Testing new alarms for medical electrical equipment

This paper reports the first of several tests of new auditory alarms originally proposed by Block et al. [1] and formalized in IEC 60601-1-8 for use in medical electrical equipment. We test whether participants who are supplied with the IEC-recommended mnemonics while learning label-alarm associations can more accurately identify the alarms after short periods of learning. Results for 18 participants strongly indicate that there is a mutual confusability between certain alarm pairs in both learning conditions, but that mnemonics may strengthen rather than diminish certain key confusions.

Learnability and discriminability of melodic medical equipment alarms

Melodic alarms proposed in the IEC 60601-1-8 standard for medical electrical equipment were tested for learnability and discriminability. Thirty-three non-anaesthetist participants learned the alarms over two sessions of practice, with or without mnemonics suggested in the standard. Fewer than 30% of participants could identify the alarms with 100% accuracy at the end of practice. Confusions persisted between pairs of alarms, especially if mnemonics were used during learning (p = 0.011). Participants responded faster (p < 0.00001) and more accurately (p = 0.002) to medium priority alarms than to high priority alarms, even though they rated the high priority alarms as sounding more urgent (p < 0.00001). Participants with at least 1 year of formal musical training identified the alarms more accurately (p = 0.0002) than musically untrained participants, and found the task easier overall (p < 0.00001). More intensive studies of the IEC 60601-1-8 alarms are needed for their effectiveness to be determined.

Thermal injuries in three children caused by an electrical warming mattress

Peroperative hypothermia is recognized to increase mortality and morbidity, and the paediatric anaesthetist faces specific challenges resulting from the increased body surface to volume ratio, particularly in smaller children. We describe three children who were consecutive patients on one operating list and sustained severe thermal injuries. These were due to a malfunctioning electrical heating mat, despite appropriate use and monitoring by the attending anaesthetist. It is rare for thermal warming devices to cause injury. We review the use of heating mats, and suggest modifications in their manufacture which may minimize the risks associated with heating devices.

Optimal periodic preventive maintenance policy for leased equipment

For leased equipment the lessor incurs penalty costs for failures occurring over the lease period and for not rectifying such failures within a specified time limit. Through preventive maintenance actions the penalty costs can be reduced but this is achieved at the expense of increased maintenance costs. The paper looks at a periodic preventive maintenance policy which achieves a tradeoff between the penalty and maintenance costs. (c) 2005 Elsevier Ltd. All rights reserved.

Optimal preventive maintenance of leased equipment with corrective minimal repairs

For leased equipment, the lessor carries out the maintenance of the equipment. Usually, the contract of lease specifies the penalty for equipment failures and for repairs not being carried out within specified time limits. This implies that optimal preventive maintenance policies must take these penalty costs into account and properly traded against the cost of preventive maintenance actions. The costs associated with failures are high as unplanned corrective maintenance actions are costly and the resulting penalties due to lease contract terms being violated. The paper develops a model to determine the optimal parameters of a preventive maintenance policy that takes into account all these costs to minimize the total expected cost to the lessor for new item lease. The parameters of the policy are (i) the number of preventive maintenance actions to be carried out over the lease period, (ii) the time instants for such actions, and (iii) the level of action. (c) 2005 Elsevier B.V. All rights reserved.

Maintenance Strategies for used equipment under lease

Abstract: Purpose – The aim of this research is to determine the optimal upgrade and preventive maintenance actions that minimize the total expected cost (maintenance costs+penalty costs). Design/methodology/approach – The problem is a four-parameter optimization with two parameters being k-dimensional. The optimal solution is obtained by using a four-stage approach where at each stage a one-parameter optimization is solved. Findings – Upgrading action is an extra option before the lease of used equipment, in addition to preventive maintenance action. Upgrading action makes equipment younger and preventive maintenance action lowers the ROCOF. Practical implications – There is a growing trend towards leasing equipment rather than owning it. The lease contract contains penalties if the equipment fails often and repairs are done within reasonable time period. This implies that the lessor needs to look at optimal preventive maintenance strategies in the case of new equipment lease, and upgrade actions plus preventive maintenance in the case of used equipment lease. The paper deals with this topic and is of great significant to business involved with leasing equipment. Originality/value – Nowadays many organizations are interested in leasing equipment and outsourcing maintenance. The model in this paper addresses the preventive maintenance problem for leased equipment. It provides an approach to dealing with this problem.