Controlling and Monitoring Induced Unconsciousness: Ergonomics and Design in Anesthesia

Abstract

This research is the continuation of that presented in these proceedings in 1987; the application of Ergonomics and Industrial Design to the problems of the anesthesia workstation. However, the focus has grown from simple estimation of the unconscious patients depth-of-anesthesia (via brain stem, vagus nerve, esophagus) to the super-ordinate ergonomic problems of controlling and monitoring anesthesia; i.e., positioning and mobility of the clinician and equipment, information feedback, line of sight and reach, etc. This required the empirical determination of the necessary and sufficient patient-derived information required to manage each case, then making this information-gathering system the basis for the design of a new integrated monitoring system. The resulting system combines and displays all the necessary parameters in such a way that the clinician can determine the instantaneous or trended states of the patient, the system and the anesthesia procedure. Secondarily, the investigation has produced a novel attempt to classify the types of mental effort required during monitoring, also a head-mounted display to satisfy the clinicians need for mobility. The system is embodied in a single compact mobile monitor with interactive screens and lends itself to easy relocation and interrogation. Although not yet statistically proven, early feedback from researchers now using the prototype system suggests that it simplifies the clinicians task of maintaining the required heuristic “mental model” of the patient, system, and procedure.