Journal of clinical engineering
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Medical procedures that require general anesthesia outside of the traditional operating room setting have become commonplace. This paper describes a portable inhalational anesthesia machine developed for use in these outlying areas within the hospital. The device combines the basic components of vaporizer, oxygen analyzer, oxygen flow-meter, disposable carbon dioxide absorber and oxygen flush valve into a small package that may be carried with one hand. The unit may be used as a tabletop anesthesia machine or may be attached to a patient transport bed by means of a dedicated stand.
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A computer-based, integrated monitor system was designed and utilized to collect and interactively manage physiologic data (13 variables and 3 waveforms) from six routinely used operating room monitors. Various approaches were developed to reduce false alarms, classify waveforms, and recognize events. False alarms: false alarms in ECG heart rate detection were reduced from 37.3% to 2.6% (p=0.005) of total alarms using multi-variable analysis and rate-of-change limits. ⋯ All ST segment elevations and depressions of 0.1 mV were correctly identified. Event recognition: an algorithm developed to identify endotracheal intubation correctly recognized 13 of 17 intubations. This resulted in a 42% reduction in low end-tidal-CO2 false alarms.
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Hospital cardiac care systems frequently provide multiple-channel cardiac monitoring by telemetry for a second phase of cardiac recuperation from a myocardial infarction. This article describes the engineering and clinical considerations in selecting, designing, and operating telemetry systems in a clinical setting.
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Malignant hyperthermia is a relatively rare condition which strikes susceptible patients undergoing surgery. This disorder is an inherited biochemical defect, triggered by certain anesthetic agents and stress. ⋯ If a patient, by family history or test, is suspected of being susceptible to malignant hyperthermia, special precautions must be taken before proceeding with surgery. The clinical engineer must: 1) prepare special anesthesia equipment which is free of trace gases capable of triggering an episode of malignant hyperthermia; 2) provide special monitoring facilities to detect the onset of an episode; and 3) have treatment facilities on hand in the event that an episode does develop.
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This paper is concerned with telephone biotelemetry, such as in the transmission of ECGs or EEGs through telephone networks. It briefly describes the applications of biotelemetry and some research activities in the field. ⋯ Shortcomings in the existing telephone biotelemetry systems are identified and some possible solutions to these problems are investigated. The paper is written as a tutorial article directed primarily at clinical engineers, biomedical equipment technicians and other health-care professionals who are interested in the subject.