It gives me anxiety just looking at this. Add this to the list of things I don't want to work on.
Alarms in medical equipment
11–20 of 118 posts
Re: Alarms in medical equipment
#12And how about the fact that there are simply too many of them! I was once in the recovery room with my wife. For some reason the sensor was having a very hard time reading her pulse. The normal bips would frequently fail. Too many failures in a row and the alarm would start it's EEEEEE scream we've all seen from Hollywood. It would shut up as soon as it managed to pick up a beat. Hers was definitely not the only one…
Knowing how to trend the patient's health is probably more useful than relying on all the alarms. People hardly deteriorate from one second to the next if you know what to expect from their baseline. At least that's what I did when working as a nurse. However, I never worked in some place like the ICU, so the approach might be different in that case.
Re: Alarms in medical equipment
#13I absolutely hate the poor design of medical equipment found in hospitals. The worst thing by far is the constant beeping and noises in the room, which totally disrupts rest and hurts recovery. It is SO obvious that this hurts patients (and visitors), that I cannot believe the entire medical industry (nurses, doctors, hospital administrators, equipment makers, insurance companies) have failed to do anything about it. It also makes it hard to know if some sound is expected or if it is a signal that something is wrong. In addition to this, I’ve seen nurses make mistakes several times because the equipment is too confusing. Once, I had to page the nurse myself because the IV they thought they set up was not functioning and I was able to discern that from the screen on the IV machine (which said one particular drug was not active) but they had not noticed, essentially administering an imbalanced cocktail of drugs for a period of time.
My take - the medical industry has too many barriers to competition, and it is too difficult for people who work with these things to do anything about it as well. It’s unclear who the buyers are at a hospital or how a startup could reach them. It’s also unclear what sort of interoperability (for example with Epic for charting) is needed. Regulations also make it difficult to get devices approved and investors are less likely to support a startup in this space.
Re: Alarms in medical equipment
#14What's not clear from this webpage is whether these are actually used anywhere. Are they? I couldn't tell.
Yes, well, some. To gain certification, often something customers require, medical devices must comply with standards such as ISO60601 (hardware) ISO62304 (software) and ISO13485 (process, quality management).
The alarm waveforms described are within the scope of the hardware standard guidelines, sufficiently common that application notes such as this exist. https://www.ti.com/lit/pdf/slaaec3 [ti.com]
Re: Alarms in medical equipment
#15And how about the fact that there are simply too many of them! I was once in the recovery room with my wife. For some reason the sensor was having a very hard time reading her pulse. The normal bips would frequently fail. Too many failures in a row and the alarm would start it's EEEEEE scream we've all seen from Hollywood. It would shut up as soon as it managed to pick up a beat. Hers was definitely not the only one…
False positives are definitely a problem. When you read industrial accident reports one extremely common theme is some sensor that was notifying the controller of the problem, but that sensor had a history of false positives so it was disregarded. Companies that don't take false positives seriously are inherently dangerous.
Many of those companies fall into the trap of “well, we’d rather a noisy alarm that catches the problem than a silent one that doesn’t.” Both are problems. The former just makes management feel like a problem would be caught be the on-call.
Re: Alarms in medical equipment
#16I seem to remember that some of these sounds (perhaps the one with syllables) were originally part of a joke paper and that the author was quite astonished how they became part of a standard.
Unfortunately, I cannot find the article anymore.
Re: Alarms in medical equipment
#17A friend of mine used to have a small side business selling loudspeakers for medical equipment. She order them in Asia and had her own little certification lab at home: heat chamber, impedance testing, that kind of stuff. Every so often, she’d receive an order of a few hundred speaker, and test them one by one.
It’s a low volume but high margin business. Some of the issues were the constant fight against the factory not following design requirements to cut costs, knockoffs etc.
Re: Alarms in medical equipment
#18And how about the fact that there are simply too many of them! I was once in the recovery room with my wife. For some reason the sensor was having a very hard time reading her pulse. The normal bips would frequently fail. Too many failures in a row and the alarm would start it's EEEEEE scream we've all seen from Hollywood. It would shut up as soon as it managed to pick up a beat. Hers was definitely not the only one…
False positives are definitely a problem. When you read industrial accident reports one extremely common theme is some sensor that was notifying the controller of the problem, but that sensor had a history of false positives so it was disregarded. Companies that don't take false positives seriously are inherently dangerous.
> Companies that don't take false positives seriously are inherently dangerous.
Alarms with incessant false positives are inherently dangerous. Sure, there's some threshold of false positives, under which we should still expect people to investigate all alarms. But above that threshold, how can we continue to blame the people involved? The hardware is at fault.
Re: Alarms in medical equipment
#19Earlier quoted context omitted.
False positives are definitely a problem. When you read industrial accident reports one extremely common theme is some sensor that was notifying the controller of the problem, but that sensor had a history of false positives so it was disregarded. Companies that don't take false positives seriously are inherently dangerous.
Many of those companies fall into the trap of “well, we’d rather a noisy alarm that catches the problem than a silent one that doesn’t.” Both are problems. The former just makes management feel like a problem would be caught be the on-call.
The ventilator company I worked for tried very hard to avoid false positives because we were very concerned about alarm fatigue. We also tried to ride the line on false negatives. It’s really hard.
Sometimes the alarm limits are set incorrectly by the RT or aren’t forgiving enough to allow some motion. When you see an entire ward of nurses totally ignoring alarms it’s a management failure. Either there aren’t enough nurses available to manage the issue or there aren’t enough technicians to properly configure the equipment for each patient. If someone dies because of that then it’s ultimately the hospital’s fault.
Re: Alarms in medical equipment
#20And how about the fact that there are simply too many of them! I was once in the recovery room with my wife. For some reason the sensor was having a very hard time reading her pulse. The normal bips would frequently fail. Too many failures in a row and the alarm would start it's EEEEEE scream we've all seen from Hollywood. It would shut up as soon as it managed to pick up a beat. Hers was definitely not the only one…
False positives are definitely a problem. When you read industrial accident reports one extremely common theme is some sensor that was notifying the controller of the problem, but that sensor had a history of false positives so it was disregarded. Companies that don't take false positives seriously are inherently dangerous.
It's hard to solve the problem of false positives when the decision to sound an alarm is reliant on a single sensor that may start to become detached (e.g. glue/tape failure). If you think the solution is multiple sensors, well, what happens when one sensor indicates an alarm condition and the other doesn't? Now you have another potential false positive. Not to mention it's untenable to connect twice as many leads to a patient.