[deleted]
Alarms in medical equipment
71–80 of 118 posts
Re: Alarms in medical equipment
#72I 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.…
If you want to feed observation data into Epic for charting that is quite easy. It supports inbound interfaces using HL7 V2 Messaging and FHIR standards for things like medical device waveforms, aggregated device data, vital signs, etc. Other major inpatient EHRs have similar functionality.
https://open.epic.com/Interface/
The FDA has a whole program office to assist startups with medical device innovation. They can help you a lot if you engage with them early in the development process and explain what you're trying to accomplish. Think of them as partners, not obstacles.
https://www.fda.gov/about-fda/cdrh-innovation/activities-sup...
Re: Alarms in medical equipment
#73I 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 p…
> 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.
Wow this sounds so dangerous and so easy to predict.
Re: Alarms in medical equipment
#74Earlier quoted context omitted.
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
Yes, but in a high-stress environment, your ability to process words--especially those not in your native language--goes down the tubes quickly. Even if you were to tune out sounds to the same degree that you tune out words, at least the sounds would still have a relatively universal meaning, e.g. loud klaxon for big problem, soft chime for minor notification.
Re: Alarms in medical equipment
#75And 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…
I used to work as a field engineer on oilfields and rigs. We had panels of equipment, each with their own alarms and beeps. Once the rig manager (the client) remarked that we were ignoring the alarms, snidely insinuating that we should pay more attention given the possibility of things going wrong. The reality was we knew what was going on just by listening to the alarms. I could predict which alarm was going to go o…
Nope. Alarm fatigue is a well documented problem in the medical field.
Like residents who are getting a few hours of sleep over days worth of high-stress / high-stakes work, poor hand-washing between patients, and not clearly printing one's handwriting on prescription forms - all things that kill patients - doctors and hospital administrators just don't care enough.
For a profession that is supposedly so pure morality-wise - do no harm, patient privacy, etc - doctors are remarkably careless.
Re: Alarms in medical equipment
#76We're building a life critical medical device, and I haven't seen this mentioned, so I thought it was worth contributing:
The use of these alarms is not something imposed by the manufacturers, but by the standards, eg 60601, 62304 etc. For devices involved in diagnostic, or more importantly interventional care, you are required to have alarms within certain auditory and visual thresholds, and a lot of them have mandated silence times (in a life critical system, you can only silence a true alarm for 120 seconds at a time).
Then again, "ALARM" as dictated by the standards means something truly emergent, though the wording can feel a bit fuzzy at times. Trust me, alarm fatigue is a known phenomenon to these manufacturers, and theres been a recent trend (with, eg, the Dexcom G7) of giving users more control over delaying alarms, silencing them until you can respond etc etc, which has its benefits, especially as quality of life is concerned.
You'll have a hard time convincing the FDA of this for critical devices like those found in hospitals though.
Re: Alarms in medical equipment
#77Some of them remind me of YouTuber Ashens' intro sound.
Re: Alarms in medical equipment
#78And 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…
My Mom recently had brain surgery and was recovering. Her machine would go off all the time and it took forever for a nurse to come buy and fiddle with it. I would joke to my Mom that it probably meant she was dying. Those beeps were so annoying. If anything, they should be beeping in the nurse's control area. It seems ridiculous it has to beep loud enough for a nurse down the hallway to hear it when it never seemed to be anything urgent or dangerous. Certainly, no one came running.
Re: Alarms in medical equipment
#79Earlier quoted context omitted.
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 brin…
What would have happened if the medic didn't notice and the patient died? Would you have got the blame for ignoring it, or management for creating a situation where you had no choice but to ignore some alarms because of false positives, or the manufacturer, or would it have been swept under the rug as "the patient was having heart failure and unfortunately even our state-of-the-art medical care couldn't save him"? Al…
There would definitely be an investigation, as all sentinel events are investigated. Management would do their RCA and I'm sure the issue with alarm fatigue would be ignored or underplayed (Something bad happen? make sure an alarm sounded. If staff ignored it, it must be the fault of the staff). I doubt any one person would be in trouble as it was a collective/systemic failure, but I don't know exactly what would have come of it. Likely a policy change or daily reminders for the next few weeks about not ignoring the monitors even if it has been going off nonstop for hours. Maybe extra charting or peer audits. It's a lot less expensive and effort to put pressure on staff than it is to change technology (even if it is as little as setting different, more sane, defaults). Depending on what was recorded from the monitor to the chart, if it looked like there wasn't a delay in resuscitation/cardioversion (like if the lethal rhythm wasn't recorded initially), it may have been just put down as clinical course for the patient, like you suggested. My perspective of that place is a bit jaded (and therefore biased), that place was a toxic burn-out factory.
BTW, "post mortem"? Thanks, the morbid humor made me laugh!
Re: Alarms in medical equipment
#80We're building a life critical medical device, and I haven't seen this mentioned, so I thought it was worth contributing: The use of these alarms is not something imposed by the manufacturers, but by the standards, eg 60601, 62304 etc. For devices involved in diagnostic, or more importantly interventional care, you are required to have alarms within certain auditory and visual thresholds, and a lot of them have manda…
The airline industry went through this too and have moderated requirements to be more understanding of who it's consumers are and when. One of the big near miss cases was QF32 out of Singapore where they had over 50 alarms to deal with in addition the the emergency at hand. Alarm pollution is a real UI/UX dilemma.