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Alarms in medical equipment

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Re: Alarms in medical equipment

#81

Post by akira2501 »

Dalewyn wrote: post #70
akira2501 wrote: post #65

Earlier quoted context omitted.

> In an airplane, the environment is highly controlled Aircraft systems are developed independently and added as options to planes. Which means they get swapped out, there are variants in capabilities, and multiple manufacturers involved. > This can lead to cognitive overload when multiple systems issue verbal warnings simultaneously. This is a known phenomenon on flights as well. There is some speculation it played…

>Aircraft systems are developed independently and added as options to planes. Which means they get swapped out, there are variants in capabilities, and multiple manufacturers involved. He means there is only ever one aircraft (the one you're flying) and hundreds of patients in a hospital. Imagine if you will, hundreds of GPWS alarms are blaring off all screaming TERRAIN PULL UP TERRAIN PULL UP PULL TERRAIN UP UPTERRA…

Yea, I kinda got myself there in a roundabout way in the end.

In any case, if that's the environment, then it reminds me of our solutions for broadcast studio alarms. There was a combined master tone alarm in the engineering control room, and a set of annunciators for each station, with three levels of severity for each. You'd hear the tone, snap your head around to look at the board, and quickly be able to tell what you were dealing with and where the priority problems were.

Likewise, in the hallway leading up to the studios, there were colored flashing lights above each studio door that also displayed the alarm level for that studio. Those were completely silent, for obvious reasons, but their flashing pattern got your attention anyways. They were arranged vertically according to severity so even if you were color blind you could understand them at a distance.

Then inside the studios there were more detailed annunciators that would actually display which part of the air chain monitoring was causing the global alarm signal. These were also silent, but did not flash, and had a clock that would pause when the first error became displayed.

Re: Alarms in medical equipment

#82

Post by hiAndrewQuinn »

KennyBlanken wrote: post #75
takinola wrote: post #68

Earlier quoted context omitted.

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 moralit…

"They just didn't care enough" is an argument which can explain everything about how 1 person operates, half of a 10 person group, and roughly 0% of an entire profession. It's a question of the economic incentives at play far more than doctors universally deciding not to give a shit.

The economic recommendation is to deregulate the medical personnel industry and allow supply to increase. A great many smart and good people would love to become doctors but aren't in love with 5 years of residency and taking a quarter million dollars in debt to make less than their dropout cousin does at Netflix.

Re: Alarms in medical equipment

#83

Post by nabusman »

hiAndrewQuinn wrote: post #82
KennyBlanken wrote: post #75

Earlier quoted context omitted.

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 moralit…

"They just didn't care enough" is an argument which can explain everything about how 1 person operates, half of a 10 person group, and roughly 0% of an entire profession. It's a question of the economic incentives at play far more than doctors universally deciding not to give a shit. The economic recommendation is to deregulate the medical personnel industry and allow supply to increase. A great many smart and good p…

Pure deregulation can lead to a bit of anarchy, but a more measured approach that ensures that the regulation doesn't act as a way to decrease supply and increase profits for the industry would make sense. Probably something for Lina Khan to look into.

Re: Alarms in medical equipment

#84

Post by jill4545 »

An amendment to IEC 60601-1-8 introduces the concept of acoustic icons. These are the alarms that mimic the sound of what the device does e.g. a ventilator would be a sighing/breathing sound as well as a pulse to indicate if its alarm with a priority. This directs the clinician to know immediately which device is alarming and how high the priority is as opposed to a plethora of beeps and pings all merging together. Could be a game changer.

Re: Alarms in medical equipment

#85

Post by kioleanu »

Only very slightly tangential, I remember when my son had his surgery and had to be in the hospital, they would have these dosing machines for the medicine and they would start throwing a warning sign 3 minutes before the syringe was empty, every 30 seconds and then a proper alarm when it was empty. Now, we were supposed to call a nurse to remove the syringe, and each nurse had their own preference on when to be called. Some said call us when the warning starts, some said call us a minute before and some said call us when the red alarm goes off. We found this strange until one of them explained it is simply related to the amount of chit chat they wanted to do with us, as the syringe always had to go out at the red alarm

Re: Alarms in medical equipment

#87

Post by matheusmoreira »

hiAndrewQuinn wrote: post #82
KennyBlanken wrote: post #75

Earlier quoted context omitted.

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 moralit…

"They just didn't care enough" is an argument which can explain everything about how 1 person operates, half of a 10 person group, and roughly 0% of an entire profession. It's a question of the economic incentives at play far more than doctors universally deciding not to give a shit. The economic recommendation is to deregulate the medical personnel industry and allow supply to increase. A great many smart and good p…

> deregulate the medical personnel industry and allow supply to increase

And salaries to plummet.

Who's gonna be the first to volunteer to spend about 14 hours of their day in some shithole hospital nearly every day sacrificing their own health and sanity for the sake of others, all while making a fraction of what people here make? Deny people their prosperity and suddenly going to medical school turns into a stupid and irrational decision and something only rich people will put up with for the status.

Re: Alarms in medical equipment

#88

Post by hejdufufjrj »

jimmySixDOF wrote: post #80
ijustlovemath wrote: post #76

We'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.

In an airplane at least all the alarms are integrated, but in a hospital room you'll have 15 devices from 7 manufacturers spanning 5 generations.

Re: Alarms in medical equipment

#90

Post by fhsm »

HeyLaughingBoy wrote: post #52
graypegg wrote: post #37

Earlier quoted context omitted.

I can kind of understand why it ended up that way. There's some benefit to just assuming, nothing works together. It's at least a consistent state of affairs. You can just wheel in any heart rate monitor, and you only need to understand that heart rate monitor. But it seems like a space that's really ripe for improving. We have very reliable simple protocols you could hook these all into. Imagine it was law that ever…

Interoperability is definitely a problem. I've been in the industry for quite some time, and at one job we got to shadow med lab techs, since they were the operators of the machines that we built. Their workload is insane and after an hour watching them work, I could identify a number of new products that would help them. I brought it up to my management and learned that "marketing is aware of those problems and we'r…

Inter op has a lot of different standards but support for all those standards is limited. Here’s an example:

https://www.astm.org/f2761-09r13.html

As you point out the corporate network operators tend to have a different set of priorities but even there too standards exist. Here’s an example:

https://www.iso.org/standard/72026.html

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