Artificial Intelligence and Anaesthesia
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Artificial intelligence has several applications in anaesthesia including decision support systems, automated assist devices, and virtual reality training. Closed loop anaesthesia systems can precisely maintain drug levels and patient vitals within target ranges using feedback control of drug infusion pumps. While AI has benefits like reduced costs and time, and more consistent care, limitations include potential errors during learning, lack of emotional intelligence, and safety issues. Future areas of research include large datasets to improve AI and automated difficult airway assessment using facial recognition.
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Artificial intelligence in anesthesiology by dr tushar chokshi
The document provides an overview of current and future applications of artificial intelligence (AI) in the field of anesthesiology. It discusses how AI is currently used for tasks like pre-anesthesia checkups, operating room monitoring and control, and teleanesthesia. It predicts that in the future, AI will allow anesthesiologists to control operating room devices and monitors using voice commands. AI may also help automate some cognitive tasks but dexterous tasks will still require human anesthesiologists. While AI can reduce some errors, it is unlikely to fully replace anesthesiologists as complex clinical decision making will still need human judgment.
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This document provides an overview of monitoring depth of anesthesia. It discusses the aims of monitoring to ensure patient safety and prevent awareness during surgery. It reviews the historical background of defining anesthesia stages. Modern concepts view anesthesia as a complex interaction between stimuli, patient responses, and drug-induced effects. Factors like patient characteristics, drug combinations, and surgery duration impact correct drug dosing. Memory is gradually impaired with deeper anesthesia levels before autonomic responses. The document outlines stages of awareness and discusses specific drugs' relationships to anesthesia depth.
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Scalp block and New GCS (GCS-P)
This document discusses the scalp block technique. It begins by describing scalp block as local anesthesia of the scalp nerves. It then discusses the history and development of scalp block, including the original description in 1986 and studies in the 1980s that demonstrated its effectiveness in reducing hemodynamic changes during craniotomy. The document outlines the specific nerves blocked in scalp block and techniques for each, and notes bupivacaine is often used. Advantages include decreased blood pressure and intracranial pressure changes during surgery. Potential complications are also reviewed. Finally, it briefly discusses recent updates to the Glasgow Coma Scale including the addition of a pupil reactivity score in 2018.
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- Proper needle placement is confirmed by visualizing expansion of the tissue plane under ultrasound. Local anesthetic spreads anesthesia from T8 to the pubic symphysis.
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1. Tonsillectomy requires maintaining deep general anesthesia to prevent reflex responses during the procedure while allowing for rapid recovery of airway reflexes.
2. Intubation is usually done under deep inhalational or muscle relaxant anesthesia to prevent bucking, and the tube is secured to prevent aspiration of blood or secretions.
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- Proper needle placement is confirmed by visualizing expansion of the tissue plane under ultrasound. Local anesthetic spreads anesthesia from T8 to the pubic symphysis.
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This document describes the design and implementation of a microcontroller-based infusion pump system for automatic drug delivery. The system uses a stepper motor to precisely deliver drugs to patients on a scheduled basis. It also includes Bluetooth connectivity to allow nurses to remotely monitor the system status without frequent bedside visits. Testing at a hospital showed the remote monitoring was particularly useful for nurses. The programmable microcontroller-based design allows for flexible control and monitoring of drug infusion.
Implanted Neural Prosthetics - an Introduction
This webinar discussed implanted neural prosthetics for restoring function. It defined neural prosthetics as devices that connect directly to the nervous system to replace or supplement function. The webinar outlined therapeutic applications that aim to restore voluntary motor control through temporary treatment versus prosthetic applications that replace lost function with an implanted device. Examples of neurostimulation applications included bladder control, breathing, hand function, and more. Clinical trials were discussed as the process for testing these devices, and resources were provided to learn about eligibility and participation. The webinar concluded by discussing how the Institute for Functional Restoration aims to create a sustainable commercialization model for neuromodulation systems to restore function long-term.
ICU Patient Deterioration Prediction : A Data-Mining Approach
A huge amount of medical data is generated every da
y, which presents a challenge in analysing
these data. The obvious solution to this challenge
is to reduce the amount of data without
information loss. Dimension reduction is considered
the most popular approach for reducing
data size and also to reduce noise and redundancies
in data. In this paper, we investigate the
effect of feature selection in improving the predic
tion of patient deterioration in ICUs. We
consider lab tests as features. Thus, choosing a su
bset of features would mean choosing the
most important lab tests to perform. If the number
of tests can be reduced by identifying the
most important tests, then we could also identify t
he redundant tests. By omitting the redundant
tests, observation time could be reduced and early
treatment could be provided to avoid the risk.
Additionally, unnecessary monetary cost would be av
oided. Our approach uses state-of-the-art
feature selection for predicting ICU patient deteri
oration using the medical lab results. We
apply our technique on the publicly available MIMIC
-II database and show the effectiveness of
the feature selection. We also provide a detailed a
nalysis of the best features identified by our
approach.
ICU PATIENT DETERIORATION PREDICTION: A DATA-MINING APPROACH
A huge amount of medical data is generated every day, which presents a challenge in analysing
these data. The obvious solution to this challenge is to reduce the amount of data without
information loss. Dimension reduction is considered the most popular approach for reducing
data size and also to reduce noise and redundancies in data. In this paper, we investigate the
effect of feature selection in improving the prediction of patient deterioration in ICUs. We
consider lab tests as features. Thus, choosing a subset of features would mean choosing the
most important lab tests to perform. If the number of tests can be reduced by identifying the
most important tests, then we could also identify the redundant tests. By omitting the redundant
tests, observation time could be reduced and early treatment could be provided to avoid the risk.
Additionally, unnecessary monetary cost would be avoided. Our approach uses state-of-the-art
feature selection for predicting ICU patient deterioration using the medical lab results. We
apply our technique on the publicly available MIMIC-II database and show the effectiveness of
the feature selection. We also provide a detailed analysis of the best features identified by our
approach.
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Recent advances in Respiratory physiotherapy covers a comprehensive aspect of newer technologies helpful in the field of pulmonary physiotherapy. Useful for MPT students. Has articles added up for reference.
AAPM Foster July 2009
I gave this talk in the "Presidential Symposium" at the annual meeting of the American Association of Physicists in Medicine, in Annaheim, California. The President of AAPM, Dr. Maryellen Giger, wanted some people to give some visionary talks. She invited (I kid you not) Foster, Gates, and Obama. Fortunately Bill and Barack had other commitments, so I did not need to share the time with them.
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ICU Patient Deterioration Prediction : A Data-Mining Approach
ICU Patient Deterioration Prediction : A Data-Mining Approach
ICU PATIENT DETERIORATION PREDICTION: A DATA-MINING APPROACH
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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ABDOMINAL TRAUMA in pediatrics part one.
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
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The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Artificial Intelligence and Anaesthesia
- 1. Artificial Intelligence & Anaesthesia How far have we come! Faiza Buhari Birmingham Heartlands Hospita
- 2. Aim • Definition • How A.I. works? • Evolution • Applications in Anaesthesia • Merits • Downsides • Future prospects
- 3. What is A.I. ? Artificial intelligence is the capability of computers to respond in a manner resembling human intelligence.
- 4. How A.I. works? • Artificial Neural Network • Fuzzy logic
- 5. Evolution
- 6. Applications in Anaesthesia • Decision Support Systems - smart monitors • Automated Assist Devices: Semi-Automated Anesthesia - Closed loop system - Mc Sleepy • Procedure training by Virtual Reality
- 7. Closed Loop Anaesthesia Delivery A closed-loop system can be defined as an automated control system using the feedback principle. • Pharmacological robots. • Integrates expert systems. • Determines right drug /right dose/right time • Feedback principle
- 8. A Basic C.L.A.D model
- 9. McSleepy
- 10. ...McSleepy • Controlling parameter: BIS+ ANALGOSCORE+ TOF • 3 phases (induction/maintenance/emergence) • 3 infusion pumps connected to a controlling unit • Safety measures A technical description of a novel pharmacological anaesthesia robot Thomas M . Hemmerling et al J Clin Monit Comput (2014) 28:27 – 34
- 11. Sedasys • A computer-assisted personalized sedation system • Mild-to-moderate Propofol sedation to be delivered by non- anaesthesiologists. • Consists of a full monitoring array .. • Multi-centre study comparing SEDASYS® to benzodiazepine/opioid : less oxygen desaturation, greater patient satisfaction, and faster recovery BJA: British Journal of Anaesthesia, Volume 113, Issue suppl_2, 1 December 2014, Pages ii37-ii47 https://doi.org/10.1093/bja/aeu378
- 12. Automated Anesthesiologist Suffers a Painful Defeat A machine that makes anesthesiologists unnecessary for some medical procedures has failed amid poor sales and resistance from doctors and nurses ASA Responds to FDA's Rejection of Johnson & Johnson's Computer-Assisted Anesthesia Device April 22, 2010
- 14. • Significant reduction in Propofol dose • Precisely maintained pre-established target BIS values with higher performance scores • Significantly lower BIS Meta-analysis on Closed loop Delivery System Closed-Loop Delivery Systems Versus Manually Controlled Administration of Total IV Anesthesia: A Meta-analysis of Randomized Clinical Trials Pasin, Laura MD et al Anesthesia & Analgesia: February 2017 - Volume 124 - Issue 2 - p 456–464
- 15. ..Meta-analysis • Time that the system was able to maintain a given variable in a desired target range. • Episodes of system undershoots or overshoots its target value. Clinical Performance and Safety of Closed-Loop Systems: A Systematic Review and Meta-analysis of Randomized Controlled Trials Brogi, Etrusca MD; Cyr, Shantale PhD; Kazan, Roy MD, MSc; Giunta, Francesco MD; Hemmerling, Thomas M. Anesthesia & Analgesia: February 2017 - Volume 124 - Issue 2 - p 446–455
- 16. KEPLER intubating system British Journal of Anaesthesia 108 (6): 1011–16 (2012) Advance Access publication 28 March 2012 . doi:10.1093/bja/aes034 RESPIRATION AND THE AIRWAY First robotic tracheal intubations in humans using the Kepler intubation system T. M. Hemmerling*, R. Taddei, M. Wehbe, C. Zaouter, S. Cyr and J. Morse 1. Robotic Arm 2. Joy stick 3.Pentax AWS video-laryngoscope 4. Software control system
- 19. Other uses • The use of automated anesthesia carts reduced the drug recording errors in medication administrations of anesthesia. J Clin Anesth. 2017 Aug;40:11-15. doi: 10.1016/j.jclinane.2017.03.051. Epub 2017 Apr 13
- 20. Benefits • Cost reduction MIT journal (sedation with the Sedasys machine cost $150 to $200 for each procedure, compared to $2,000 for an anesthesiologist) • Time reduction A robot to reduce the time and number of steps to deliver intravenous medication during anaesthesia Yan E. Anaesthesia and Analgesia 2012;115(2) • No Inter-individual difference
- 21. Is A.I a threat? (the spooky bit) • Learns by itself • Deep learning programmes- (the Tensor Flow by Google 2018) (unpredictable therefore uncontrollable)
- 22. Downsides • Errors with huge learning curve • Absent emotional intelligence • Morality • Problem solving limited • Safety
- 23. Future Prospects: Database of Expected sample size of 50k Estimated to be finished by 2022 University of Zhejiang - China Automated Assessment of Difficult Airway with Facial Recognition Techniques
- 25. ….Thank you !