Silent ICU: ICAS (Intensive Care Alarm System)

ICAS, Intensive Care Alarm System, aims to remove all alarming sounds from the patient box. It can be seen as a system design, in which all medical devices that are installed in the patient box will be connected to a central server inside the hospital. This server connects the signals from the devices to the right monitor or to the Ascom Myco 2, a smart pager which Erasmus MC will start using in 2018. This way, alarms can be communicated to medical staff directly and alarming sounds can be removed from the patient box when no medical staff is present.

Alarms are communicated in different ways through the Myco, depending on their urgency level. Currently there are three levels with corresponding colours: blue, yellow and red. ICAS introduces a fourth level: purple (Immediate assistance required). The purple alarm is the highest urgency and is used for calling backup and in case of a cardiac arrest. Each urgency level corresponds to a different way of alarming. In ICAS, the intensity and mode of communication of the alarms increases with the urgency level.

Through location determination, ICAS knows the location of staff members and automatically selects the right operating mode. When a patient is alone in his or her box, patient mode is selected. The monitor display is turned off and alarms from this patient are communicated to the responsible nurse’s Myco. The patient box is completely silent to ensure optimal rest. When medical staff is inside the box, ICAS switches to staff mode and the monitor display and sound switch on. Alarms are now communicated by the monitor instead of the Myco. Visitor mode is selected if only persons without a Myco are present in the box. The monitor now only shows heart frequency and oxygen saturation. Location Determination is made possible through infrared identification and entrance detection.

When an alarm comes in on the Myco, a nurse has 3 options: accept, forward or snooze. When a nurse is available, the alarm should be accepted within 30 seconds. When a nurse isn’t available, he or she can choose the forward option. This forwards the alarm to his or her unit of 4 nurses. If they don’t accept within 30 seconds, the alarm is sent to the whole department. Snoozing is an option only available for yellow or blue alarms. If selected, the alarm will repeat itself within 2 minutes. Next to these options, there is a backup function.

This function can be used when immediate assistance is required. It triggers a special backup alarm with nurses in the unit. The unit has to respond within 30 seconds, otherwise the backup request is sent to the entire department. If a nurse due to hygiene reasons isn’t available to touch the Myco to ask for backup or accept, forward or snooze an alarm, it is possible to use voice control.