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UBC Theses and Dissertations

The development of a microcomputer-based perioperative patient monitoring system Cox, Neil B.

Abstract

A computer-based perioperative patient monitoring system, called the Mobile Operation Monitoring for Anesthetists or MOMA, is discussed. The primary objective of this work was to produce a flexible, mobile prototyping system which could be used to develop a clinically useful tool to aid the anesthetist in the task of patient maintenance during anesthesia. Potential application areas are discussed along with the limitations and necessary design considerations. The system developed for this thesis uses a PDP-11V03-L microcomputer system with an A/D converter and dual double-density floppy disk drive to acquire, process, and store four channels of EEG along with up to four channels of non-EEG data. The data is displayed on a Tektronix 4025 video graphics terminal in a number of user-selectable display formats. A currently popular EEG display format (Density modulation of the compressed Spectral Array or (DSA)) is modified to simplify the determination of long-term EEG trends. This display format is presented along with non-EEG data in order to facilitate comparisons between parameters. The user can recall any EEG display which appeared earlier in the operation without interfering with data acquisition, processing, and storage. The keyboard is configured in an easy-to-use format with the keys clearly labelled and grouped according to their function. Each command is generated by typing a single key. A facility for the entry of comments through the keyboard was implemented so that the time of occurrence of certain significant events during surgery, such as pharmacological intervention, can be tagged. These tags are then displayed along with the automatically acquired data. An emphasis was placed on maximizing MOMA's flexibility and an attempt was made to anticipate and simplify the modifications which may be desirable in the future. Programs are written in Fortran, are fully documented, and are run under the RT-11 operating system. The potential usefulness of the system and the non-technical documentation was assessed by five anesthetists practicing at Vancouver General Hospital (VGH). It was their opinion that MOMA is a potentially useful addition to the operating room and each assessor expressed an interest in being involved in future clinical applications. The adequacy and overall quality of the programs and related technical documentation was assessed by an engineer employed in the EEG department at VGH and experienced in both Fortran and RT-11. It was his opinion that the programs and related documentation are adequate and will be useful for the development of a clinically useful patient monitoring system.

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