Headset Helps Anesthesiologists Monitor Data During Surgery

The HMD displayed the patient's electrocardiogram, plethysmogram, and capnogram waveforms; heart rate; pulse rate, blood oxygen saturation (SpO2), and perfusion; end-tidal and inspired carbon dioxide (CO2), anesthetic agent, Oxygen (O2), and Nitrous Oxide (N2O); respiratory rate; noninvasive blood pressure; and mean alveolar concentration(MAC). Current time, technical, and patient alarms are also displayed.

Six attending anesthesiologists were then asked to test the system undergoing rigid cystoscopy. Each anesthesiologist performed six cases, alternating between standard monitoring and standard monitoring plus the HMD. Video footage was recorded during all cases and analyzed to determine the percentage of time, frequency, and duration of looks at the anesthesia workstation, the patient, and the surgical field during various anesthetic phases. The results showed that when the anesthesiologists were using the HMD, they spent less time looking toward the anesthesia workstation, and more time looking toward the patient and surgical field. The report describing the system and the study was published in the April 2010 issue of Anesthesia & Analgesia.

"An HMD of patient vital signs reduces anesthesiologists' surveillance of the anesthesia workstation and allows them to spend more time monitoring their patient and surgical field during normal anesthesia,” concluded lead author anesthesiologist David Liu, M.D., and colleagues of the department of information technology and electrical engineering. "More research is needed to determine whether the behavioral changes can lead to improved anesthesiologist performance in the operating room.”

The HMD device was based on the NOMAD ND2000 expert technician system, developed by Microvision (Redmond, MA, USA), a wireless, head-up, wearable computer display module that delivers a high contrast, high-resolution (SVGA) transparent images that can be overlaid on the user's vision. The system includes a fully integrated wireless (802.11b) Windows CE "thin client" computer, with controls input and navigation through a touch pad and keypad on a belt-mounted control module.

"Fighter pilots in close combat cannot afford to take their eyes off of the enemy to see their flight instruments. Instead, combat planes are equipped with a 'heads-up display' that projects the instrument readings into the pilot's line of sight,” said Steven Shafer, M.D., of Columbia University (New York, NY, USA), editor-in-chief of Anesthesia & Analgesia. "In just the same way, anesthesiologists cannot afford to look away from a critically ill patient to the bank of monitors several feet behind them.”

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University of Queensland
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