Aimen Hassani - Academia.edu (original) (raw)
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Background: There is a time-delay between obstruction of the infusion apparatus and the onset of ... more Background: There is a time-delay between obstruction of the infusion apparatus and the onset of the occlusion alarm on both the Alaris PK and Braun Perfusor Space target controlled infusion (TCI) pumps. Depending on the extent of this time-delay, it is possible that drug effect-site concentrations could decrement below minimally effective levels during this period, potentially exposing patients to the risk of accidental awareness under general anaesthesia. Methods: In a bench-top experiment, we recorded the alarm response time of both devices after intentional obstruction using a standardised protocol. We then computer-simulated a series of clinically relevant TCIs to determine if the effect-site concentration of propofol or remifentanil could decrement below 2 ug.mL-1 or 3 ng.mL-1 before the alarm was predicted to sound. Results: The alarm response time of both devices was longer at higher alarm level settings and slower infusion rates, but different between brands at equivalent a...
BJA: British Journal of Anaesthesia, 2006
Nursing in Critical Care, 2012
To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG displ... more To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG display tool plus conventional 12-lead electrocardiogram (ECG) versus 12-lead ECG alone by UK critical care nurses who were members of the British Association of Critical Care Nurses (BACCN). Critically ill patients are prone to myocardial ischaemia. Symptoms may be masked by sedation or analgesia, and ECG changes may be the only sign. Critical care nurses have an essential role in detecting ECG changes promptly. Despite this, critical care nurses may lack expertise in interpreting ECGs and myocardial ischaemia often goes undetected by critical care staff. British Association of Critical Care Nurses (BACCN) members were invited to complete an online survey to evaluate the analysis of two sets of eight ECGs displayed alone and with the new display device. Data from 82 participants showed diagnostic accuracy improved from 67·1% reading ECG traces alone, to 96·0% reading ECG plus Panoramic ECG display tool (P < 0·01, significance level α = 0·05). Participants' diagnostic certainty score rose from 41·7% reading ECG alone to 66·8% reading ECG plus Panoramic ECG display tool (P < 0·01, α = 0·05). The Panoramic ECG display tool improves both accuracy and certainty of detecting ST segment changes among critical care nurses, when compared to conventional 12-lead ECG alone. This benefit was greatest with early ischaemic changes. Critical care nurses who are least confident in reading conventional ECGs benefit the most from the new display. Critical care nurses have an essential role in the monitoring of critically ill patients. However, nurses do not always have the expertise to detect subtle ischaemic ECG changes promptly. Introduction of the Panoramic ECG display tool into clinical practice could lead to patients receiving treatment for myocardial ischaemia sooner with the potential for reduction in morbidity and mortality.
IEEE Transactions on Biomedical Engineering, 2008
Background: There is a time-delay between obstruction of the infusion apparatus and the onset of ... more Background: There is a time-delay between obstruction of the infusion apparatus and the onset of the occlusion alarm on both the Alaris PK and Braun Perfusor Space target controlled infusion (TCI) pumps. Depending on the extent of this time-delay, it is possible that drug effect-site concentrations could decrement below minimally effective levels during this period, potentially exposing patients to the risk of accidental awareness under general anaesthesia. Methods: In a bench-top experiment, we recorded the alarm response time of both devices after intentional obstruction using a standardised protocol. We then computer-simulated a series of clinically relevant TCIs to determine if the effect-site concentration of propofol or remifentanil could decrement below 2 ug.mL-1 or 3 ng.mL-1 before the alarm was predicted to sound. Results: The alarm response time of both devices was longer at higher alarm level settings and slower infusion rates, but different between brands at equivalent a...
BJA: British Journal of Anaesthesia, 2006
Nursing in Critical Care, 2012
To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG displ... more To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG display tool plus conventional 12-lead electrocardiogram (ECG) versus 12-lead ECG alone by UK critical care nurses who were members of the British Association of Critical Care Nurses (BACCN). Critically ill patients are prone to myocardial ischaemia. Symptoms may be masked by sedation or analgesia, and ECG changes may be the only sign. Critical care nurses have an essential role in detecting ECG changes promptly. Despite this, critical care nurses may lack expertise in interpreting ECGs and myocardial ischaemia often goes undetected by critical care staff. British Association of Critical Care Nurses (BACCN) members were invited to complete an online survey to evaluate the analysis of two sets of eight ECGs displayed alone and with the new display device. Data from 82 participants showed diagnostic accuracy improved from 67·1% reading ECG traces alone, to 96·0% reading ECG plus Panoramic ECG display tool (P < 0·01, significance level α = 0·05). Participants' diagnostic certainty score rose from 41·7% reading ECG alone to 66·8% reading ECG plus Panoramic ECG display tool (P < 0·01, α = 0·05). The Panoramic ECG display tool improves both accuracy and certainty of detecting ST segment changes among critical care nurses, when compared to conventional 12-lead ECG alone. This benefit was greatest with early ischaemic changes. Critical care nurses who are least confident in reading conventional ECGs benefit the most from the new display. Critical care nurses have an essential role in the monitoring of critically ill patients. However, nurses do not always have the expertise to detect subtle ischaemic ECG changes promptly. Introduction of the Panoramic ECG display tool into clinical practice could lead to patients receiving treatment for myocardial ischaemia sooner with the potential for reduction in morbidity and mortality.
IEEE Transactions on Biomedical Engineering, 2008