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How a new graphical monitor such as the pulmonary display will be integrated and accepted by the users is an important step when introducing new information and technology in the ICU. We developed a pulmonary display that depicts pulmonary information for an intubated, mechanically ventilated patient. This study observed caregivers attending ICU patients in the presence of the pulmonary display. Attendings observed the pulmonary display an average of 3 times per visit whereas nurses glanced at it at least once per visit. The pulmonary display showed distinct patterns demonstrating the changing underlying pulmonary physiology. Based on analysis of questionnaires, the pulmonary display was perceived as useful information, a desirable addition to the current ICU monitors, and an accurate representation of patient pulmonary information.

We have developed graphic technology to display data from the respiratory monitors used during anesthesia. The display uses color, texture, shape and emergent features to highlight abnormal pulmonary physiology. Nineteen anesthesiologists participated in a simulator based evaluation (METI, Sarasota, FL.). Half the subjects used the metaphor display and half did not. Each subject was trained for 10 minutes on the pulmonary display. The time difference during the obstructed endotracheal tube did prove significant (p=0.02) in favor of the pulmonary display condition. During the intrinsic PEEP scenario, the subjects treated the patient earlier (positive trend p=0.l) with the pulmonary display compared to the control condition. The group that used the pulmonary display treated a restricted upper airway more quickly (2.3 min vs. 3.9 min). Subjects liked the simplicity of the design. In future studies, we hope to further reduce the time for the detection and treatment of all scenarios by improving the design's intuitiveness, integration, and emergent features.

Medical decision making is a crucial process to successfully treat a critical medical emergency. During an unexpected medical event, astronauts, like anesthesiologists, must react quickly in a complex environment. Tools, such as the pulmonary metaphor display, were created to aid the medical caregiver's decision making process. The pulmonary metaphor display is designed to help the caregiver collect and integrate pulmonary data to provide a more accurate, quicker diagnosis and treatment. The following outline anesthesiology simulation study will provide the data to prove that the pulmonary metaphor display is beneficial to medical decision making.