Saturday, April 2, 2011

needs assessment


We are in the MRI and a peditric patient is on the table with our current Invivo monitor which is all wireless except for the blood pressure cable.  The child is under anesthesia and all monitors are on the child.  The EKG is providing a clear waveform after application of the EKG pad.  We leave the room and the MRI starts and there is no longer a readable EKG which in turn does not provide a accurate heart rate.  Our anesthesiologist feels uncomfortable that he/she is not getting an accurate reading on their anesetized patient.  There is so much interference with our current monitor. 

Next scenario is that many times, we enter the MRI room and the monitor is on and the cordless oxygen probe is sitting in the holder on the Invivo monitor.  We notice that the probe is hanging there and not connected to a patient and yet we are getting readings on the monitor for the heart rate and the oxygen saturations.  If we are getting readings and the probe is not even on the finger, how reliable is this.  We also have found times that the probes have come off during anesthesia and yet we still get readings as if the probe is still on.

Our needs assessment:

We are in need of a new machine that allows us to monitor a patient's cardiac activity during an MRI without the current distortions of the EKG due to electromagnetic interferences.  This in turn will allow us to feel more comfortable that we are getting an accurate reading of not only the patient's EKG, but in addition, we will also get an accurate heart rate.  We also need to feel reassured that a monitor will not be giving us a reading while the oxygen saturation probe is sitting in the cradle of the monitor and not on the patient.  It would also be very nice to be able to have a monitor that provides us with the capaility of monitoring the patient's temperature while under anesthesia due to the fact that pediactric patient's tend to be able to regulate their temperature under anesthsiea, resulting in a drop in their core temperature.  While the MRI is know to heat up the patient while they are inside the MRI, we do not have any current ways to monitor their temperature.  We need to make sure that we are providing the patient with the safest anesthesia experience ever.

Debbie and Caren,

I have to take a look to see what monitor we currently have.  It is not even on their website anymore.  The one that we are currently looking to get is the expressions with Invivo...this monitor provides an electrode fail indicator which we do not have now and is very essential to have as the probe may become loose during the procedure.

It reads perfusion rates so it assures that we are getting a correct reading.  it has :

  • Ultra Advanced Gradient Removal algorithms provide stable traces even during Perfusion, SWI and Diffusion MRI sequences

  • Express Wireless OR quality SpO2 with Neo, Infnant, Pediatric and Adult Quick Connect Sensors...more sensors and better sizes for all ages

  • Continuous Temperature for Esophageal, Rectal, Nasal and surface temperature

  • Precision EtCO2 with OR traces...(we do not have this now and the anesthesiologist keep requesting this)

  • Active Trend Arrows adds depth to each vital signs helping you identify patient conditions earlier

  • Perfusion Index provides confidence in the SpO2 saturation levels helping you setup and treat the patient faster

  • User enabled T Wave Suppression allows you to normalize the waveform from the control room for unparalleled gating efficiency( which we do not have now)

  • The other monitor we were looking at was the MedRad

    This monitor is much cheaper, however, Invivo is the umber one monitor used and medrad is more used for their pumps and they are new to the monitor industry.  In fact, there is only one hospital that has one...only one of these monitors in all of southern california and they have it as a cheap back up in case their Invivo breaks. 

    I hope all of this information helps.  Please let me know what else you need.


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