• Title/Summary/Keyword: Clinical alarms

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Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units (중환자실에서 사용되는 의료장비의 경보음 발생과 관리 현황)

  • Jeong, Yu Jin;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.20 no.4
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    • pp.228-235
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    • 2018
  • Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.

The impact of modern airport security protocols on patients with total shoulder replacements

  • Michael D. Scheidt;Neal Sethi;Matthew Ballard;Michael Wesolowski;Dane Salazar;Nickolas Garbis
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.416-422
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    • 2023
  • Background: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA). Methods: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants. Results: A total of 53 patients (62%) responded "yes" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30). Conclusions: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

Effects of the Schematized Alarm-managing Manual for Continuous Renal Replacement Therapy on the Alarm Resolution Rate and Nursing Competence of Nurses in Intensive Care Units (지속적 신대체요법 시 도식화된 알람 관리 매뉴얼 사용이 중환자실 간호사의 알람 해결률과 간호수행능력에 미치는 효과)

  • Choi, Aeng Ja;Yi, Young Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.535-544
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    • 2014
  • Purpose: This study was done to develop a schematized alarm-managing manual for continuous renal replacement therapy (CRRT) and to investigate its effects in maintaining continuity in the patients' treatment and promptly resolving alarms when CRRT is being carried out. Methods: Sixtynurses from two medical intensive care units (ICUs) (one experimental and one control) at one hospital were asked to answer a questionnaire including their CRRT nursing competency and satisfaction with the manual. Data on alarm resolution rate were collected by analyzing existing data, such as the details of each alarm and the number of resolutions around the clock in the CRRT device. Results: The alarm resolution rate and some of CRRT nursing competency scores in the experimental group were higher than those in the control group. The experimental group was also satisfied with the manual. Conclusion: The study confirmed that the schematized alarm-managing manual can be useful for ICU nurses to resolve alarms and can be used as a guideline. Application of this manual to clinical practices and its use can therefore, be encouraged through continuous education and promotion.

Comparison of the Clinical Performance between Two Pulse Oximeters in NICU: Nellcor $N-595^{(R)}$ versus Masimo $SET^{(R)}$ (신생아 중환자실에서 맥박산소측정기의 감지도 비교: Nellcor $N-595^{(R)}$ versus Masimo $SET^{(R)}$)

  • Lee, Heun-Ji;Choi, Jang-Hwan;Min, Sung-Ju;Kim, Do-Hyun;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.245-249
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    • 2010
  • Purpose: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo $SET^{(R)}$ was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor $N-595^{(R)}$ and Masimo $SET^{(R)}$) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. Methods: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2$\leq$85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. Results: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo $SET^{(R)}$ pulse oximetry (48 in Nellcor $N-595^{(R)}$, 27 in Masimo $SET^{(R)}$) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor $N-595^{(R)}$, 19 in Masimo $SET^{(R)}$). Conclusion: The Masimo $SET^{(R)}$ pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor $N-595^{(R)}$ pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.

Anomaly Detection in Medical Wireless Sensor Networks

  • Salem, Osman;Liu, Yaning;Mehaoua, Ahmed
    • Journal of Computing Science and Engineering
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    • v.7 no.4
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    • pp.272-284
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    • 2013
  • In this paper, we propose a new framework for anomaly detection in medical wireless sensor networks, which are used for remote monitoring of patient vital signs. The proposed framework performs sequential data analysis on a mini gateway used as a base station to detect abnormal changes and to cope with unreliable measurements in collected data without prior knowledge of anomalous events or normal data patterns. The proposed approach is based on the Mahalanobis distance for spatial analysis, and a kernel density estimator for the identification of abnormal temporal patterns. Our main objective is to distinguish between faulty measurements and clinical emergencies in order to reduce false alarms triggered by faulty measurements or ill-behaved sensors. Our experimental results on both real and synthetic medical datasets show that the proposed approach can achieve good detection accuracy with a low false alarm rate (less than 5.5%).

A Case Study on the Implementation of a Real-time Patient Monitoring System based on Wireless Network (무선 네트워크 기반의 실시간 환자 모니터링 시스템 구축 사례 연구)

  • Choi, Jong-Soo;Kim, Dong-Soo
    • IE interfaces
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    • v.23 no.3
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    • pp.246-256
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    • 2010
  • As wireless and mobile technologies have advanced significantly, lots of large sized healthcare organizations have implemented so called mobile hospital (m-Hospital) which provides a location independent and point of care (POC) clinical environment. Implementation of m-Hospital enhances quality of care because health professionals such as physicians and nurses can use hospital information systems at the very place where patients are located without any delay. This paper presents a real-time patient monitoring system based on wireless network technologies. A general framework for the patient monitoring process is introduced and the architecture and components of the proposed monitoring system is described. The system collects and analyzes biometric signals of in-patients who suffer from cancer. Specifically, it continuously monitors oxygen saturation of patients in bed and alarms health professionals instantly when an abnormal status of the patient is detected. The monitoring system has been used and clinically verified in a university hospital.

DEVELOPMENTAL AND CLINICAL CHARACTERISTICS IN CHILDREN WITH NOCTURNAL ENURESIS : RESULTS OF A MULTICENTER STUDY (야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 발달학적 및 임상적 특성을 중심으로)

  • Cho Soo-Churl;Shin Min-Sup;Hwang Jun-Won;Han Sang-Won;Park Kwan-Hyun;Lee Sang-Don;Kim Kyung-Do;Kim Kun-Suk;Suh Hong-Jin;Lee Yoo-Sik;Chung Jae-Yong;Kim Young-Kyoon;Kim Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.1
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    • pp.32-39
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    • 2006
  • Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

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