Using Multisensory Haptic Integration to Improve Monitoring in the Intensive Care Unit

Introduction: Alarm fatigue and medical alarm mismanagement reduces the quality of patient care and creates stressful work environments for clinicians. Here, the feasibility of a novel “prealarm” system that utilizes multisensory integration of auditory and haptic stimuli is examined as a possible solution. Methods: Three vital signs (heart rate, blood pressure, and blood oxygenation) were represented by three musically distinct sounds that were combined into soundscapes and progressed through five pre-alarm zones (very low to very high). Three haptic conditions were tested with the auditory stimulus to determine the best combination of auditory and haptic stimulation. Qualitative data was collected through surveys and the NASA TLX index Results: Alterations in frequency and timbre were most effective at transmitting information regarding changing vital sign zones with comparatively higher accuracy and quicker reaction time (RT), p \u3c .01. The addition of haptic stimuli to the auditory soundscape caused no significant decline in study participant accuracy or RT. However, two weeks after training, participants performed the tasks significantly faster ( p \u3c .001) and felt the alarm monitoring task was significantly less cognitively demanding ( p \u3c .01), compared to the unisensory condition. Participants also felt more confident in identifying changing vital signs with the addition of haptic stimuli. Discussion: The current study demonstrates that multisensory signals do not diminish the perception of transmitted information and suggest efficient training benefits over unimodal signals. Multisensory training may be beneficial over time compared to unisensory training due to a stronger consolidation effect. The potential integration of haptic input with existing auditory alarm systems and training is supported

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease