title: An integrated graphic data display improves detection and identification of critical events during anesthesia.
abstract: OBJECTIVE
  To show that an integrated graphic data display can shorten the time taken to detect and correctly identify critical events during anesthesia.
  
  
  METHODS
  We developed a graphic display which presents 30 anesthesia-related physiologic variables as shapes and colors, rather than traditional digits and waveforms. To evaluate the new display, we produced four critical events on a computer-based anesthesia simulator and asked two groups of five anesthesiologists to identify the events as quickly as possible. One group observed the new display while the other group viewed a traditional cardiovascular monitor with digital and waveform displays.
  
  
  RESULTS
  The group which observed the integrated graphic display saw changes caused by inadequate paralysis 2.4 min sooner, and changes caused by a cuff leak 3.1 min sooner than those observing the traditional display. The integrated display group correctly identified the reason for the change 2.8 min sooner for inadequate paralysis, 3.1 min sooner for cuff leak and 3.1 min sooner for bleeding. These differences were all statistically significant.
  
  
  CONCLUSIONS
  The results show that some simulated critical events are detected and correctly identified sooner, when an anesthesiologist views an integrated graphic display, rather than a traditional digital/waveform monitor.
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City 84132, USA.
authors.forename: P
authors.initials: P
authors.lastname: Michels
authors.forename: D
authors.initials: D
authors.lastname: Gravenstein
authors.forename: D R
authors.initials: DR
authors.lastname: Westenskow
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000776:Anesthesiology / Q000295:instrumentation*; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D001803:Blood Transfusion; D017610:Calcium Compounds; D002245:Carbon Dioxide / Q000378:metabolism; D002302:Cardiac Output; D003196:Computer Graphics; D003198:Computer Simulation; D003199:Computer Systems; D004868:Equipment Failure; D005440:Fluid Therapy; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008954:Models, Biological; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D019148:Neuromuscular Blockade; D010087:Oxides; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D012119:Respiration; D012972:Sodium Hydroxide; D012984:Software; D018511:Systems Integration; D013997:Time Factors
chemical_list: D017610:Calcium Compounds; D010087:Oxides; D002245:Carbon Dioxide; C004569:soda lime; D012972:Sodium Hydroxide; D010100:Oxygen