becoming a GTV in your hospital.

There also may be current volunteers in your hospital that have interest in tasks a GTV would help with. However it is important to speak with your volunteer department or the volunteer supervisor about sharing or adjusting the volunteers role. Volunteers, particularly good ones, can be hard to find, so you don't want to get the reputation of poaching excellent volunteers.

=== Training and Supervision ===
Each hospital has different standards in training, but if your GTV will be doing unique tasks, you will likely be training them to some extent. Providing documentation volunteers can keep can be helpful as a reference materiel for them in the future and being able to shadow yourself or another volunteer can help them feel more comfortable navigating the medical space and introducing self and resources. See resources section for examples of training assets.

While supervising your volunteers, it is important to provide guidance in the form of referrals. Keeping a running list of patients that would benefit from interactions or reaching out to child life or other peers can help give your volunteers direction, particularly during their first few shifts. More importantly by having the volunteers be independent, you can see other patients or work on projects without having to "babysit". Referral lists are also help for statistic both for keeping metrics and contact tracing if infection control issue arise.

=== Resources ===

==== Volunteer Descriptions ====

==== Training ====

==== Fliers ====
[[File:Lurie Children's Recuirt Flier (Front).png|center|thumb|Lurie Children's Recruitment Flier (front)]]
[[File:Lurie Children's Recuritment Flier (back).png|center|thumb|Lurie Children's Recruitment Flier (back)]]

Volunteers

2023-06-27T15:42:26Z

Srafferty: /* Resources */

=== Needs and Uses ===
Volunteers can be helpful in day to day tasks and let a Game Tech focus on higher acuity needs or projects. While each hospital program has a unique volunteer recruit/screening process it can be helpful to express certain "skills sets" that would be useful for a Game Tech Volunteer (GTV) vs a typical volunteer, including experience in troubleshooting basic technology and interest/knowledge in current gaming trends. Below are examples of current programs uses of their volunteers.

* Game Kart inventory/maintence
* "Lower priority" (e.g. coping well but bored) bedside sessions
* CCTV support including flier handouts, hosting, or camera work
* Playroom/Teen room supervision and transportation

=== Recruiting ===
Due to daytime shifts, most hospital volunteer programs are primarily composed of college students and retirees. While anyone can have tech knowledge and gaming interest, it tends to be more common in the younger demographic. It can be helpful to speak to your hospital's volunteer department and explore how they are recruiting from this demographic. Are they reaching out directly to local colleges? Attending recruitment fairs common at the start of semesters? These can be easy ways to either attend in person or share fliers/documentation that goes into more detail about becoming a GTV in your hospital.

There also may be current volunteers in your hospital that have interest in tasks a GTV would help with. However it is important to speak with your volunteer department or the volunteer supervisor about sharing or adjusting the volunteers role. Volunteers, particularly good ones, can be hard to find, so you don't want to get the reputation of poaching excellent volunteers.

=== Training and Supervision ===
Each hospital has different standards in training, but if your GTV will be doing unique tasks, you will likely be training them to some extent. Providing documentation volunteers can keep can be helpful as a reference materiel for them in the future and being able to shadow yourself or another volunteer can help them feel more comfortable navigating the medical space and introducing self and resources. See resources section for examples of training assets.

While supervising your volunteers, it is important to provide guidance in the form of referrals. Keeping a running list of patients that would benefit from interactions or reaching out to child life or other peers can help give your volunteers direction, particularly during their first few shifts. More importantly by having the volunteers be independent, you can see other patients or work on projects without having to "babysit". Referral lists are also help for statistic both for keeping metrics and contact tracing if infection control issue arise.

=== Resources ===
[[File:Lurie Children's Recuirt Flier (Front).png|center|thumb|Lurie Children's Recruitment Flier (front)]]
[[File:Lurie Children's Recuritment Flier (back).png|center|thumb|Lurie Children's Recruitment Flier (back)]]

File:Lurie Children's Recuritment Flier (back).png

2023-06-27T15:41:57Z

Srafferty:

Ann and Robert H Lurie Children's Hospital of Chicago game and technology volunteer recruitment flier back

File:Lurie Children's Recuirt Flier (Front).png

2023-06-27T15:38:50Z

Srafferty:

The front of Ann and Robert H Lurie Children's Hospital of Chicago tech and gaming volunteer recruitment flier

Volunteers

2023-06-27T15:34:43Z

Srafferty:

Volunteers

2023-06-27T15:30:40Z

Srafferty:

=== Needs and Uses ===
Volunteers can be helpful in day to day tasks and let a Game Tech focus on higher acuity needs or projects. While each hospital program has a unique volunteer recruit/screening process it can be helpful to express certain "skills sets" that would be useful for a Game Tech Volunteer (GTV) vs a typical volunteer, including experience in troubleshooting basic technology and interest/knowledge in current gaming trends. Below are examples of current programs uses of their volunteers.

* Game Kart inventory/maintence
* "Lower priority" (e.g. coping well but bored) bedside sessions
* CCTV support including flier handouts, hosting, or camera work
* Playroom/Teen room supervision and transportation

=== Recruiting ===
Due to daytime shifts, most hospital volunteer programs are primarily composed of college students and retirees. While anyone can have tech knowledge and gaming interest, it tends to be more common in the younger demographic. It can be helpful to speak to your hospital's volunteer department and explore how they are recruiting from this demographic. Are they reaching out directly to local colleges? Attending recruitment fairs common at the start of semesters? These can be easy ways to either attend in person or share fliers/documentation that goes into more detail about becoming a GTV in your hospital.

There also may be current volunteers in your hospital that have interest in tasks a GTV would help with. However it is important to speak with your volunteer department or the volunteer supervisor about sharing or adjusting the volunteers role. Volunteers, particularly good ones, can be hard to find, so you don't want to get the reputation of poaching excellent volunteers.

=== Training and Supervising ===
Each hospital has different standards in training, but if your GTV will be doing unique tasks, you will likely be training them to some extent. Providing documentation volunteers can keep can be helpful as a reference materiel for them in the future and being able to shadow yourself or another volunteer can help them feel more comfortable navigating the medical space and introducing self and resources. See resources section for examples of training assets.

=== Resources ===

Charting

2023-06-13T16:52:30Z

Srafferty: /* Tips */

==Importance of Charting==
While Game Techs are not providing direct medical care for patients and families, it can be argued that providing documentation of interactions is an important aspect of the profession. Not only can this provide an easy source of trackable metrics, but can help provide continuity of care for long term or frequent admission patients. Documentation can remind staff to provide formal referrals at re-admission, help carry over coping/socialization plans, and increase exposure of the role to other team members. Each hospital program has different philosophies on what is considered "chart worthy" information so you may need to advocate to have this access granted for your role. Reaching out to other social/emotional support teams such as Child Life or Creative Arts can give insight into their process and can be used as starting template. As the Game Tech profession grows, exploring and creating standards of care will become increasingly important and which may include standardization of charting.

==Potential Content to Chart==
- Services Provided

- Time Spent (both with patient and working on projects tied to them)

- Response to interventions (change in mood/affect, verbal gratitude/excitement, increase movement/tolerances, pain levels [will need to be verbally prompted before and after intervention to effectively track])

- Intervention/Game preferences

- Presence during co-treat sessions

- VR screening results (if they pass/fail established guidelines)

- Future and Long term goals

- Source of referral

==Examples from Established Programs==

===Ann & Robert H Lurie Children's Hospital of Chicago===
Lurie Children's charts using EPIC and game techs use a combination of flowcharts and narrative notes. All interactions are documented using drop down menus in the flowchart and if interactions are more complex (co-treat, long term goals, etc), the data is pulled into a narrative note, where the game tech provides more detail as needed. Examples used under Provided Service include: introduction, normalization, socialization, co-treat, procedure support, education, and troubleshooting.

[[File:Chart Flowsheet.png|center|thumb|Epic Flow Sheet]]

===Upstate Golisano Children's Hospital===
Upstate Golisano Children's Hospital charts using EPIC and game techs use a combination of manual charting and smart notes. All interactions are documented using drop down menus, or fill in the blanks. If interactions are more complex, a detailed manually written note is included in the session summary section.

''(choices are in parenthesis)''<blockquote>'''Gaming & Technology Specialist Progress Note:'''

'''Session Type:''' (Introduction and overview of services / Offer of game play session / PlayStation game play session / Xbox game play session / Nintendo Switch game play session / Technology Assistance/Maintenance).

'''Session Length:''' ___ minutes.

Patient was (alone / with ___) (in room / in playroom / other).

Prior to session start, patient appeared (comfortable / in pain / upset / anxious / fatigued / other), as evidenced by ___.

'''Session Summary:''' [will be one of the three options below]

'''Game Session:''' Gaming and Technology Specialist was referred to patient by (Child Life Specialist / Other) ___. Gaming and Technology Specialist met patient and ___ at the bedside (to provide introduction and overview of services) (Patient known to this writer from previous admissions) Patient chose to play ___ (competitively / cooperatively) with this writer (continuing from previous session). This writer spent approximately ___ minutes with patient in session. Patient was (not very / somewhat / very) talkative and engaging throughout session. Session paused to allow for medical team to speak with patient and ___. (play continued / session ended) afterwards.

'''Patient Declined:''' This writer offered services, patient politely declined at this time. (Patient stated they were not interested in video games / other reasoning)

'''Technical Issues:''' Gaming & Technology Specialist was asked to visit patient room to assist with the gaming system. Patient was having trouble getting the (system / controller) working. This writer resolved the issues (and replaced the (system / controller) with a working one.) This writer confirmed the system was working correctly before leaving the room. This writer will continue to assist for any future needs.

Optional: Patient and ___ thanked this writer for (game session / game delivery / technical assistance).

Optional: Patient continued playing after this writer left the room.

'''Plans:''' (Anticipate that patient will be discharged prior to additional follow-up / Will continue to follow throughout inpatient hospital course / Will continue to be available for any future needs)</blockquote>

===Connecticut Children's===
Connecticut Children's Child Life Gaming and Technology Specialist (GTS) utilizes narrative chart notes on EPIC to document their interventions with patients. The purpose of these narrative notes is to tell a story about the impact that the GTS has on the patient's care plan. These notes can be reviewed by other professionals on the patient's care team, as well as the patient's family.

Actions to hit in nearly every chart note at Connecticut Children's are:
* Target(s)/goal(s) of intervention (normalization, socialization, coping, diversion, boredom, co-treat with physical/occupational therapies, assistive technology support, sibling support, etc.)
* Where the patient was engaged (bedside, unit playroom, Family Resource Center, etc.)
* How the patient was engaged, brief explanation of equipment used or provided throughout engagement, collaborative/co-op, or competitive session
* Patient's history with gaming and technology (teaching or orientation required prior to session?)
* Patient's affect/demeanor prior to engagement
* Patient's affect/demeanor during engagement
* Patient's affect/demeanor following engagement
* Challenges/successes experienced throughout
* Intentions of further GTS intervention throughout remainder of admission

This GTS also utilizes EPIC SmartPhrases, where possible, to aid in the efficiency and consistency of documenting patient interventions. SmartPhrases will not tell the whole story and the note will typically require additional details specific to each patient for the intervention to be described. Below are examples of SmartPhrases that can be used:

[[File:SmartPhrases23.png|center|Connecticut Children's EPIC SmartPhrases|800x800px|thumb]]

==Tips==

* If using EPIC, create SartPhrases for common interactions (introductions, bedsides etc) that allows you to just fill in specifics for that session and in turn saves a lot of time.

Charting

2023-06-13T16:42:57Z

Srafferty:

==Importance of Charting==
While Game Techs are not providing direct medical care for patients and families, it can be argued that providing documentation of interactions is an important aspect of the profession. Not only can this provide an easy source of trackable metrics, but can help provide continuity of care for long term or frequent admission patients. Documentation can remind staff to provide formal referrals at re-admission, help carry over coping/socialization plans, and increase exposure of the role to other team members. Each hospital program has different philosophies on what is considered "chart worthy" information so you may need to advocate to have this access granted for your role. Reaching out to other social/emotional support teams such as Child Life or Creative Arts can give insight into their process and can be used as starting template. As the Game Tech profession grows, exploring and creating standards of care will become increasingly important and which may include standardization of charting.

==Potential Content to Chart==
- Services Provided

- Time Spent (both with patient and working on projects tied to them)

- Response to interventions (change in mood/affect, verbal gratitude/excitement, increase movement/tolerances, pain levels [will need to be verbally prompted before and after intervention to effectively track])

- Intervention/Game preferences

- Presence during co-treat sessions

- VR screening results (if they pass/fail established guidelines)

- Future and Long term goals

- Source of referral

==Examples from Established Programs==

===Ann & Robert H Lurie Children's Hospital of Chicago===
Lurie Children's charts using EPIC and game techs use a combination of flowcharts and narrative notes. All interactions are documented using drop down menus in the flowchart and if interactions are more complex (co-treat, long term goals, etc), the data is pulled into a narrative note, where the game tech provides more detail as needed. Examples used under Provided Service include: introduction, normalization, socialization, co-treat, procedure support, education, and troubleshooting.

[[File:Chart Flowsheet.png|center|thumb|Epic Flow Sheet]]

===Upstate Golisano Children's Hospital===
Upstate Golisano Children's Hospital charts using EPIC and game techs use a combination of manual charting and smart notes. All interactions are documented using drop down menus, or fill in the blanks. If interactions are more complex, a detailed manually written note is included in the session summary section.

''(choices are in parenthesis)''<blockquote>'''Gaming & Technology Specialist Progress Note:'''

'''Session Type:''' (Introduction and overview of services / Offer of game play session / PlayStation game play session / Xbox game play session / Nintendo Switch game play session / Technology Assistance/Maintenance).

'''Session Length:''' ___ minutes.

Patient was (alone / with ___) (in room / in playroom / other).

Prior to session start, patient appeared (comfortable / in pain / upset / anxious / fatigued / other), as evidenced by ___.

'''Session Summary:''' [will be one of the three options below]

'''Game Session:''' Gaming and Technology Specialist was referred to patient by (Child Life Specialist / Other) ___. Gaming and Technology Specialist met patient and ___ at the bedside (to provide introduction and overview of services) (Patient known to this writer from previous admissions) Patient chose to play ___ (competitively / cooperatively) with this writer (continuing from previous session). This writer spent approximately ___ minutes with patient in session. Patient was (not very / somewhat / very) talkative and engaging throughout session. Session paused to allow for medical team to speak with patient and ___. (play continued / session ended) afterwards.

'''Patient Declined:''' This writer offered services, patient politely declined at this time. (Patient stated they were not interested in video games / other reasoning)

'''Technical Issues:''' Gaming & Technology Specialist was asked to visit patient room to assist with the gaming system. Patient was having trouble getting the (system / controller) working. This writer resolved the issues (and replaced the (system / controller) with a working one.) This writer confirmed the system was working correctly before leaving the room. This writer will continue to assist for any future needs.

Optional: Patient and ___ thanked this writer for (game session / game delivery / technical assistance).

Optional: Patient continued playing after this writer left the room.

'''Plans:''' (Anticipate that patient will be discharged prior to additional follow-up / Will continue to follow throughout inpatient hospital course / Will continue to be available for any future needs)</blockquote>

===Connecticut Children's===
Connecticut Children's Child Life Gaming and Technology Specialist (GTS) utilizes narrative chart notes on EPIC to document their interventions with patients. The purpose of these narrative notes is to tell a story about the impact that the GTS has on the patient's care plan. These notes can be reviewed by other professionals on the patient's care team, as well as the patient's family.

Actions to hit in nearly every chart note at Connecticut Children's are:
* Target(s)/goal(s) of intervention (normalization, socialization, coping, diversion, boredom, co-treat with physical/occupational therapies, assistive technology support, sibling support, etc.)
* Where the patient was engaged (bedside, unit playroom, Family Resource Center, etc.)
* How the patient was engaged, brief explanation of equipment used or provided throughout engagement, collaborative/co-op, or competitive session
* Patient's history with gaming and technology (teaching or orientation required prior to session?)
* Patient's affect/demeanor prior to engagement
* Patient's affect/demeanor during engagement
* Patient's affect/demeanor following engagement
* Challenges/successes experienced throughout
* Intentions of further GTS intervention throughout remainder of admission

This GTS also utilizes EPIC SmartPhrases, where possible, to aid in the efficiency and consistency of documenting patient interventions. SmartPhrases will not tell the whole story and the note will typically require additional details specific to each patient for the intervention to be described. Below are examples of SmartPhrases that can be used:
[[File:SmartPhrases23.png|center|Connecticut Children's EPIC SmartPhrases|frameless|900x900px]]

==Tips==

Gaming & CCTV Studio Charities

2023-05-30T17:57:27Z

Srafferty: /* Summary */

== Summary ==
Charities and non-profits that have a primary mission revolving around games, technology, or similar outlets that are useful with kids and teens.

{| class="wikitable sortable"
|+
!Charity Name
!Provides Devices
!Provides Volunteers
!Position Funding
!Game Carts
!Adaptive Resources
!Education\ Training
!Discretionary Funds
!Sells Items
!Named Spaces
|-
|[https://childsplaycharity.org/ Child's Play]
|X
|
|X
|
|
|
|X
|
|
|-
|[https://ablegamers.org/ Able Gamers]
|X
|
|
|
|X
|X
|
|
|
|-
|[https://www.specialeffect.org.uk/ Special Effect]
|
|
|
|
|X
|
|
|
|
|-
|[https://www.charity-gaming.org/ Charity Gaming]
|X
|
|
|
|
|
|
|
|
|-
|[https://gamersoutreach.org/ Gamers Outreach]
|
|X
|
|X
|
|
|
|X
|
|-
|[https://gametogrow.org/ Game to Grow]
|
|
|
|
|
|X
|
|
|
|-
|[https://bungiefoundation.org/ Bungie Foundation]
|X
|
|
|
|
|
|
|
|
|-
|[https://www.buildupsteam.org/ Buildup STEAM]
|X
|
|
|
|
|
|
|
|
|-
|[https://www.joyinchildhoodfoundation.org/what-we-do/connectingjoy/ Dunkin Joy]
|X
|
|X
|
|
|
|X
|
|
|-
|[https://www.teammatesforkids.com/ Teammates for Kids]
|
|
|
|
|
|
|
|
|X
|-
|[https://www.ryanseacrestfoundation.org/ Ryan Seacrest Foundation]
|
|
|
|
|
|
|
|
|X
|-
|[https://www.starlight.org/ Starlight Foundation]
|X
|
|
|X
|
|
|
|X
|
|}

Gaming & CCTV Studio Charities

2023-05-30T17:54:51Z

Srafferty: /* Summary */

== Summary ==
Charities and non-profits that have a primary mission revolving around games, technology, or similar outlets that are useful with kids and teens.

{| class="wikitable sortable"
|+
!Charity Name
!Provides Devices
!Provides Volunteers
!Position Funding
!Game Carts
!Adaptive Resources
!Education\ Training
!Discretionary Funds
!Sells Items
!Named Spaces
|-
|[https://childsplaycharity.org/ Child's Play]
|X
|
|X
|
|
|
|X
|
|
|-
|[https://ablegamers.org/ Able Gamers]
|X
|
|
|
|X
|X
|
|
|
|-
|[https://www.specialeffect.org.uk/ Special Effect]
|
|
|
|
|X
|
|
|
|
|-
|[https://www.charity-gaming.org/ Charity Gaming]
|X
|
|
|
|
|
|
|
|
|-
|[https://gamersoutreach.org/ Gamers Outreach]
|
|X
|
|X
|
|
|
|X
|
|-
|[https://gametogrow.org/ Game to Grow]
|
|
|
|
|
|X
|
|
|
|-
|[https://bungiefoundation.org/ Bungie Foundation]
|X
|
|
|
|
|
|
|
|
|-
|[https://www.buildupsteam.org/ Buildup STEAM]
|X
|
|
|
|
|
|
|
|
|-
|[https://www.joyinchildhoodfoundation.org/ Dunkin Joy]
|X
|
|X
|
|
|
|X
|
|
|-
|[https://www.teammatesforkids.com/ Teammates for Kids]
|
|
|
|
|
|
|
|
|X
|-
|[https://www.ryanseacrestfoundation.org/ Ryan Seacrest Foundation]
|
|
|
|
|
|
|
|
|X
|-
|[https://www.starlight.org/ Starlight Foundation]
|X
|
|
|X
|
|
|
|X
|
|}

3D Printing

2023-05-30T17:44:28Z

Srafferty: /* Sanitizing */

3D Printing

2023-05-30T17:43:59Z

Srafferty: /* Models of Printers */

Filament

2023-05-30T17:38:35Z

Srafferty:

Return to [[3D Printing]]

== PLA ==
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

== ABS ==
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

== PET (PETG) ==
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

== TPU ==
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

== ASA ==
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

3D Printing Software

2023-05-30T17:38:17Z

Srafferty:

Return to [[3D Printing]]

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

Models of 3D Printers

2023-05-30T17:37:25Z

Srafferty:

Return to [[3D Printing]]

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}
=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

3D Printing

2023-05-30T17:36:16Z

Srafferty: /* Filament */

Filament

2023-05-30T17:34:52Z

Srafferty: /* Summary */

== PLA ==
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

== ABS ==
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

== PET (PETG) ==
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

== TPU ==
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

== ASA ==
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

3D Printing

2023-05-30T17:33:45Z

Srafferty: /* Lithophanes */

3D Printing

2023-05-30T17:33:28Z

Srafferty: /* Slicers */

Filament

2023-05-30T17:32:10Z

Srafferty: /* Summary */

== Summary ==
Fused deposition modeling (FDM) printers use rolls of filament as their material source and are several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

== PLA ==
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

== ABS ==
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

== PET (PETG) ==
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

== TPU ==
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

== ASA ==
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

Filament

2023-05-30T17:31:58Z

Srafferty: /* Summery */

== Summary ==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

== PLA ==
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

== ABS ==
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

== PET (PETG) ==
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

== TPU ==
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

== ASA ==
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

Filament

2023-05-30T17:31:29Z

Srafferty:

== Summery ==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

== PLA ==
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

== ABS ==
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

== PET (PETG) ==
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

== TPU ==
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

== ASA ==
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

Filament

2023-05-30T17:30:02Z

Srafferty: Created page with "Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs. ===PLA=== PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, bio..."

Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

3D Printing Software

2023-05-30T17:29:19Z

Srafferty: Created page with "==Slicers== Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the filament being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer. ===[https..."

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

3D Printing

2023-05-30T17:28:35Z

Srafferty: /* Models of Printers */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable code, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==
'''FDM vs SLA in Healthcare Settings'''

There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

'''Models/Scans as PHI'''

(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==[[Models of 3D Printers|Models of Printers]]==
(click above to visit page)

==[[3D Printing Software|Software]]==
(click above to visit page)

==[[Filament]]==
(click above to visit page)

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-30T17:26:30Z

Srafferty: /* Models of Printers */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable code, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==
'''FDM vs SLA in Healthcare Settings'''

There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

'''Models/Scans as PHI'''

(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==[[Models of 3D Printers|Models of Printers]]==
(click above to visit page)

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

Models of 3D Printers

2023-05-30T17:24:24Z

Srafferty:

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}
=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

Models of 3D Printers

2023-05-30T17:24:05Z

Srafferty:

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}
=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

Models of 3D Printers

2023-05-30T17:23:00Z

Srafferty: Created page with "=== Designed for Industries === {| class="wikitable" |center | ==== Makerbot Method ==== '''Brand:''' Makerbot '''Current Programs Using:''' '''Build Volume:''' '''Features:''' '''Limitations:''' '''Default Slicer:''' '''Cost:''' |- |center | ==== Ultimaker S5 ==== '''Brand:''' '''Current Programs Using:''' '''Build Volume:'''..."

3D Printing

2023-05-30T17:21:21Z

Srafferty:

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable code, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==
'''FDM vs SLA in Healthcare Settings'''

There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

'''Models/Scans as PHI'''

(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==[[Models of 3D Printers|Models of Printers]]==
[[File:3D Printer Placeholder.png|left|thumb|200x200px|Placeholder Pic]]

==== Name (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:24:36Z

Srafferty: /* Name (template) */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable code, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|200x200px|Placeholder Pic]]

==== Name (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:24:10Z

Srafferty: /* Summary */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable code, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|200x200px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:23:25Z

Srafferty: /* Designed for Industries */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|200x200px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:22:44Z

Srafferty: /* Designed for Industries */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|200x200px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:22:02Z

Srafferty: /* Name (template) */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:21:49Z

Srafferty: /* Policies & Procedures */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:21:21Z

Srafferty: /* 3D Models */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

==Best Practices==

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA). PHI concerns primarily come in the following form:

* '''3D Scans'''
** The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

* '''Printing Patient Data'''
** Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

* '''Storage of Patient Data'''
** The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance]

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
Example Text

===Sanitizing===
It is rare that direct interaction with a 3D printer would be necessary for a patient or patient's room, so ignoring day to day cleaning, sanitizing is not a concern. As for models, prints are typically inexpensive so models given to patients should often be treated as giveaways and will not be sanitized.

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:14:03Z

Srafferty:

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

==Best Practices==

=== 3D Models ===
A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA)

PHI concerns primarily come in the following form:

'''3D Scans'''

The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

'''Printing Patient Data'''

Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

'''Storage of Patient Data'''

The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance].

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

[Consents needed? File labels? Cloud usage?]

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
Example Text

===Sanitizing===
Example Text

==Account Settings & Management==
Example Text

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Prusa MK3S+ (template) ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:13:39Z

Srafferty: /* Designed for Industries */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

==Best Practices==

=== 3D Models ===
A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA)

PHI concerns primarily come in the following form:

'''3D Scans'''

The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

'''Printing Patient Data'''

Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

'''Storage of Patient Data'''

The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance].

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

[Consents needed? File labels? Cloud usage?]

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
Example Text

===Sanitizing===
Example Text

==Account Settings & Management==
Example Text

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Makerbot Method ====
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
==== Ultimaker S5 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
==== Dremel DigiLab 3D45 ====
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
==== Adventurer 4 ====
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
==== Ender 3 Pro ====
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== '''Prusa MK3S+ (template)''' ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Flashforge Creator Pro 2 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
==== Bambu Labs Carbon X1 ====
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:11:51Z

Srafferty: /* 3D Scans */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

==Best Practices==

=== 3D Models ===
A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA)

PHI concerns primarily come in the following form:

'''3D Scans'''

The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

'''Printing Patient Data'''

Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

'''Storage of Patient Data'''

The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance].

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

[Consents needed? File labels? Cloud usage?]

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
Example Text

===Sanitizing===
Example Text

==Account Settings & Management==
Example Text

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
===Makerbot Method===
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
===Ultimaker S5===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
===Dremel DigiLab 3D45===
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
|
|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
===Adventurer 4===
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
===Ender 3 Pro===
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|'''Prusa MK3S+ (template)'''
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
===Flashforge Creator Pro 2===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
===Bambu Labs Carbon X1===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
Example Text

==Adaptive & Inclusive options==
Example Text

==Additional Resources==
Example Text

3D Printing

2023-05-22T18:10:52Z

Srafferty: /* FDM vs SLA in Healthcare Settings */

== Summary ==
3D printers are tools to help bring 3D models or scans into the real world. While the technology has been present for numerous years, it has only been in the past few years that this technology has been available to the consumer market. Becoming more affordable, accessible, and applicable to almost every industry (e.g., local libraries, schools, and even individuals owning a 3D printer for as little as a few hundred dollars). In the healthcare setting, these machines have near limitless use potential from simply being a fun "toy factory", unique end product for an art/design project, resource for adaptive and medical education equipment, a personalized keepsake from a bereavement experience or several other uses your team or adjacent departments can dream up.

The most common steps involved with 3D printing, from start to finish, is the creation of a 3D model, conversion into a sliceable model, printing, and post processing. For each step, there are a variety of options, and subsequent learning curve that makes picking a printer, software program, and 3D model an important decision. Which is why it is a tool that perfectly fits the role of Game Techs, as most other hospital programs may not have the flexibility or bandwidth to tackle the education needed to fully utilize a 3D printing initiative within the healthcare settings.

==Best Practices==

=== 3D Models ===
A 3D model is a digital representation of a three-dimensional object, surface, or scene created using specialized computer software. 3D models can be used for a variety for purposes, such as animation, gaming, prototyping, simulation, and visualization. Computer-aided design (CAD) is the primarily type of software application used to design, modify, analyze, and optimize designs in a virtual environment. 3D models are integral in 3D printing, it is the digital instructions that a 3D printer needs in order to create a physical object.

=== FDM vs SLA in Healthcare Settings ===
There are a wide variety of commercially available 3D printing processes, that utilize a variety of techniques and materials to create a physical object from a digital model. In the non-clinical pediatric healthcare settings, there are two suitable technologies that standout: fused deposition modeling (FDM) and stereolithography (SLA).

FDM is the most widely used and works by extruding thermoplastic filaments, through a heated nozzle to rapidly heat and cool plastic, building up the physical model layer by layer. FDM is the most popular process because offers the most simplicity, low cost, and versatility. Through FDM, a printer uses string-like plastic (known as filament) to print parts with layer height accuracy of 100-200 microns (0.1-0.2 mms) and minimal post-processing needs.

SLA uses a UV layer to selectively cure a liquid resin, creating a physical object layer by layer out of a pool of liquid plastic. SLA primary difference from FDM, is that it uses light and liquid technology to develop parts with layer height accuracy as small as 25 microns (0.025mm), offering more detailed and complex geometries with finer features and smoother surfaces. However, this requires a much more in-depth and timely post-processing procedure in order to safely handle the final product. Known as curing and washing, these steps use potentially harmful liquid solutions that require ventilation, gloves, and other protective equipment.

Overall FDM is likely the best initial fit for use in the non-clinical healthcare setting, as it has a simplified workflow process and does not require extensive safety accommodations. However, every program is different in needs and accommodations, so it is helpful to know if your hospital program has alternative locations/workshops/etc - potentially opening the door to the variety of 3D printing technologies available.

===Models/Scans as PHI===
(This section will be a general rule of thumb, please remember to always check with your specific hospital's guidelines and rules for topics on PHI/HIPAA)

PHI concerns primarily come in the following form:

==== 3D Scans ====
The primary concern with scans regards the act of photographing and converting 2D images of the patient (whether it be partial body, full body, with/without family members, etc) into 3D renders. From facial scans to fingerprints, there are many identifiable features that may or may not fall under PHI/HIPAA concerns.

==== Printing Patient Data ====
Many programs display the 3D printer and ongoing printing process to patients, families, and guests. When printing personalized data/models (e.g., patient scans, bereavement/legacy items, etc) please keep in my who may be able to see the end product.

==== Storage of Patient Data ====
The largest concern lies in how data is stored, what is stored, and who has access to it. Metadata used to label the 3D model/file should always be anonymized (e.g., patient name, date of birth, etc). Other considerations, many 3D printing slicers, programs, and companies are moving to a cloud storage solution, which increases the security risk for data leaks and the need for the cloud service providers on behalf of healthcare providers to ensure confidentiality, integrity, and availability of PHI stored. For more information on [https://www.hhs.gov/hipaa/for-professionals/special-topics/cloud-computing/index.html HIPAA cloud-computing] and general [https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html HIPAA security guidance].

While many hospitals have various operating procedures and standards, consent forms are always a safe step in ensuring and protecting staff and the hospital in a similar capacity as to when photography and videography is used.

[Consents needed? File labels? Cloud usage?]

==Recommended Uses==
===Normalization/Play===
A 3D printer can simply be a fun way to engage and play with a patient while they are hospitalized. The "wow" factor is typically enough to ice break most interactions and there are numerous fun and free models available on the internet to print favorite characters, and fun fidgets. It is also can be a great expression tool where a patient can create a 3D model in [[Tinkercad]] or in a VR sculpting program and then have the physical end product. This can be great for extended admissions or "frequent fliers" to have long term projects to work on while hospitalized. Patients and families will often come up with fun and unique ideas once they wrap their head around what a 3D printer can do, so ask away! Below are some examples shared by numerous programs:

* A 3D scan of a siblings face was added to a generic game piece and used in numerous games the patient and sibling would play over video chat.
* A patient explored options for IV line management, as they were often frustrated as things would get tangled and independently found carabiner clip models to print.

===Medical Play/Education===
Medical play and education is large aspect of how a Child Life Specialists can help a patient and their family cope with being in the healthcare environment. Utilization of real medical materials is particularly helpful as it gives a concrete experience for the child and allows them to explore what actually be used for their care, thus making it less surprising/scary. However medical items are typically expensive and unique items such as trachs or g-tubes are in limited supply for teaching and typically the patient is not able to keep said item after an education session. Using 3D printing, models of these items can be printed to real life specs and used in sessions with patients who in turn can keep them at bedside to continue medical play even after the CCLS has left the room. Models can also be scaled up to explore aspects in greater details or scaled down to fit teddy bears or medical dolls. While the exact textures and colors may be different then the real models, 3D printed models will still provide a positive impact. Meet with your child life team to explore what items would be most utilized and explore modeling the item yourself or use program curated collections list below.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Adaptive Equipment===
Adaptive equipment is often expensive and at time difficult to obtain in the health care setting. While some devices are complex and tailored to the individually, others can be fairly simplistic and universal. 3D printing allows a quick/cheap resource for patients and can help them participate in other distracting/normalizing activities while hospitalized. These devices may be only needed temporarily if a patient is simply weak from treatment/recovery or preeminent due to a diagnosis or injury. It will likely be beneficial to consult your child life, rehabilitation, or orthotics teams to explore current needs/deficits. That being said simple tools like grips can be helpful in art or music therapy sessions and there are numerous options that can be utilized with gaming and other tech that would be utilized gaming focused bedside sessions. Here are a few models or curated collections that may be helpful.

*[https://www.printables.com/@LurieChildren_642788/models Models created at Ann and Robert H Lurie Children's Hospital of Chicago]
*[https://www.printables.com/@RileyCLZTechS_331130/models Models created at Riley Hospital for Children]

===Legacy/Bereavement Items===
3D printing can provide unique and powerful keepsakes in memory making for a family. This is a difficult and nuanced experience which often has social workers, Chaplins, or child life specialists being the main emotional support during these experiences. Touching with these teams or your hospital palliative care department is a good first step to explore how 3D printing can help during the experiences. From there it is important to establish a referral system, realistic time lines, and print limits for this process to be sustainable. Often one may be tempted to be over accommodating due to weight of these interactions, but having clearly defined and upheld limits is important. We have listed some common model type/techniques that programs use in Legacy Building/Bereavement referrals.

==== Lithophanes====

== Policies & Procedures==
Example Text

===Sanitizing===
Example Text

==Account Settings & Management==
Example Text

==Models of Printers==
[[File:3D Printer Placeholder.png|left|thumb|300x300px|Placeholder Pic]]

===Name (template)===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''

=== Designed for Industries ===
{| class="wikitable"
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
===Makerbot Method===
'''Brand:''' Makerbot

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|300x300px|Placeholder Pic|center]]
|
===Ultimaker S5===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
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|[[File:Dremel DigiLab 3D45.png|center|thumb|Dremel DigiLab 3D45]]
|
===Dremel DigiLab 3D45===
'''Brand:''' Dremel

'''Current Programs Using:''' Hassenfeld Children's Hospital at NYU Langone

'''Build Volume:''' 255 x 155 x 170 mm (10 x 6 x 6.7 in)

'''Features:''' Enclosed, heated glass bed, direct drive extruder, bed leveling, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary filament (0.5kg and adapter needed for other filament), nozzle tolerance is peculiar

'''Default Slicer:''' Cura

'''Cost:''' $2,000 (May 2023)
|-
|
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|}

=== Designed for Consumers ===
{| class="wikitable"
|[[File:Flash Forge Adventurer 4.png|center|thumb|Flash Forge Adventurer 4]]
|
===Adventurer 4===
'''Brand''': Flashforge

'''Current Programs Using''': Ann & Robert H Lurie Children's Hospital of Chicago

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features:''' Enclosed, heated bed, quick swap nozzles, flexible/removable build plate, build-in camera, filament detection sensor, touch screen UI

'''Limitations:''' Proprietary nozzles, misleading bed leveling (uses average based on 9 points, not mesh), limit opportunities for user mods/adjustments

'''Default Slicer:''' FlashPrint

'''Cost:''' $700 (March 2023)
|-
|[[File:Creality Ender 3 Pro.png|thumb|Creality Ender 3|center]]
|
===Ender 3 Pro===
'''Brand''': Creality

'''Current Programs Using''': Riley Hospital for Children

'''Build Volume:''' 220 x 220 x 250 mm (8.7 x 7.9 x 9.8 in)

'''Features''': open frame, heated & removable build plate, fast, customizable, open source, well documented, pretty big build area

'''Limitations''': some assembly required, manual bed leveling, exposed print area

'''Default Slicer:''' Prusa Slicer

'''Cost:''' <$200 (March 2023)
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|'''Prusa MK3S+ (template)'''
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
===Flashforge Creator Pro 2===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:'''

'''Limitations:'''

'''Default Slicer:'''

'''Cost:'''
|-
|[[File:3D Printer Placeholder.png|thumb|Placeholder Pic|center]]
|
===Bambu Labs Carbon X1===
'''Brand:'''

'''Current Programs Using:'''

'''Build Volume:'''

'''Features:''' Open source,

'''Limitations:''' Prints go through cloud servers or offline,

'''Default Slicer:'''

'''Cost:'''
|}

==Slicers==
Slicers are programs that take 3D models and "slice" them into horizontal layers for the 3D printer to print. This is also where you will be adjusting layer height (affects detail/time of print), supports (needed to print overhangs), print speed/temperature (slight adjustments needed depending on the [[filament]] being used), and other settings. Most printers have a default slicer but some are better supported and most can be used with any printer.

===[https://ultimaker.com/software/ultimaker-cura Cura]===
The default slicer for the UltiMaker devices, but the arguable favorite in the 3D printing community. Actively being developed with updates coming out several times a year, often with industry changing advancements. Can be a bit more complex in advance settings, but nothing that isn't learnable through watching a few YouTube videos. Also has an option for community add-ons which offer several quality of life improvements.

=== [https://www.flashforge.com/product-detail/FlashPrint-slicer-for-flashforge-fdm-3d-printers FlashPrint]===
The default slicer for the Flashforge devices. Works well with these devices and can be used with other brands of printers, but nothing flashy or special that puts it above other slicers.

==Modeling Software==
To edit or clean up 3D models, there are several different programs one can use. Each has different levels of complexity and limitations.

===[https://www.tinkercad.com/ Tinkercad]===
A web based design program that allows the user to create 3D models using predefined shapes. Shape dimensions can be modified free hand or inputting precise measurements. Users combine normal and "ghost" shapes to delete portions of objects. While it will load already created STL files, it does have a set limit on file size/triangle account. This is a great introduction into 3D modeling and a good resource to introduce to a patient to create their own project.

===[https://www.blender.org/ Blender]===
A free program revolving around 3D modeling and animation. A bit more in depth then other software, requiring time spend watching tutorials or simply messing around to get a feel for the process. Users can modify models on the mesh level by adjust vectors and face or use the sculpting mode for a more artistic approach. Will load most complex STL files and is a great way to combine two models into one (e.g. a [[lithophane]] and a stand).

=== [https://www.autodesk.com/products/fusion-360/overview?term=1-YEAR&tab=subscription Fusion360]===
Fusion 360 is a cloud-based 3D CAD program that utilizes the cloud storage for easier use in collaboration on complex projects. Another advantage of the cloud platform is that Fusion stores the entire history of the model including the changes to it. Numerous design options are available, including freeform, solid, and mesh modeling. The software is free for personal and noncommercial use, but has limitations on the number of projects stored on the cloud.

===[https://meshmixer.com/ Meshmixer]===
While it is no longer being developed, Meshmixer provides straight forward and unique tools in editing mesh models including planner cuts, filling/hollowing models, and creating tubes. While likely not the first choice in creating models from scratch, these tools can be helpful in end stage processing.

==Filament==
Fused deposition modeling (FDM) printers use rolls of filament as their material source andare several different types that each have ideal usages, strengths, and limitations. Below are some of the most common types used, but advancements are made each year, so other unique products may be available/best fit for your needs.

===PLA===
PLA (Polylactic Acid) is the most common 3D printing material because it is easy to use and is made from renewable resources and thus, biodegradable. Some companies have PLA+ or Silk variants that mix additives into the base PLA to increase strength, smoothness, texture etc. This will often modify print temperature or other setting, so make note on what is listed on the package.

'''Typical Temp Range:''' 205±15 °C

'''Heated Bed:''' Not Required

'''Ventilation:''' Not Required

'''Pros''': most cost effective, easiest materiel to work with

'''Cons:''' not super strong, can warp in high heat, degrades with UV exposure over time

===ABS===
ABS (Acrylonitrile Butadiene Styrene) is another commonly used 3D printer material. Best used for making durable parts that need to withstand higher temperatures.

'''Typical Temp Range:''' 230±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell

'''Pros''': strong heat/UV resistant prints, can be post process with acetone for a glossy finish

'''Cons:''' prone to warping so may require an enclosure, stinky fumes

===PET (PETG)===
PET (Polyethylene terephthalate) is almost a combination of the ease of use of PLA with the durability of ABS.

'''Typical Temp Range:''' 245±10 °C

'''Heated Bed:''' Not required

'''Ventilation:''' Not required

'''Pros''': stronger then PLA, barley warps, no odor, more transparent then other materials,

'''Cons:''' harder to clean during post-processing, can get stuck to print bed, very hygroscopic so requires a dry box for storage or drying before use

===TPU===
TPU (Thermoplastic Polyurethane) is an elastic, oil/grease resistant, and abrasion-resistant material with a shore hardness of 95A. This materials is great for grips, cases, and other item that require more flexibility

'''Typical Temp Range:''' 220±10 °C (can depend on brand)

'''Heated Bed:''' 40±10 °C

'''Ventilation:''' Not required

'''Pros''': elastic/soft material, low warp-age/shrinkage,

'''Cons:''' difficult to print, prone to clogging particularly with systems using a bowden extruder, difficult to post-process especially support removal, hygroscopic so requires a dry box for storage or drying before use

===ASA===
Acrylonitrile styrene acrylate (ASA) was developed as an alternative to ABS. With a number of additional features, like improved weather resistance and resistance to yellowing from UVs, making it an excellent choice for parts or prints meant for outdoor use.

'''Typical Temp Range:''' 250±10 °C

'''Heated Bed:''' 90±10 °C

'''Ventilation:''' Likely, fumes aren't toxic but do smell (less then ABS)

'''Pros''': strong heat/UV resistant prints, post processed with acetone,

'''Cons:''' prone to warping so may require an enclosure, stinky fumes, hygroscopic so requires a dry box for storage or drying before use

==Compatible Accessories==
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==Adaptive & Inclusive options==
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==Additional Resources==
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