Prevention and control of surgical site infections: review of the Basel Cohort Study

INTRODUCTION: Surgical site infections (SSI) are the most common hospital-acquired infections among surgical patients, with significant impact on patient morbidity and health care costs. The Basel SSI Cohort Study was performed to evaluate risk factors and validate current preventive measures for SSI. The objective of the present article was to review the main results of this study and its implications for clinical practice and future research. SUMMARY OF METHODS OF THE BASEL SSI COHORT STUDY: The prospective observational cohort study included 6,283 consecutive general surgery procedures closely monitored for evidence of SSI up to 1 year after surgery. The dataset was analysed for the influence of various potential SSI risk factors, including timing of surgical antimicrobial prophylaxis (SAP), glove perforation, anaemia, transfusion and tutorial assistance, using multiple logistic regression analyses. In addition, post hoc analyses were performed to assess the economic burden of SSI, the efficiency of the clinical SSI surveillance system, and the spectrum of SSI-causing pathogens. REVIEW OF MAIN RESULTS OF THE BASEL SSI COHORT STUDY: The overall SSI rate was 4.7% (293/6,283). While SAP was administered in most patients between 44 and 0 minutes before surgical incision, the lowest risk of SSI was recorded when the antibiotics were administered between 74 and 30 minutes before surgery. Glove perforation in the absence of SAP increased the risk of SSI (OR 2.0; CI 1.4-2.8; p <0.001). No significant association was found for anaemia, transfusion and tutorial assistance with the risk of SSI. The mean additional hospital cost in the event of SSI was CHF 19,638 (95% CI, 8,492-30,784). The surgical staff documented only 49% of in-hospital SSI; the infection control team registered the remaining 51%. Staphylococcus aureus was the most common SSI-causing pathogen (29% of all SSI with documented microbiology). No case of an antimicrobial-resistant pathogen was identified in this series. CONCLUSIONS: The Basel SSI Cohort Study suggested that SAP should be administered between 74 and 30 minutes before surgery. Due to the observational nature of these data, corroboration is planned in a randomized controlled trial, which is supported by the Swiss National Science Foundation. Routine change of gloves or double gloving is recommended in the absence of SAP. Anaemia, transfusion and tutorial assistance do not increase the risk of SSI. The substantial economic burden of in-hospital SSI has been confirmed. SSI surveillance by the surgical staff detected only half of all in-hospital SSI, which prompted the introduction of an electronic SSI surveillance system at the University Hospital of Basel and the Cantonal Hospital of Aarau. Due to the absence of multiresistant SSI-causing pathogens, the continuous use of single-shot single-drug SAP with cefuroxime (plus metronidazole in colorectal surgery) has been validated.

Variable impedance LED matrix control system for lamps in PV applications

The interest in LED lighting has been growing recently due to the high efficacy, lifelime and ruggedness that this technology offers. However the key element to guarantee those parameters with these new electronic devices is to keep under control the working temperature of the semiconductor crystal. This paper propases a LED lamp design that fulfils the requ irements of a PV lighting systems, whose main quality criteria is reliability. It uses directly as a power supply a non·stabilized constant voltage source, as batteries. An electronic control architecture is used to regulate the current applied to the LEO matri)( according to their temperature and the voltage output value of the batteries with two pulse modulation signals (PWM) signals. The first one connects and disconnects the LEOs to the power supply and the second one connects and disconnects several emitters to the electric circuit changing its overall impedance. A prototype of the LEO lamp has been implemented and tested at different temperaturas and battery voltages.

Proprioceptive force estimation and control for teleoperation in radioactive environments

A medida que se incrementa la energía de los aceleradores de partículas o iones pesados como el CERN o GSI, de los reactores de fusión como JET o ITER, u otros experimentos científicos, se va haciendo cada vez más imprescindible el uso de técnicas de manipulación remota para la interacción con el entorno sujeto a la radiación. Hasta ahora la tasa de dosis radioactiva en el CERN podía tomar valores cercanos a algunos mSv para tiempos de enfriamiento de horas, que permitían la intervención humana para tareas de mantenimiento. Durante los primeros ensayos con plasma en JET, se alcanzaban valores cercanos a los 200 μSv después de un tiempo de enfriamiento de 4 meses y ya se hacía extensivo el uso de técnicas de manipulación remota. Hay una clara tendencia al incremento de los niveles de radioactividad en el futuro en este tipo de instalaciones. Un claro ejemplo es ITER, donde se esperan valores de 450 Sv/h en el centro del toroide a los 11 días de enfriamiento o los nuevos niveles energéticos del CERN que harán necesario una apuesta por niveles de mantenimiento remotos. En estas circunstancias se enmarca esta tesis, que estudia un sistema de control bilateral basado en fuerza-posición, tratando de evitar el uso de sensores de fuerza/par, cuyo contenido electrónico los hace especialmente sensitivos en estos ambientes. El contenido de este trabajo se centra en la teleoperación de robots industriales, que debido a su reconocida solvencia y facilidad para ser adaptados a estos entornos, unido al bajo coste y alta disponibilidad, les convierte en una alternativa interesante para tareas de manipulación remota frente a costosas soluciones a medida. En primer lugar se considera el problema cinemático de teleoperación maestro-esclavo de cinemática disimilar y se desarrolla un método general para la solución del problema en el que se incluye el uso de fuerzas asistivas para guiar al operador. A continuación se explican con detalle los experimentos realizados con un robot ABB y que muestran las dificultades encontradas y recomendaciones para solventarlas. Se concluye el estudio cinemático con un método para el encaje de espacios de trabajo entre maestro y esclavo disimilares. Posteriormente se mira hacia la dinámica, estudiándose el modelado de robots con vistas a obtener un método que permita estimar las fuerzas externas que actúan sobre los mismos. Durante la caracterización del modelo dinámico, se realizan varios ensayos para tratar de encontrar un compromiso entre complejidad de cálculo y error de estimación. También se dan las claves para modelar y caracterizar robots con estructura en forma de paralelogramo y se presenta la arquitectura de control deseada. Una vez obtenido el modelo completo del esclavo, se investigan diferentes alternativas que permitan una estimación de fuerzas externas en tiempo real, minimizando las derivadas de la posición para minimizar el ruido. Se comienza utilizando observadores clásicos del estado para ir evolucionando hasta llegar al desarrollo de un observador de tipo Luenberger-Sliding cuya implementación es relativamente sencilla y sus resultados contundentes. También se analiza el uso del observador propuesto durante un control bilateral simulado en el que se compara la realimentación de fuerzas obtenida con las técnicas clásicas basadas en error de posición frente a un control basado en fuerza-posición donde la fuerza es estimada y no medida. Se comprueba como la solución propuesta da resultados comparables con las arquitecturas clásicas y sin embargo introduce una alternativa para la teleoperación de robots industriales cuya teleoperación en entornos radioactivos sería imposible de otra manera. Finalmente se analizan los problemas derivados de la aplicación práctica de la teleoperación en los escenarios mencionados anteriormente. Debido a las condiciones prohibitivas para todo equipo electrónico, los sistemas de control se deben colocar a gran distancia de los manipuladores, dando lugar a longitudes de cable de centenares de metros. En estas condiciones se crean sobretensiones en controladores basados en PWM que pueden ser destructivas para el sistema formado por control, cableado y actuador, y por tanto, han de ser eliminadas. En este trabajo se propone una solución basada en un filtro LC comercial y se prueba de forma extensiva que su inclusión no produce efectos negativos sobre el control del actuador. ABSTRACT As the energy on the particle accelerators or heavy ion accelerators such as CERN or GSI, fusion reactors such as JET or ITER, or other scientific experiments is increased, it is becoming increasingly necessary to use remote handling techniques to interact with the remote and radioactive environment. So far, the dose rate at CERN could present values near several mSv for cooling times on the range of hours, which allowed human intervention for maintenance tasks. At JET, they measured values close to 200 μSv after a cooling time of 4 months and since then, the remote handling techniques became usual. There is a clear tendency to increase the radiation levels in the future. A clear example is ITER, where values of 450 Sv/h are expected in the centre of the torus after 11 days of cooling. Also, the new energetic levels of CERN are expected to lead to a more advanced remote handling means. In these circumstances this thesis is framed, studying a bilateral control system based on force-position, trying to avoid the use of force/torque sensors, whose electronic content makes them very sensitive in these environments. The contents of this work are focused on teleoperating industrial robots, which due its well-known reliability, easiness to be adapted to these environments, cost-effectiveness and high availability, are considered as an interesting alternative to expensive custom-made solutions for remote handling tasks. Firstly, the kinematic problem of teloperating master and slave with dissimilar kinematics is analysed and a new general approach for solving this issue is presented. The solution includes using assistive forces in order to guide the human operator. Coming up next, I explain with detail the experiments accomplished with an ABB robot that show the difficulties encountered and the proposed solutions. This section is concluded with a method to match the master’s and slave’s workspaces when they present dissimilar kinematics. Later on, the research studies the dynamics, with special focus on robot modelling with the purpose of obtaining a method that allows to estimate external forces acting on them. During the characterisation of the model’s parameters, a set of tests are performed in order to get to a compromise between computational complexity and estimation error. Key points for modelling and characterising robots with a parallelogram structure are also given, and the desired control architecture is presented. Once a complete model of the slave is obtained, different alternatives for external force estimation are review to be able to predict forces in real time, minimizing the position differentiation to minimize the estimation noise. The research starts by implementing classic state observers and then it evolves towards the use of Luenberger- Sliding observers whose implementation is relatively easy and the results are convincing. I also analyse the use of proposed observer during a simulated bilateral control on which the force feedback obtained with the classic techniques based on the position error is compared versus a control architecture based on force-position, where the force is estimated instead of measured. I t is checked how the proposed solution gives results comparable with the classical techniques and however introduces an alternative method for teleoperating industrial robots whose teleoperation in radioactive environments would have been impossible in a different way. Finally, the problems originated by the practical application of teleoperation in the before mentioned scenarios are analysed. Due the prohibitive conditions for every electronic equipment, the control systems should be placed far from the manipulators. This provokes that the power cables that fed the slaves devices can present lengths of hundreds of meters. In these circumstances, overvoltage waves are developed when implementing drives based on PWM technique. The occurrence of overvoltage is very dangerous for the system composed by drive, wiring and actuator, and has to be eliminated. During this work, a solution based on commercial LC filters is proposed and it is extensively proved that its inclusion does not introduce adverse effects into the actuator’s control.

OTDM network processing using all-optical and electro-optical devices

The current optical communications network consists of point-to-point optical transmission paths interconnected with relatively low-speed electronic switching and routing devices. As the demand for capacity increases, then higher speed electronic devices will become necessary. It is however hard to realise electronic chip-sets above 10 Gbit/s, and therefore to increase the achievable performance of the network, electro-optic and all-optic switching and routing architectures are being investigated. This thesis aims to provide a detailed experimental analysis of high-speed optical processing within an optical time division multiplexed (OTDM) network node. This includes the functions of demultiplexing, 'drop and insert' multiplexing, data regeneration, and clock recovery. It examines the possibilities of combining these tasks using a single device. Two optical switching technologies are explored. The first is an all-optical device known as 'semiconductor optical amplifier-based nonlinear optical loop mirror' (SOA-NOLM). Switching is achieved by using an intense 'control' pulse to induce a phase shift in a low-intensity signal propagating through an interferometer. Simultaneous demultiplexing, data regeneration and clock recovery are demonstrated for the first time using a single SOA-NOLM. The second device is an electroabsorption (EA) modulator, which until this thesis had been used in a uni-directional configuration to achieve picosecond pulse generation, data encoding, demultiplexing, and 'drop and insert' multiplexing. This thesis presents results on the use of an EA modulator in a novel bi-directional configuration. Two independent channels are demultiplexed from a high-speed OTDM data stream using a single device. Simultaneous demultiplexing with stable, ultra-low jitter clock recovery is demonstrated, and then used in a self-contained 40 Gbit/s 'drop and insert' node. Finally, a 10 GHz source is analysed that exploits the EA modulator bi-directionality to increase the pulse extinction ratio to a level where it could be used in an 80 Gbit/s OTDM network.

Fabrication of a two-terminal super conducting device with a poled ferroelectric control layer

The discovery of High-Temperature Superconductors (HTSCs) has spurred the need for the fabrication of superconducting electronic devices able to match the performance of today's semiconductor devices. While there are several HTSCs in use today, YBaCuO7-x (YBCO) is the better characterized and more widely used material for small electronic applications. This thesis explores the fabrication of a Two-Terminal device with a superconductor and a painted on electrode as the terminals and a ferroelectric, BaTiO 3 (BTO), in between. The methods used to construct such a device and the challenges faced with the fabrication of a viable device will be examined. The ferroelectric layer of the devices that proved adequate for use were poled by the application of an electric field. Temperature Bias Poling used an applied field of 105V/cm at a temperature of approximately 135*C. High Potential Poling used an applied field of 106V/cm at room temperature (20*C). The devices were then tested for a change in their superconducting critical temperature, Tc. A shift of 1-2K in the Tc(onset) of YBCO was observed for Temperature Bias Poling and a shift of 2-6K for High Potential Poling. These are the first reported results of the field effect using BTO on YBCO. The mechanism involved in the shifting of Tc will be discussed along with possible applications.

Simulation tools for the analysis of single electronic systems

Developments in theory and experiment have raised the prospect of an electronic technology based on the discrete nature of electron tunnelling through a potential barrier. This thesis deals with novel design and analysis tools developed to study such systems. Possible devices include those constructed from ultrasmall normal tunnelling junctions. These exhibit charging effects including the Coulomb blockade and correlated electron tunnelling. They allow transistor-like control of the transfer of single carriers, and present the prospect of digital systems operating at the information theoretic limit. As such, they are often referred to as single electronic devices. Single electronic devices exhibit self quantising logic and good structural tolerance. Their speed, immunity to thermal noise, and operating voltage all scale beneficially with junction capacitance. For ultrasmall junctions the possibility of room temperature operation at sub picosecond timescales seems feasible. However, they are sensitive to external charge; whether from trapping-detrapping events, externally gated potentials, or system cross-talk. Quantum effects such as charge macroscopic quantum tunnelling may degrade performance. Finally, any practical system will be complex and spatially extended (amplifying the above problems), and prone to fabrication imperfection. This summarises why new design and analysis tools are required. Simulation tools are developed, concentrating on the basic building blocks of single electronic systems; the tunnelling junction array and gated turnstile device. Three main points are considered: the best method of estimating capacitance values from physical system geometry; the mathematical model which should represent electron tunnelling based on this data; application of this model to the investigation of single electronic systems. (DXN004909)

Real-time load-side control of electric power systems

Two trends are emerging from modern electric power systems: the growth of renewable (e.g., solar and wind) generation, and the integration of information technologies and advanced power electronics. The former introduces large, rapid, and random fluctuations in power supply, demand, frequency, and voltage, which become a major challenge for real-time operation of power systems. The latter creates a tremendous number of controllable intelligent endpoints such as smart buildings and appliances, electric vehicles, energy storage devices, and power electronic devices that can sense, compute, communicate, and actuate. Most of these endpoints are distributed on the load side of power systems, in contrast to traditional control resources such as centralized bulk generators. This thesis focuses on controlling power systems in real time, using these load side resources. Specifically, it studies two problems.

(1) Distributed load-side frequency control: We establish a mathematical framework to design distributed frequency control algorithms for flexible electric loads. In this framework, we formulate a category of optimization problems, called optimal load control (OLC), to incorporate the goals of frequency control, such as balancing power supply and demand, restoring frequency to its nominal value, restoring inter-area power flows, etc., in a way that minimizes total disutility for the loads to participate in frequency control by deviating from their nominal power usage. By exploiting distributed algorithms to solve OLC and analyzing convergence of these algorithms, we design distributed load-side controllers and prove stability of closed-loop power systems governed by these controllers. This general framework is adapted and applied to different types of power systems described by different models, or to achieve different levels of control goals under different operation scenarios. We first consider a dynamically coherent power system which can be equivalently modeled with a single synchronous machine. We then extend our framework to a multi-machine power network, where we consider primary and secondary frequency controls, linear and nonlinear power flow models, and the interactions between generator dynamics and load control.

(2) Two-timescale voltage control: The voltage of a power distribution system must be maintained closely around its nominal value in real time, even in the presence of highly volatile power supply or demand. For this purpose, we jointly control two types of reactive power sources: a capacitor operating at a slow timescale, and a power electronic device, such as a smart inverter or a D-STATCOM, operating at a fast timescale. Their control actions are solved from optimal power flow problems at two timescales. Specifically, the slow-timescale problem is a chance-constrained optimization, which minimizes power loss and regulates the voltage at the current time instant while limiting the probability of future voltage violations due to stochastic changes in power supply or demand. This control framework forms the basis of an optimal sizing problem, which determines the installation capacities of the control devices by minimizing the sum of power loss and capital cost. We develop computationally efficient heuristics to solve the optimal sizing problem and implement real-time control. Numerical experiments show that the proposed sizing and control schemes significantly improve the reliability of voltage control with a moderate increase in cost.

Resonant metamaterials for the control of Rayleigh waves

Since their emergence, locally resonant metamaterials have found several applications for the control of surface waves, from micrometer-sized electronic devices to meter-sized seismic barriers. The interaction between Rayleigh-type surface waves and resonant metamaterials has been investigated through the realization of locally resonant metasurfaces, thin elastic interfaces constituted by a cluster of resonant inclusions or oscillators embedded near the surface of an elastic waveguide. When such resonant metasurfaces are embedded in an elastic homogeneous half-space, they can filter out the propagation of Rayleigh waves, creating low-frequency bandgaps at selected frequencies. In the civil engineering context, heavy resonating masses are needed to extend the bandgap frequency width of locally resonant devices, a requirement that limits their practical implementations. In this dissertation, the wave attenuation capabilities of locally resonant metasurfaces have been enriched by proposing (i) tunable metasurfaces to open large frequency bandgaps with small effective inertia, and by developing (ii) an analytical framework aimed at studying the propagation of Rayleigh waves propagation in deep resonant waveguides. In more detail, inertial amplified resonators are exploited to design advanced metasurfaces with a prescribed static and a tunable dynamic response. The modular design of the tunable metasurfaces allows to shift and enlarge low-frequency spectral bandgaps without modifying the total inertia of the metasurface. Besides, an original dispersion law is derived to study the dispersive properties of Rayleigh waves propagating in thick resonant layers made of sub-wavelength resonators. Accordingly, a deep resonant wave barrier of mechanical resonators embedded inside the soil is designed to impede the propagation of seismic surface waves. Numerical models are developed to confirm the analytical dispersion predictions of the tunable metasurface and resonant layer. Finally, a medium-size scale resonant wave barrier is designed according to the soil stratigraphy of a real geophysical scenario to attenuate ground-borne vibration.

Identificação eletrônica para avaliação do comportamento dos suínos na fase de gestação

The efficiency of swine production performance depends on the herd administration, such as good nutrition, sanitary control, facilities and appropriate environmental conditions. The concept of this production model is directly related with the reduction of selective losses and the process control. Each production segment is controlled to reach the optimization in the system totality, it is necessary to apply animals handling concepts, environmental control implementation, diseases control, nutrition control, information concerning in guaranteeing the animal welfare and individual identification. The present work presents as objective the development of the mathematical model to evaluate interactions among the internal atmosphere of the installation and the thermal animals preference, in the expectation of detecting a relationship among the frequency access to the drinking fountain and the atmosphere conditions - temperature, black globe temperature and relative humidity, using as tool the electronic identification. The results obtained by the mathematical model, allowed to conclude accurately the evaluation of the swine thermal preference correlating with the climatic variables in the pregnancy stage.

Avaliação do uso de identificadores eletrônicos em suínos

Nowadays the consumer market demands a gradually increase in the products' quality control. The manual control that exits, used in animal production, shows ineficiency in warrating an increasing percentual of the desirable quality, so this can only be reached when an effective animal tracebility system is applied, from birth to slaughter. Individual electronic identification presents high importance in this focus, providing information recorded directly from the animal. Electronic traceability uses electronic devices that emit a signal activated by a fixed reader placed where it is needed to record a certain event, or uses a manual reader which allows a higher independence of the operator. Knowing the importance of the electronic identification as a tool for applying traceability in animal production, this research had as objective to evaluate the use of transponders in order to garantee the manual reading as well as the fixed antenna reading. The following implant places were analized in piglet, just after their birth: 1) forehead, 2) external ear lobule, 3) the posterior auricular base, and 4) a transponder inserted in a earing implanted in the ear lobule. The factors of skin damage and migration were analized, as well as the reading efficiency. It was found that the best implant place was the posterior ear base.

Vancomycin use in a brazilian teaching hospital: comparison with the Hospital Infection Controlpractices Advisory Committee Guidelines (HICPAC)

This study describes vancomycin prescribing patterns in an average complexity hospital and compare the guidelines proposed by the Hospital Infection Control Practices Advisory Committee (HICPAC). The study was conducted in a 256-bed secondary-care hospital. Data were collected of all patients given vancomycin from March 2003 to February 2004, using a standardized chart-extraction form designed. Appropriate and inappropriate use was reviewed according to the Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines on prudent vancomycin use. Out of 118 prescriptions, 95 (80.5%) were considered appropriate. Out of these 95 orders, 77 (81.1%) were administered for empiric treatment of suspected Gram-positive infections, 17 (17.9%) were administered for treatment of proven Gram-positive infections (76.5% identified as Staphyloccocus aureus-like agents) and 1 (1.0%) for beta-lactam allergy. The majority of the patients (96.6%) had recently used an antimicrobial medication (3 months). The mean pre-treatment hospitalization period was 11±10 days. Out of the 118 treatments, 67 (56.8%) were for nosocomial infections. The more frequent indications for vancomycin use were pneumonia (48.3%) and primary sepsis (18.6%), accounting for more than 66% of all treatments. No restriction policy was suggested because vancomycin use was considered adequate in the majority of the treatment cases. The broad empiric use of this antimicrobial was greater than expected in the institution and its use should be revised.

Evaluation of biologic occupational risk control practices: Quality indicators development and validation

Background: There is growing demand for the adoption of qualification systems for health care practices. This study is aimed at describing the development and validation of indicators for evaluation of biologic occupational risk control programs. Methods: The study involved 3 stages: (1) setting up a research team, (2) development of indicators, and (3) validation of the indicators by a team of specialists recruited to validate each attribute of the developed indicators. The content validation method was used for the validation, and a psychometric scale was developed for the specialists` assessment. A consensus technique was used, and every attribute that obtained a Content Validity Index of at least 0.75 was approved. Results: Eight indicators were developed for the evaluation of the biologic occupational risk prevention program, with emphasis on accidents caused by sharp instruments and occupational tuberculosis prevention. The indicators included evaluation of the structure, process, and results at the prevention and biologic risk control levels. The majority of indicators achieved a favorable consensus regarding all validated attributes. Conclusion: The developed indicators were considered validated, and the method used for construction and validation proved to be effective.

Development of Control Systems for Safety Instrumented Systems

Safety Instrumented Systems (SIS) are designed to prevent and / or mitigate accidents, avoiding undesirable high potential risk scenarios, assuring protection of people`s health, protecting the environment and saving costs of industrial equipment. The design of these systems require formal methods for ensuring the safety requirements, but according material published in this area, has not identified a consolidated procedure to match the task. This sense, this article introduces a formal method for diagnosis and treatment of critical faults based on Bayesian network (BN) and Petri net (PN). This approach considers diagnosis and treatment for each safety instrumented function (SIF) including hazard and operability (HAZOP) study in the equipment or system under control. It also uses BN and Behavioral Petri net (BPN) for diagnoses and decision-making and the PN for the synthesis, modeling and control to be implemented by Safety Programmable Logic Controller (PLC). An application example considering the diagnosis and treatment of critical faults is presented and illustrates the methodology proposed.

Electro-optically sensitive diamond-like carbon thin films deposited by reactive magnetron sputtering for electronic device applications

The goal of this work is to study and relate electrical and optical properties of diamond-like carbon (DLC) thin films for applications in electronic devices. DLC films were deposited in a reactive RF magnetron sputtering system on p-type silicon and glass substrates. The target was a 99.9999% pure, 6 in. diameter graphite plate and methane was used as processing gas. Eight DLC films were produced for each substrate, varying deposition time, the reactor pressure between 5 mTorr and 10 mTorr while the RF power was applied at 13.56 MHz and varied between 100, 150, 200 and 250W. After deposition, the films were analyzed by I-V and C-V measurements (Cheng et al. (2004) [1]) in order to determine the electric resistivity, photo-current response and dielectric constant, optical transmittance, used to find the optical gap by the Tauc method; and by photoluminescence analysis to determine the photoemission and confirm the optical band gap. These characteristics are compared and the influence of the deposition parameters is discussed. (C) 2011 Published by Elsevier B.V.

Flatness-based control of a single qubit gate

This work considers the open-loop control problem of steering a two-level quantum system from any initial to any final condition. The model of this system evolves on the state space X = SU(2), having two inputs that correspond to the complex amplitude of a resonant laser field. A symmetry preserving flat output is constructed using a fully geometric construction and quaternion computations. Simulation results of this flatness-based open-loop control are provided.