Integration of monitoring for intelligent alarms in anesthesia: Neural networks—Can they help?

Mylrea, Kenneth C.; Orr, Joseph A.; Westenskow, Dwayne R.

doi:10.1007/bf01627634

Cited by 36 publications

(17 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such analysis will facilitate the introduction, in the future, of integrated alarms, and decision-support systems to assist the anaesthetist) By recognition and analysis of patterns of vital signs and trends, integrated alarm systems will provide early detection of impending crisis, in advance of possible catastrophe. 9 A variety of hypermedia electronic textbook products (e.g., Micromedix Inc, Micromedix, Colorado; Physician's Desk Reference etc. ), is becoming available in clinical medicine with a range of on-line information fdes, including those on drug interaction, dosage and toxicity.…”

Section: Item 8)mentioning

confidence: 99%

Patient data management systems in anaesthesia: an emerging technology

et al. 1995

View full text Add to dashboard Cite

show abstract

Section: Item 8)mentioning

confidence: 99%

Patient data management systems in anaesthesia: an emerging technology

et al. 1995

View full text Add to dashboard Cite

show abstract

“…For example, this is especially important in monitoring levels of anesthesia in the operating room or the state of consciousness of human volunteers in experiments involving very high accelerative forces [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…These are either monitored visually or the physician or researcher relies on an automatic alarm triggered by a parameter value that is out of the normal expected range. A significant problem with such methods is that there is often a high false alarm rate (FAR) due to such things as sensor movement, physiological parameter variability, and electrical signal noise [2].…”

Section: Introductionmentioning

confidence: 99%

Two compartment fusion system designed for physiological state monitoring

Ryoo

Sun

Hrebien³

2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society

View full text Add to dashboard Cite

Abstract-A two-compartment fusion system designed to reduce high rates of false alarm (FAR) in single channel monitoring systems was tested with physiological data from pilots exposed to high +Gz forces on a human centrifuge. The first compartment expands input signals into time-frequency domain, where transient changes are captured by wavelet coefficients in frequency ranges of interest. The second compartment optimally combines local decisions of various statistics using a unifying operation rule regardless of individual subject physiology and channel features. Three channels were used to measure respiration, blood pressure, and electroencephalogram under various high performance aircraft maneuver profiles: rapid onset run (ROR) to a fixed plateau, gradual onset run (GOR) at 0.1 Gz per second onset, and simulated aerial combat (SACM) profiles. Pilots sometimes perform anti-G straining maneuvers (AGSM) against the blood pressure drop at head level for greater tolerance. Signals were simultaneously processed to decide the presence of such AGSM. Significant reductions of FAR when detecting AGSM by signal fusion were achieved in our experiment (10~38% during ROR /GOR, 25~35% during SACM, and 21~36% overall), when compared to single channel monitoring. This implies that our approach is very promising and system performance can be enhanced even with poor quality signals.

show abstract

“…immobility and consciousness) (Xiao, 1994) in dynamic and complex environments with varying or high workload and risk levels (Gaba & Howard, 1995). It is for this reason that a vast amount of patient monitoring research has traditionally been focused on the anaesthesia environment (Boquet, Bushman, & Davenport, 1980;Loeb et al, 1989;Mylrea et al, 1993;Navabi et al, 1989;Seagull & Sanderson, 2001;Thompson, Watson, & Sanderson, 2005;Watson et al, 1999;Williams & Beatty, 2005) with more focuses on nursing staff (Potter et al, 2005) and home care being reviewed in recent times particular due to the developed world's increasingly aging population.…”

Section: Users Of the Patient Monitoring Equipmentmentioning

confidence: 99%

“…Intelligent alarms (Blom, 1988;Loeb, Brunner, Westenskow, Feldman, & Pace, 1989;Mylrea, Orr, & Westenskow, 1993;Navabi, Mylrea, & Watt, 1989;Orr & Westenskow, 1994;Rheineck-Leyssius & Kalkman, 1999a, 1999bTsien, 1997;Westenskow & Orr, 1992) on the other hand, use knowledge-based networks to decide if an abnormal parameter is an indication of an event that requires the operator's attention.…”

Section: The Intelligent Alarmmentioning

confidence: 99%

A human factors evaluation of auditory displays in medical electrical equipment

Wee¹

View full text Add to dashboard Cite

Auditory alarms have, for the most part, gone unchanged in human technological developmental history. This is largely due to their success and simplicity. As they take advantage of the primitive human principle of fight or flight, they have been found to be a significant attractor of attention, are generally easy to understand, omi-directional, and to the point.Medical staff, for instance, use sounds in many aspects of patient monitoring-the steady beeping of the pulse oximeter, or insistent alarms from equipment when a patient is going critical. However, due to the complex nature of patient care, the sounds that demand the most attention are not always the most useful, and are sometimes detrimental to work, causing annoyance and confusion.Thus the problem is determining the best way to alert medical and nursing staff to changes in a patient's state, provide them with enough information about this change when needed, and not affect their ability to address it and other immediate concerns. For about three decades, the design of effective auditory alarms and displays in the operating room and intensive care unit (ICU) environment has received a significant amount of attention from human factors researchers. Contributing studies on the physical limitations of the auditory channel (Neurobiology and Psychoacoustics), how this information is processed (Cognitive Psychology), and how best to represent the information (Display Engineering) provide a valuable source of information which should inform the design of such displays. How much effect this has had on the industry, however, is debatable, as the design and development of the majority of auditory displays currently in operating rooms seems to have largely ignored these findings.Instead, human factors researchers have found it necessary to perform their evaluations on an ad hoc basis. Often well after the medical systems have been produced and put into use.This thesis presents the findings of a study involving a set of informative melodic medical alarms which has been presented as a design standard for implementation in the International Electrotechnical Commission standard for Medical Electrical Equipment. The goal in providing this design was to provide alarms which not only direct attention, but iii convey simple information encoded within the melody, which communicates to medical practitioners which organ system has entered an abnormal state.In the first 2 experiments, the practicability of the presented alarms as an informative auditory display was evaluated on both novice and professional (practicing nurses) populations. The use of mnemonic learning aids was also examined as these were central to the fundamental design intention of the alarm melodies. The results confirmed participant testimonies that the provided mnemonics did not aid them in identifying alarm labels when presented with the alarm sound, even after prolonged testing over 2 days.Expert knowledge in the domain and knowledge of the context of the menmonics also did not provide any perfor...

show abstract

Integration of monitoring for intelligent alarms in anesthesia: Neural networks—Can they help?

Cited by 36 publications

References 42 publications

Patient data management systems in anaesthesia: an emerging technology

Patient data management systems in anaesthesia: an emerging technology

Two compartment fusion system designed for physiological state monitoring

A human factors evaluation of auditory displays in medical electrical equipment

Contact Info

Product

Resources

About