The high number of false positive alarms has long been known to be a serious problem in critical care medicine - yet it remains unresolved. At the same time, threats to patient safety due to missing or suppressed alarms are being reported. The purpose of this paper is to present results from a workshop titled "Too many alarms? Too few alarms?" organized by the Section Patient Monitoring and the Workgroup Alarms of the German Association of Biomedical Engineering of the Association for Electrical, Electronic and Information Technologies. The current situation regarding alarms and their problems in intensive care, such as lack of clinical relevance, alarm fatigue, workload increases due to clinically irrelevant alarms, usability problems in alarm systems, problems with manuals and training, and missing alarms due to operator error are outlined, followed by a discussion of solutions and strategies to improve the current situation. Finally, the need for more research and development, focusing on signal quality considerations, networking of medical devices at the bedside, diagnostic alarms and predictive warnings, usability of alarm systems, education of healthcare providers, creation of annotated clinical databases for testing, standardization efforts, and patient monitoring in the regular ward, are called for.
Wearable electronics may become a key element in the future to measure a patient's physiological parameters not only in a clinical environment. This work describes dry electrodes based on conductive rubber, which can be integrated into clothing for monitoring purposes. Characteristic electrical properties like warm up time, skin-electrode impedance and motion artefacts will be discussed.
The paper describes an approach to monitor a person's ECG and activity continuously with functional clothing. A belt with integrated electronics has been developed and has proven long-term robustness of all electrical components. A low-power module measures the ECG signal as well as the acceleration (2-axis) and stores data continuously up to two days. A user test has been performed to evaluate the belt according to system performance at different daily-life activities like sleeping, walking and so on. System parameters are ECG-signal quality, system up-time, and ECG-signal coverage during a day.
The paper compares the data obtained from a continuous wave Doppler radar sensor based on a commercially available microwave motion sensor KMY24 to an impedance cardiograph measured using a Cardiac Output Monitor (Medis Niccomo). Both sensors are used to analyze the mechanical activity of the heart. System parameters, signal content and robustness are discussed.
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