Preliminary development and evaluation of the support system for care of mechanically ventilated patients.
BACKGROUND
We wanted to demonstrate the feasibility of a novel computer-assisted ventilator alarm system, the support system for care of mechanically ventilated patients (SCMVP), to detect gas leaks and provide graphical information on the site of the leak in a manikin model.


METHODS
We tested six leakage scenarios. Four scenarios were applied to both the respiratory circuits with the SCMVP and without the SCMVP (conventional system), and two scenarios were each specific to one of the systems. Fifteen registered nurses were asked to manage three scenarios each (two mutual and one system-specific scenario). Time to identify the site of the leak was measured and compared between the two systems.


RESULTS
The SCMVP showed significantly shorter time for troubleshooting in one of the four mutual scenarios and shorter accumulated time for troubleshooting in the four mutual scenarios [18.0 (range, 14.5-19.5) and 48.5 (9.0-180.0) s, respectively] compared with the conventional system [76.0 (47.0-133.8) and 82.5 (16.0-180.0) s, respectively]. In the mutual scenarios, SCMVP resulted in significantly more frequent incidences of successful troubleshooting within 30 s and less frequent incidences of troubleshooting requiring >180 s [43.3% (13/30) and 6.7% (2/30), respectively] compared with the conventional system [13.3% (4/30) and 30% (9/30), respectively].


CONCLUSIONS
The SCMVP can facilitate rapid and successful recognition of the site of leak in a respiratory circuit in a simulation environment.
Department of Anesthesiology, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan maru555md@yahoo.co.jp.
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Maruyama
Department of Medical Engineering, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Morohashi
Department of Medical Engineering, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Fukakura
Department of Medical Engineering, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Takeuchi
Department of Medical Engineering, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Miyaji
Department of Medical Engineering, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Tsuji
Engineering Development Division, Sango Co., Ltd, 5-35 Yawatayama, Miyoshi-cho, Miyoshi, Aichi 470-0224, Japan.
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Hasegawa
Teikyo University Joint Program Center, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
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Eguchi
Department of Anesthesiology, Saitama Medical University, Saitama International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1241, Japan.
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Usuda
Department of Anesthesiology, Teikyo University, School of Medicine, University Hospital Mizonokuchi, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
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Andoh
D056902:Clinical Alarms; D003198:Computer Simulation; D003201:Computers; D003626:Data Display; D003658:Decision Making, Computer-Assisted; D004867:Equipment Design; D004868:Equipment Failure; D005240:Feasibility Studies; D006801:Humans; D008348:Manikins; D017146:Models, Organizational; D009726:Nurses; D061214:Patient Safety; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*; D013997:Time Factors
monitoring, ventilation; safety, equipment