Edward H. Shortliffe, “Medical Thinking:

What Should We Do?,” Conference on

Medical Thinking. University College of

London. June23rd, 2006.

3

4

Graphics: “Anatomy”; Barcharts, Inc. 1998; Boca Raton, FL

1. Septicemia (except in labor) — $20.3 billion2. Osteoarthritis — $14.8 billion3. Complication of device, implant or graft — $12.9 billion4. Liveborn (general childbirth) — $12.4 billion5. Heart attack — $11.5 billion6. Spondylosis, intervertebral disc disorders, other back problems — $11.2 billion7. Pneumonia (except caused by tuberculosis and STDs) — $10.6 billion8. Congestive heart failure — $10.5 billion9. Coronary atherosclerosis — $10.4 billion10. Adult respiratory failure — $8.7 billion11. Acute cerebrovascular disease — $8.4 billion12. Cardiac dysrhythmias — $7.6 billion13. Complications of surgical procedures or medical care — $6.9 billion14. Chronic obstructive pulmonary disease and bronchiectasis — $5.7 billion15. Rehab care, fitting of prostheses and adjustment of devices — $5.5 billion16. Diabetes mellitus with complications — $5.4 billion17. Biliary tract disease — $5.1 billion18. Hip fractures — $4.9 billion19. Mood disorders — $4.8 billion20. Acute and unspecified renal failure — $4.7 billion

Top 20 Most Expensive Inpatient ConditionsBecker’s Hospital Review | Bob Herman | October 09, 2013 http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/top-20-most-expensive-inpatient-conditions.html

“Hospital staff are exposed to an average of 350 alarms

per bed per day, based on a sample from an intensive

care unit at the Johns Hopkins Hospital in Baltimore.”

Source: Ilene MacDonald, “Hospitals rank alarm fatigue as top patient safety concern”, Fierce Healthcare. January 22, 2014.

etCO2

Source: Wong, Michael; Mabuyi, Anuj; Gonzalez, Beverly; “First National Survey of Patient-Controlled Analgesia Practices.” March-April 2013, A Promise to Amanda Foundation and the Physician-Patient Alliance for Health & Safety.

Capnography:• An objective

measurement of exhaled CO2 levels in the airway

• Provides a breath-to-breath measure of the status of ventilation—fast response, versus pulse oximetry

• Provides an immediate measure of patient condition (e.g.: apnea)

Watch closely and notify staff of trending behavior

Region of immediate concern and action

0.01 mmHg etCO2 process noise 0.1 mmHg etCO2 process noise 1 mmHg etCO2 process noise

Signal smoothing or averaging; less response to variation

Key: datamodel

Time Update (Prediction) Measurement Update (Correction)

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0.01 mmHg etCO2 meas. Err. 0.1 mmHg etCO2 meas. err. 1 mmHg etCO2 meas. err.

Signal smoothing or averaging; less response to variation