ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Oscillometric non-invasive blood pressure (NIBP) monitors determine systolic, mean and diastolic pressures by recording the waveform of low-amplitude pressure pulses induced in a cuff placed around a limb, as the cuff pressure is decreased from above the systolic to below the diastolic pressure. The low-amplitude pressure pulses form a waveform known as the oscillometric waveform. Empirical algorithms extract the pressures from the relationship between the oscillometric waveform and the cuff pressure. The pressure pulses in the cuff occur at each arterial pulsation, and hence the pulse rate affects the determination. Any movement of the cuff may also induce artifactual pressure pulses in the cuff, which may disturb the determination, while weak arterial pulsations may reduce the amplitude of the pressure pulses, degrading the signal-to-noise ratio. We used test simulators to examine how variations in pulse rate and pulse strength and the addition of artifact influence the measurements recorded by NIBP monitors. We tested 22 different models of NIBP monitors, with five determinations recorded under each condition. The average blood pressures recorded by the monitors were not significantly affected by pulse rate over the range from 40 to 200 bpm; consistent reading at low pulse rates were achieved by decreasing the deflation rate, thus increasing the determination time (from under 20 sec at 200 bpm to over 30 sec at 40 bpm). Several monitors recorded erratic and sometimes excessively high systolic blood pressures in the presence of artifact, while others signalled to the operator that the high level of artifact made recordings impossible. Pulse strengths of 25% nominal were coped with by most monitors, with a tendency for the monitors to record slightly low systolic pressures at pulse strengths of 25% or less.

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The safe, effective and consistent use of medical devices requires that they be technically capable of achieving their desired functions, and that they be designed to address the potential for user problems that may arise during their use. While the issue of usability arises throughout the hospital, the intensive care unit has been shown to be an area with unique human factors problems. The reasons for this include the multiple devices often being used, the stress under which the staff works, and the condition of the patients that may make them more susceptible to device mishaps. To investigate this issue we examined the ICU at a local hospital for potential causes of human error. Our observations revealed a range of problems, including: multiple alarm use; excessive clutter; anthropo-metric limits; and the potential for confusion in the various interfaces between devices, disposables, and patients. Our investigation also included discussions with the nursing staff and a survey to see how they feel about the medical equipment they use. As a result of these investigations, several recommendations for in-house and manufacturer improvements are given.

ISSN:0363-8855    

出版商:OVID    

年代:1998

数据来源: OVID