The Trojan Horse of the Operating Room: Alarms and the Noise of Anesthesia
Marilyn Sue Bogner in Misadventures in Health Care, 2003
The equipment Jessica uses in the operating room (OR) includes an anesthesia machine that delivers anesthetic gas to patients to put them to sleep; the patient monitoring system that displays patients’ vital signs so she can check that the patients are safe; and infusion pumps (computer-chip-based devices) that deliver intravenous drugs at programmed rates of flow to the patient as needed throughout surgery. Anesthesia technicians, who traditionally are trained to work with the mechanical aspects of the anesthesia equipment but have no medical or nursing certification, set up the anesthesia machine before Jessica arrives in the OR. Each piece of equipment has its unique quirks in functioning that anesthesia care providers (ACPs), including Jessica, get to know as they use it. If equipment malfunctions or if quirks require workarounds (ways of compensating for problems) that are unsafe, the ACPs can send equipment to the biomedical engineering department where specialist engineers and technicians fix it, as their workload and level of training allows.
Radiation Therapy Politics
Barbara Bridgman Perkins in Cancer, Radiation Therapy, and the Market, 2017
In turning to specialty and trade associations to formulate health-planning and Certificate of Need standards, the government assigned the foxes to guard the henhouse. The American College of Radiology and the National Electrical Manufacturers Association collaborated in developing guidelines for radiation therapy services.62 They chose the college’s 300-patient minimum-volume criterion, based on an estimated financial break-even point, to ensure that services could support themselves economically. The medical electronics industry also favored minimum volume standards, as larger institutions purchased more equipment.63 Health planning, as it was implemented under the 1974 law, was primarily a financial strategy.
Chemical and Molecular Imaging of Deep Tissue through Photoacoustic Detection of Chemical Bond Vibrations
Lingyan Shi, Robert R. Alfano in Deep Imaging in Tissue and Biomedical Materials, 2017
VPAI has shown its powerful ability for deep tissue imaging. However, it is still in its early stage. Future development of VPAI may be focused on the optical beam management to reduce the optical scattering in deep tissue, excitation laser with specific wavelength, high repetition rate and high output power pulsed laser to realize high-sensitivity video-rate imaging, and the miniaturization of imaging device, for example catheter in IVPA system, to access deep body tissues with minimal invasion and reliable performance. This exciting technology is anticipated to bring great opportunity to biomedical engineering and eventually benefit the health of entire human beings.
Electrophysiological predictors of hyperfunctional dysphonia
Published in Acta Oto-Laryngologica, 2023
Agata Szkiełkowska, Paulina Krasnodębska, Andrzej Mitas, Monika Bugdol, Marcin Bugdol, Patrycja Romaniszyn-Kania, Anita Pollak
After the physical examination, each proband participated in a follow-up study focused on the non-invasive determination of additional physiological biomarkers using the Empatica E4 professional measurement system. This wearable wristband enables real-time acquisition of certain physiological parameters: skin resistance (electrodermal activity, EDA), heart-beat (blood volume pulse, BVP, and heart rate variability, HRV), and movement sensor (accelerometer signal, ACC). The device is widely used in biomedical engineering, especially for in-field measurements, providing acceptable data quality (resolution, linearity, temperature stability). The wristband provides controlled contact with the subject’s body, with a wireless connection allowing freedom of movement. The data from the wristband, recorded continuously and synchronously throughout the test procedures, was analyzed. We analyzed the whole recording as well as discrete parts of the recording corresponding to each part of the examination.
Oxford’s clinical experience in the development of high intensity focused ultrasound therapy
Published in International Journal of Hyperthermia, 2021
Ishika Prachee, Feng Wu, David Cranston
High Intensity Focused Ultrasound (HIFU) is a minimally invasive therapeutic technique that uses non-ionising ultrasound waves to cause tissue necrosis. A shift in focus to find a reliable alternative to open surgery has highlighted other available methods including transarterial chemo-embolisation (TACE), percutaneous ethanol injection (PEI), and energy-based ablative techniques such as radiofrequency, microwave, cryoablation and HIFU. Unlike its minimally invasive counterparts, HIFU provides the only truly non-invasive method. Its unique ability to perform selective tissue necrosis in a well-defined area from a distant source is central to its attraction. HIFU is becoming more recognised across the world as a tool for tumour ablation and other applications. The scope of this technique, however, goes beyond the treatment of cancers to chronic pain management, various benign conditions, and haemostasis. HIFU has been used at the Churchill Hospital Oxford for treatment of solid abdominal tumours including those of the liver, kidney, uterus, pancreas, pelvis and prostate. By bridging the disciplines of surgery, cancer medicine and biomedical engineering science, this technology promises to play a significant role in the future of surgery.
Towards Patient-centered Diagnosis of Pediatric Obstructive Sleep Apnea—A Review of Biomedical Engineering Strategies
Published in Expert Review of Medical Devices, 2019
Given the need for and lack of recent advancement in the identification of pediatric OSA outlined above, this review serves as a call for action. A task force of key opinion leaders should be formed to outline specific goals to be met, which the biomedical community can subsequently achieve. The Food and Drug Administration (FDA) should consider evaluating data derived from consumer devices such as the Apple Watch®, Actiwatch-2®, Fitbit Ultra®, UP®, and Motionlogger® Sleep Watch for clinical validation. Biomedical engineering companies and large technology companies such as Apple and Google should invest in research to create medical-grade devices for sleep diagnostics in children. The use of HSAT in children is an attainable goal that could greatly reduce health-care costs and improve patient and parent satisfaction associated with diagnostic testing and is a goal to be realized by 2025.
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