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Alarms in medical equipment

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Re: Alarms in medical equipment

#21

Post by kmoser »

tux3 wrote: post #5

Trying to figure out which melody was which in an emergency doesn't seem like the most human-friendly. Contrast with the GPWS warnings in aviation, which tells you what the problem is (TERRAIN TERRAIN) and what to do (PULL UP) in a progressively more alarmed voice as things get worse. (Well.. Sometimes you hear of some particularly bright individuals who think the bank angle warning is a checklist item , but it's gen…

At least chimes are language-agnostic. Verbal warnings like "pull up" are only good if you have a reasonable grasp of English.

Re: Alarms in medical equipment

#22

Post by btach »

LorenPechtel wrote: post #4

And 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…

Anecdote: At an ED I used to work at, our cardiac monitors got "upgraded" to another manufacturer. Silencing false alarms was a black hole of a game of whack-a-mole. You could never silence them all, another would just pop up to spite you. Anyway, one night, it was continuing to alarm and being ignored (with a glance occasionally to make sure). Except somebody was in v-tach and the person who noticed was a medic bringing a patient in. Thank goodness they noticed amid the noise! (We had as good of outcome as could be expected with that patient, and they went to the cath lab and lived).

Re: Alarms in medical equipment

#23

Post by Lammy »

sebmellen wrote: post #6
tux3 wrote: post #5

Trying to figure out which melody was which in an emergency doesn't seem like the most human-friendly. Contrast with the GPWS warnings in aviation, which tells you what the problem is (TERRAIN TERRAIN) and what to do (PULL UP) in a progressively more alarmed voice as things get worse. (Well.. Sometimes you hear of some particularly bright individuals who think the bank angle warning is a checklist item , but it's gen…

GPWS warnings should be the gold standard for any sort of urgent audio alarm. Examples: https://www.youtube.com/watch?v=W5Z-d1Zx02o

Making this my PagerDuty alert sound https://youtu.be/fbfVGIBcD8c?t=77

Re: Alarms in medical equipment

#24

Post by atahanacar »

blackeyeblitzar wrote: post #13

I 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.…

>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

This doesn't sound like the equipment's fault.

Re: Alarms in medical equipment

#25

Post by graypegg »

tux3 wrote: post #5

Trying to figure out which melody was which in an emergency doesn't seem like the most human-friendly. Contrast with the GPWS warnings in aviation, which tells you what the problem is (TERRAIN TERRAIN) and what to do (PULL UP) in a progressively more alarmed voice as things get worse. (Well.. Sometimes you hear of some particularly bright individuals who think the bank angle warning is a checklist item , but it's gen…

I wonder how much information any 1 medical device with an alert knows though. GPWS has the benefit of being part of 1 system, where (I think, no experience here) hospitals seem to treat equipment as singular items that do 1 thing or are meant for a specific area of responsibility in an operation. Like a vitals monitor might not know what the drug pump is doing.

I could imagine

    ventilation? arrhyth-*C-chord*-ARRHYTHMIA! CHECK PUMP! HEART RATE!
coming from different devices to be pretty distracting.

I think GPWS can set windows of cases where an alert is given. Like, a terrain warning isn't much help when landing. Maybe there's something like that already for medicine, but a device who's job is to consume information from other devices, and only provide alerts based on rules the staff can configure before an operation, could be a thing that's useful.

Re: Alarms in medical equipment

#26

Post by bee_rider »

kmoser wrote: post #20
jandrese wrote: post #9

Earlier 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.

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…

If they’d use three sensors, they could vote. If one sensor often votes differently from the other two, it could be marked as defective and replaced or re-seated.

Three times as many leads would be pretty annoying, though.

Re: Alarms in medical equipment

#27

Post by mschuster91 »

blackeyeblitzar wrote: post #13

I 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's a necessity, a side-product of not having anywhere near enough nurses, assistant staff and doctors in hospitals. They're juggling alarms constantly (which have to blare in a cacophony) and speed from one patient to the next.

Ideally you'd have a 1:1 (or better!) assignment between a single patient to a single nurse in critical care, 1:3 for patients that can't move around on their own (and thus need more assistance, even if it's just helping them to eat or go to the loo), and 1:5 to 1:10 for everyone else. The sad reality is that even in Germany, you have care home staff calling in the fire department to assist because there were just three staff in a night shift, having to deal with 170 patients.

[1] https://www.morgenpost.de/berlin/article242110812/Kurioser-G...

Re: Alarms in medical equipment

#28

Post by graypegg »

kmoser wrote: post #21
tux3 wrote: post #5

Trying to figure out which melody was which in an emergency doesn't seem like the most human-friendly. Contrast with the GPWS warnings in aviation, which tells you what the problem is (TERRAIN TERRAIN) and what to do (PULL UP) in a progressively more alarmed voice as things get worse. (Well.. Sometimes you hear of some particularly bright individuals who think the bank angle warning is a checklist item , but it's gen…

At least chimes are language-agnostic. Verbal warnings like "pull up" are only good if you have a reasonable grasp of English.

At the very end, there's some examples of more literal sounds. It says there hasn't been a study, but I would bet they're a lot more clear with out having to resort of the aviation standard of "just learn basic english".

buh-bump is cardiac stuff. wiSShhh... wooosSH is respiratory stuff.

Only thing is, I bet you can hear sounds similar to those in a hospital. The "beep beep" they put over it might not be enough. Still a really interesting research topic!

Re: Alarms in medical equipment

#29

Post by HeyLaughingBoy »

graypegg wrote: post #25
tux3 wrote: post #5

Trying to figure out which melody was which in an emergency doesn't seem like the most human-friendly. Contrast with the GPWS warnings in aviation, which tells you what the problem is (TERRAIN TERRAIN) and what to do (PULL UP) in a progressively more alarmed voice as things get worse. (Well.. Sometimes you hear of some particularly bright individuals who think the bank angle warning is a checklist item , but it's gen…

I wonder how much information any 1 medical device with an alert knows though. GPWS has the benefit of being part of 1 system, where (I think, no experience here) hospitals seem to treat equipment as singular items that do 1 thing or are meant for a specific area of responsibility in an operation. Like a vitals monitor might not know what the drug pump is doing. I could imagine ventilation? arrhyth-*C-chord*-ARRHYTHM…

That's really the problem many here are describing. 60601 mandates what alarms shall be active, but it spans a single device. If you have, e.g., 10 ventilators in a room that are alarming, you can't silence them all with a single button press.

Re: Alarms in medical equipment

#30

Post by HeyLaughingBoy »

davidw wrote: post #11

It gives me anxiety just looking at this. Add this to the list of things I don't want to work on.

On the producing or consuming side? FWIW, I found the article interesting as I'm starting a new Oxygenator project so I'm probably about to become even more familiar with IEC60601 :-(
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