###### Abstract
report that the tactical combat casualty care guidelines recommend the use of the radial pulse strength to guide the administration of blood products or intravenous fluids when equipment for blood pressure monitoring is not available [17]. They performed a correlation study between the radial pulse strength and the systolic blood pressure (SBP) readings using the dataset from the Department of Defense Trauma Registry to analyze the efficacy of the radial pulses for casualty assessment. Other studies also studied the radial pulse in relationship to systolic blood pressure and trauma guidelines [18; 19]. The studies and TCCC guidelines suggest that the quality of RAPP (such as strong, weak, and absent radial pulse) in conjunction with SBD is used to assess combat casualty and guide resuscitation protocols. [PERSON] points out that palpation of radial pulses is highly subjective and inconsistent between examiners [20]. Thus, pulse simulators that can produce controlled pulses consistently and repeatedly would be useful for training medical examiners on the battlefield. They would allow a scientific study between the radial pulses and SBPs to establish statistical correlations and quantify the subjective assessments of pulse strength. Currently, a few radial pulse simulators are available for medical training. They offer their own advantages and disadvantages in generating sophisticated blood pressure waveforms. ViVitro Labs, Inc., developed an endovascular simulator that can generate pulsatile flow and blood pressure waveforms similar to humans [21]. [PERSON] et al. developed a cardiovascular simulator for studying the depth, rate, shape, and strength of radial pulses [22]. Tellyes Scientific Inc. developed a pulse-training simulator (Victor Pulse) that can adjust the characteristic parameters of the pulse wave by manipulating the opening time of the hydraulic valve and the hydraulic pressure intensity [23]. Although these simulators create various blood pressure waveforms, they circulate fluid using pumps. Thus, they present maintenance issues that include fluid leakage. Moreover, the repeatability and accuracy of the generated pulse waveforms can be compromised by unwanted vortexes originating from the reflection of pressure waves. In general, it is challenging to produce age-dependent pulse waveforms with precise notches in the pulse pressure waveforms due to the bifurcation of the arteries. As an alternative to fluid-based simulators, [PERSON] et al. developed simulators based on pneumatic pressure produced by a cam mechanism [24]. Because the cam profiles are determined based on human pulse pressure waveform data obtained from a tonometric measurement method, the pneumatic simulators can precisely reproduce actual radial pulse pressure waveforms. Despite this strength, the primary limitation of the pneumatic simulator is that it only produces a single pulse waveform defined in the cam profile. Thus, a new cam needs to be constructed for a different pulse waveform, so a large number of cams would need to be fabricated and replaced to generate a range of age-specific pulse waveforms. In other words, the cam simulator can only discretely generate a pulse waveform depending on the specific cam used in the system. In an effort to develop a new portable pulse simulator for medical palpation training, this study intends to develop a pneumatic system based on a cam mechanism that is capable of generating a wide range of age-related radial pulse waveforms. For a simple yet versatile system design, it proposes to develop a \"universal\" cam, which is a single cam that encompasses a range of pulse waveform profiles. Unlike the \"discrete\" cam system, the universal cam allows the system to produce a range of pulses continuously without replacing cams.