Continuous patient monitoring in anaesthesia with head-mounted displays
PhD Research Topic
Anaesthetists monitor their patients' electronic vital signs by looking at a visual display mounted on the anaesthesia machine. The display incorporates auditory alarms, designed to prevent anaesthetists from missing important events when they are busy or distracted. However, auditory alarms are often distracting, noisy and uninformative.
Head-mounted displays (HMDs) are one proposed solution to the problems with alarms. The patient monitoring display is superimposed over the anaesthetists's field of view, allowing the surgical field and the patient's vital signs to be monitored simultaneously. Prior studies have reported ambiguous results regarding the performance benefits of HMDs.
Perceptual and cognitive issues with HMDs have been found in other domains, including worsening of the inattentional blindness phenomenon and eye mis-accommodation with HMDs. These issues could lead to anaesthetists missing visual cues and events which may be important for safe practice.
Experiment 1, already completed, investigated the performance benefits of HMDs and the existence of the inattentional blindness phenomenon in a full-scale patient simulator. Anaesthetists did not detect events faster with the HMD, but the HMD did affect their monitoring behaviour. Experiment 2 is a proposed clinical trial of HMDs at the Royal Adelaide Hopsital.
The acting and support team from a full-scale simulator study conducted at the Royal Adelaide Hospital during September 2006.
Capnography simulation on the METI ECS
The METI Emergency Care SimulatorTM is a portable version of the METI Human Patient SimulatorTM, designed primarily for training in trauma scenarios. However, since the ECS is significantly cheaper than the HPS, many institutions use the ECS instead of the HPS for anaesthesia and nursing training. One limitation of this is that exhaled carbon dioxide (CO2) gas on the ECS is intended only to confirm correct ETT placement, not to produce realistic capnographs.In this project, I am working on a software tool called Capnosim that simulates realistic capnographs for the METI ECS during spontaneous ventilation, mechanical ventilation and hand bagging.
The METI Waveform Display (simulated patient monitor for the ECS) augmented with my Capnosim software.
Patient simulator interoperability
The Medical Device "Plug-and-Play" Interoperability Program encourages the adoption of open standards for interconnectivity between medical devices to improve patient safety and healthcare efficiency. Many of the issues raised by the MDPnP program are applicable to patient simulators used for research.As with clinical patient monitors, both desktop and full-scale patient simulators also use proprietary communication protocols and application programming interfaces (APIs). This makes it difficult for researchers to interface with these simulators or use them interchangeably, especially for laboratories without access to specialised software developers.
Related to the issue of proprietary protocols, the highly capable full-scale simulator manikins are tied to the manufacturers' desktop control software. Componentizing these simulators via an open communications protocol would allow researchers to investigate alternative physiological models, provide more control for experiments, and integrate the manikin with other hardware simulators (such as surgical simulators).
Having interoperable patient simulators would also help the MDPnP program by facilitating testing of the program's proposed safety interlocks.
Designing anaesthesia simulators for human factors research
Traditional human patient simulators such as the METI HPS or BODY Simulation are designed to support practitioner training and education. In recent years, researchers have begun using these simulators in human factors research such as evaluation of monitoring displays and anaesthesia machines.The requirements for simulators used in this context are different to the requirements of education and training. I am particularly interested in designing the next generation of patient simulators to better support human factors research, with emphasis on aspects such as:
Last updated: 24th December 2007.