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Alarms in medical equipment

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Re: Alarms in medical equipment

#41

Post by turrican »

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.

True, but professional pilots from all countries are expected to be fluent in Aviation English. https://en.wikipedia.org/wiki/Aviation_English

Re: Alarms in medical equipment

#42

Post by strnisa »

The standardization of medical alarms was important when introduced, providing consistent and clear communication across devices and countries. However, with modern technology, these standards may now limit innovation.

It seems to me that clear verbal alerts like "BLOOD PRESSURE VERY HIGH" could be more immediately understandable than tones. A hybrid system combining verbal alerts with alarm tones might be a good compromise for clarity and international usability.

Re: Alarms in medical equipment

#43

Post by dmd »

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.…

About 15 years ago I worked for a medical usability firm. We did a review of the Baxter Large Volume Infusion Pump. Among dozens of other issues[1] we found, the absolute mother of them all was the stop button, which had been overloaded to have multiple functionalities:

If you push the button once, it would stop infusing drug into the patient.

If you push the button twice, it would EMPTY THE SYSTEM - as in, run the pump continuously, infusing all remaining drug into the system, at high speed.

We ran usability tests where we'd say to the nurse "wrong drug! stop! you're giving the patient the wrong drug!"

90+ percent of them did what any human would do - jab STOP over and over. Whoops, patient's dead.

In part because of our report Baxter was forced to recall[0] hundreds of thousands of the pumps and pay for their replacements with competitors' products. The stock dropped by 30% in a day. Sadly I didn't short it, or I'd be [checks notes] in jail.

[0] https://archive.is/s1wEU

[1] like drug libraries where sometimes the units were displayed, sometimes they weren't, and sometimes they were displayed in your "preferred" units even though the number being shown was in a DIFFERENT unit and the system didn't translate it, just showed the wrong value.

Re: Alarms in medical equipment

#44

Post by lostlogin »

bee_rider wrote: post #26
kmoser wrote: post #20

Earlier quoted context omitted.

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.

You’ve hit the nail on the head. It’s often tedious getting one to work.

Re: Alarms in medical equipment

#45

Post by ncallaway »

strnisa wrote: post #42

The standardization of medical alarms was important when introduced, providing consistent and clear communication across devices and countries. However, with modern technology, these standards may now limit innovation. It seems to me that clear verbal alerts like "BLOOD PRESSURE VERY HIGH" could be more immediately understandable than tones. A hybrid system combining verbal alerts with alarm tones might be a good com…

I don’t know, I kinda think if you’re going to have verbal warnings you kinda need a centralized system that processes all alarms to triage them like in an airplane.

If even 2 verbal alarms are going at the same time, it’s going to create a chaotic environment.

In a decentralized system, I think tones have less of an overlapping problem.

Re: Alarms in medical equipment

#46

Post by flemhans »

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

I used to have pull up as my ringtone, freaked my uncle out (who's a commercial pilot) when he was over for dinners. Or at least he pretended to be :P

Re: Alarms in medical equipment

#47

Post by flemhans »

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.

Another good thing is that they allow for talking over them better. The same way you may sing along to an instrumental-only music track using whichever lyrics you prefer.

Re: Alarms in medical equipment

#48

Post by masto »

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

Now I have this.

https://looptube.io/?videoId=W5Z-d1Zx02o&start=77.1286764705...

Re: Alarms in medical equipment

#49

Post by unsignedint »

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…

One significant difference between verbal warning systems in airplanes and those in medical environments, such as hospitals, is the level of environmental control. In an airplane, the environment is highly controlled, with a single set of systems specific to that aircraft. In contrast, hospitals often have multiple systems operating simultaneously in the same room or nearby. This can lead to cognitive overload when multiple systems issue verbal warnings simultaneously. In such scenarios, tone alarms might be easier to manage and differentiate than multiple overlapping verbal warnings.

Re: Alarms in medical equipment

#50

Post by _yb2s »

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…

Hospitals have a sort of manic "New York Stock Exchange" energy and environment to them... The entire environment of a modern hospital seems brutally incompatible with the type of peaceful relaxing environment you'd want to reduce stress and improve patient outcomes. Bright lights, constant noise, loud electronics, preventing patients from sleeping based on whatever schedule is convenient to medical staff, etc.

I think they could substantially improve patient outcomes by taking some tips from the best modern birthing centers, and make a quiet, relaxing, dimly lit, and peaceful environment at hospitals. I'd also say add some plants, natural (wood) surfaces and natural light, but realize that might make it hard to keep things sterile and private. It would make sense to create a rough schedule for each patient also with a consistent "left alone unless there is an emergency" time for sleep, etc.

I would imagine a calm and quiet physical environment would also reduce stress, fatigue, and improve performance of the medical staff themselves.

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