Manual Interfaces in Medicine and Mechanics—2

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Considering our results and the impact of tasks on dimensions like performance and effort for some devices, manufacturers may primarily focus on interface simplification and rationalization, immediately providing the most important settings and alarms on a first screen, leaving expert settings to a second one. As with other bench tests, the main limitations of our study may concern the inability to extrapolate our results to the real clinical situation.

First, our technical evaluation was performed on a model, which cannot mimic the complexity of all interactions between a patient and a ventilator. The ASL is a simulator and it remains different from patients, mainly because the spontaneous inspiratory profile is not modified by pressurization during the inspiratory phase.

A new global and comprehensive model for ICU ventilator performances evaluation

However, the bench simulates most other situations and combinations that can be encountered in the clinical field. Second, the objective and subjective ergonomics measurements were assessed during standardized conditions that may be considered as different from real-life conditions. In order to be able to use various physiological sensors during the ergonomics evaluation, we chose not to use a high-fidelity environment with a manikin. We do agree with the fact that human behaviour under test may be significantly affected by the context and set-up of the experiment.

However, while we only included experts, it would have been difficult to reach our experimental goals while also trying to run after a more important degree of immersion that may not be necessary with these types of physicians. A simulated condition may never reproduce all the complexities of the interactions between a patient, a clinician and a ventilator, especially if the tester is an experienced clinician [ 39 ]. There are many techniques available for usability evaluation, such as cognitive walk-through, expert reviews, focus groups, Delphi technique, heuristic evaluation or objective timed tasks completion, all of them providing different information [ 38 ].

To the best of our knowledge, our study is the only one to provide a global and complete ergonomics evaluation, taking into account different techniques. Third, we may also consider that the small number of senior ICU physicians that were included in our study does not enable firm conclusions to be drawn.

Considering the design of the ergonomics evaluation, it required a huge amount of dedicated time from the physicians to undergo the different scenarios and various measurements for the experimental team. Moreover, none of them were familiar with the six tested devices, which exacerbated the difficulty in recruitment.

It was therefore unrealistic to use more testers, and such a drawback also tended to be limited by the use of a device that was known to everyone as a comparison and by the fact that we included physicians from five different ICUs. Such a bias was limited within our evaluation by the fact that, in an attempt to assess the ease of use, we only included naive subjects in order to limit the impact of such experience on the evaluation.

Despite significant technological improvements, several ICU ventilators do exhibit low ergonomics performance and a high risk of misusage. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial.

Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care.

Barriers in Human Medicine; Biophysics and mechanics at the disease interface

Bench testing of pressure support ventilation with three different generations of ventilators. Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation. A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators.

Bench-test comparison of 26 emergency and transport ventilators. Crit Care. Evaluation of ventilators used during transport of critically Ill patients: a bench study. Institute of Medicine. To err is human: building a safer health system. Washington: The National Academies Press; To err is not entirely human: complex technology and user cognition. J Biomed Inform. ICU mechanical ventilators, technological advances vs. Evaluation of the ventilator-user interface of 2 new advanced compact transport ventilators.

Evaluation of the user interface simplicity in the modern generation of mechanical ventilators. Evaluation of the user-friendliness of seven new generation intensive care ventilators. Evaluation of the user-friendliness of 11 home mechanical ventilators. Eur Respir J. Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

Br J Anaesth. Patient-ventilator trigger asynchrony in prolonged mechanical ventilation. Assessment of physiologic variables and subjective comfort under different levels of pressure support ventilation. Brooke J. SUS: A quick and dirty usability scale. Usability evaluation in industry. London: Taylor and Francis; Patient-ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study.

Performance of noninvasive ventilation modes on ICU ventilators during pressure support: a bench model study. Patient-ventilator asynchrony during noninvasive ventilation: a bench and clinical study. Bleichner G Iatrogenic complications in adult intensive care units: a prospective two-center study. Human errors in a multidisciplinary intensive care unit: a 1-year prospective study.

Overview of medical errors and adverse events. Ann Intensive Care. Cowan N. The magical number 4 in short-term memory: a reconsideration of mental storage capacity.

MECHANICS AND THERMODYNAMICS OF BRITTLE INTERFACIAL FAILURE IN BIMATERIAL SYSTEMS

Behav Brain Sci. The usability of ventilators: a comparative evaluation of use safety and user experience. Pupil size in relation to mental activity during simple problem-solving. Beatty J, Kahneman D. Pupillary changes in two memory tasks. Psychon Sci. An investigation of pupil-based cognitive load measurement with low cost infrared webcam under light reflex interference.


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