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Comment by amluto | Hacker News Reader

> Same with audio on machines, that constant beep is annoying to you, but it means the machines are operating and you are getting your prescribed fluids - silence on a night ward is a sign something is wrong, and quickly precedes an emergency alarm.

Sure, if there is one source of beeps, then no beeps would be conspicuous, but when there are many things all beeping, having one of them stop beeping may not be so obvious at all.

A simple technological solution seems appropriate here. Have each machine that needs to work check in every couple seconds with each of two centralized monitoring machines. Have each monitoring machine alert the nurse desk if a monitored machine stops checking in. This is silent and has no single point of failure.

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To me the beeping also seemed like a quality backwards solution where much better, seemingly obvious solutions exist. Reality is probably much more complicated though. In a solution like you described and I had in my head we'd need a agreed upon protocol between IV drip and monitoring device. Probably the same standard should be used by other, similar devices. If that doesn't happen we get vendor lock in. In addition we are taking about medical devices so everything has to be fool proof, audited, double checked and certified. So what might be cheap in a consumer device now probably made the IV drip an order of magnitude more expensive. That is, if we agreed on a protocol in the first place.

I’m sure you’re right, but being unable to sleep when you need to heal is bad. "It’s complicated" is not a get-out-of-jail-free card.

May I weigh in with an outside perspective? My impression is this is a cultural issue, i.e. Americans are very insensitive to noisy disturbances during sleep hours. Biggest examples for me are your freight trains. Deadly accidents? Sure, the only solution is to disturb sveryone in a 5 mile radius around each crossing. In my home country this is unthinkable. People get chewed up, sometimes called the police on, for even running the washing machine past 10pm.

I'll never forget the night I was visited by police in northern Norway because we committed the crime of ... haymaking at 11 pm.

I don't get this? What is haymaking?

sex

No, no. Literal haymaking. Cutting grass for hay.

I'm surprised you managed to fit the combine harvester in the bedroom

Do you know what parts of the world is hay used as a slang for sex?

I don't know the reach, but many agricultural activities can be a euphemism if you put a significant pause in front of them. "Where are alice and bob? Oh they're out... (gathering fruit|sowing barley|haymaking|looking for lost sheep|etc)"

To be fair - its a very suspicious time to be haymaking. Threshing maybe yes - but haymaking... A word of advice: Don’t burn the candle in both ends - you need your strenght to work on the jarls estate (unless you are on a tenth or headtax plan of course).

Ironically, in the US we have a saying: "Make hay while the sun shines."

This was in northern Norway, in June. The sun was defininetly shining, even though it was at 11 pm ;)

You must be from Switzerland... :-)

bingo ;)

Don't many Swiss buildings have shared washing machines in the basement?

Since someone already guessed that you live in Switzerland, may I also ask if you are in an apartment building with neighbors above/under/around you? We have similar neighborly complaints in Austria where (at least in cities) almost everyone lives in apartment buildings and thus when someone runs the washing machine, you not only hear it, you also feel it. In the USA, I think most people in cities are living in individual houses and therefore things like running a washing machine at 10pm would probably not even be audible by any neighbors.

We do, and yes, it's the most common form of housing, including upper scale units.

> In a solution like you described and I had in my head we'd need a agreed upon protocol between IV drip and monitoring device. Probably the same standard should be used by other, similar devices. If that doesn't happen we get vendor lock in.

And a vendor lock-in is the goal of the vendor, both in medical and consumer space! Which is why such protocols rarely happen in either.

The medical space has a surprising number of widely used protocols. If you’ve ever gotten a CD with the raw data from some scan, it probably had a crappy proprietary viewer and the raw data. The raw data is almost invariably DICOM, and there are plenty of open-source viewers.

I suspect there are strong economic factors here. When a hospital buys a $2M imaging machine, the vendor is making money on the machine, not on ads, and that $2M machine had better interoperate with the HIPAA-compliant image archiving and distribution system the hospital already has from some other vendor.

> The medical space has a surprising number of widely used protocols.

There are also a wide range of interpretations of a single protocol. See the horror of HL7.

In terms of DICOM viewers, I’ll be the one who mentions Horos. If it doesn’t do what you want with a DICOM or have a plug-in that does, you are doing something quite unusual. Before the psych department come at me - I work in radiology. Functional imaging is best served with other tools, and I don’t understand them.

Can we not repurpose CAN for medical purposes?

Technically yes but seriously just don't. CAN is a horror show for security that can't handle a radio without being a security liability and medical privacy violations are expensive let alone wrongful deaths.

absence of signal is not a good indicator of operation. it is the same signal as total failure of your system.

Interestingly that reflects Airbus vs Boeing cockpit philosophies.

In the early 1980s Airbus adopted Dark Cockpit where the default state of all annunciator lights is off. If one illuminates then it indicates something worthy of attention. The colour of illumination indicates functional state; blue is good, amber is malfunctional.

When would something illuminated blue? When it's both working smoothly and worthy of attention?

I assume that's for indicators of abnormal, but safe, state. One example could be the undercarriage being down, a situation that would usually not be expected, but when you're in the process of landing doesn't warrant attracting your attention as an error state.

According to [1] for the wing anti-ice system, Blue = Turned on, Unlit = Turned off, Amber = Malfunction

Of course, one might very well argue that 'turned on' is not 'worthy of attention'

[1] http://www.smartcockpit.com/docs/A330-A340_Overhead_Pushbutt...

The nurse desk is a SPoF. If something goes wrong with that area, then how can you tell each monitoring machine is working?

Failover to beeps?

The nurse desk is a desk. If the desk literally fails, you have serious issues, and your average multiple person desk is well enough engineered that there isn’t a single piece that can fail and take out the entire desk. But there are generally multiple nurses at the nurse desk, and there are often multiple desks, too. Also, you could hook the monitoring system up to the PA system.

edit: when I say hooking it to the PA system, I mean that, if no one acknowledges the light or computer message or whatever, then an announcement could play after a set delay.

Network failure in the desk room sounds like a complete outage for that.

How do you know if each machine is reporting in a consistent manner without being there 24/7 and making sure they beep all the time vs %40 of the time?

Central monitors are quite common. There are even entire units based on it (telemetry).

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