Improving Patient Safety by Developing an Algorithm to Detect Patient Respiratory Status During Remifentanil Administration for Lithotripsy
Remifentanil, an anesthetic that is administered intravenously during acoustic shock wave treatment for kidney stones, depresses a patient's ability to breathe and can lead to apnea. Respiration is normally detected via standard patient monitors which sound alarms in the event that the patient ceases to breathe for a given length of time. However, a physician or nurse often intervenes before the alarms sound and is able to prompt the patient to breathe properly. The decision to intervene includes visual observation of respiration conditions, and requires vigilant monitoring. The Vancouver General Hospital Healthcare Technology Management Department is interested in customizing a tool that will aid hospital staff in the assessment and intervention of depressed respiration during these procedures. In partnership with the Department of Anesthesia, the intern will perform statistical analysis of simulated patient parameters to develop a type of “smart” monitoring. This predictive tool will monitor trends in the data and alert the physician to impending apnea rather than apneic conditions that have already been in place over an interval of time. The intern will also couple the monitor to an audio intervention mechanism that will preemptively prompt the patient to breathe. This project encompasses the development of such a tool and the assessment of its usefulness in preventing patient apnea and improving patient outcomes.