Seeking Clinically-Significant Events
The various types of smart alarms and the flexible nature of the parameters surrounding their configuration are a key feature of the Bernoulli One™ platform. The smart alarms function on continuous real-time data. Here’s how. The Bernoulli system provides the ability to create unique alarm events by taking into consideration various features that are observed in the medical-device-originating raw data, versus simply filtering alarms as issued by bedside patient care medical devices (i.e. Limit Alarms). This enables the platform to issue custom alarm signals that are independent of the patient care medical device. Further, Bernoulli enables the creation of signals that are more clinically actionable by placing the power of alarm signal customization and tailoring in the hands of the bedside clinician. Therefore, these alarm signals are more clinically relevant to the specific conditions and patient cohort, staff workflow, and context of the clinical environment.
A Smart Alarms Clinical Use Case
To help explain how the system works, let’s look at an instance where Bernoulli detects consecutive patient events and sends an early warning alert to a clinician.
The Situation: Jill is a 32-year old female patient that has been involved in a car crash. She is currently conscious and receiving support on a mechanical ventilator in the Intensive Care Unit. When Jill coughs, this effectively causes a sharp peak pressure rise in the inspiratory tubing, resulting in an alarm being issued to the central nursing station. Individually, these coughs are episodic and do not pose a clinical threat to Jill, and intervention is not required. The situation, however, can change if sputum should block her breathing tube or if Jill’s movement should result in a kink in the inspiratory tubing. Either of these situations would result in a persistent high peak pressure measurement – several per minute, or more. These events can be dangerous to the patient as they would prevent Jill from receiving needed oxygen. Hence, a notification indicating multiple or consecutive peak pressure alarm signals within a specific, finite timeframe – three or more per minute, for example – may be identified as a policy by the house staff that these events, when indicated, would advise attention when detected. In either of the example causes listed above, intervention by respiratory therapy or nursing would be needed to either suction and clear the line or remove occlusions in tubing to ensure the free-flow of oxygen to Jill.
The Bernoulli Resolution: A parameter is set within the Bernoulli system to detect the consecutive occurrence of high peak pressure. When these occur within a one-minute timeframe, Bernoulli generates a new type of alarm – a “consecutive events smart alarm”. Then a “tap on the shoulder” message is sent to the appropriate clinician. Timely patient care yields a more positive experience and outcome.