The computer-based anesthetic monitors: the Duke Automatic Monitoring Equipment (DAME) system and the microDAME

Area of Science:

• Biomedical Engineering
• Medical Informatics
• Anesthesiology Technology

Background:

• Duke University's Anesthesiology Department historically built its own patient monitoring equipment.
• A new hospital facility in 1980 prompted the development of a computer-based system.

Purpose of the Study:

• To design, build, and test a novel computer-based patient monitoring system for operating rooms.
• To address challenges in real-time physiological data acquisition and presentation during surgery.

Main Methods:

• Development of the Duke Automatic Monitoring Equipment (DAME) System, featuring microcomputer-based instrumentation on mobile carts.
• Integration with a central minicomputer for flexible software monitoring package selection.
• Subsequent design of a smaller, multiprocessor microDAME system to improve upon DAME's limitations.

Main Results:

• The DAME System experienced frequent total monitoring failures and poor user acceptance due to large cart size, inadequate waveform display, and difficult man-machine interface.
• Despite resolving many initial issues, fundamental design limitations of the original carts persisted.
• A new generation, the microDAME, was designed to be more compact and user-friendly, though it was not fully implemented.

Conclusions:

• Early computer-based patient monitoring systems faced significant technical and usability challenges.
• Design factors such as size, waveform quality, and user interface are critical for clinical adoption.
• Lessons learned from the DAME and microDAME projects offer valuable insights for future operating room monitor development.