Pediatrics and Medical Technologies

I spent most of my mornings this week rounding in the Pediatric ICU (PICU). It was a very interesting experience, having spent a couple of weeks in the neonatal ICU. In the neonatal ICU, the most common issues were nutrition/growth, respiratory distress, and cardiac problems. The cases in the PICU were a lot more varied and more complex. In one of the cases, a child was admitted for fever with irritability and inconsolable crying. But because the patient had such an extensive medical history (despite being so young), which included a repaired paraesophageal hiatus hernia , Lennox-Gastaut syndrome, and myoclonic seizures, it was difficult to diagnose whether the crying was a result of pain from the surgery or a neurological issues. It took an entire week, and consults from multiple departments and hospitals, to rectify the problem at admission. By the end of the week, the child was dramatically better and was due for discharge. It was really satisfying to experience the entire diagnosis process of a complex case that led to resolution of the problem.

In the past month, I've made some interesting observations regarding medical technologies in the hospital too through my time on the floor, and at various conferences. These are key considerations for any technology to be developed for patient care.

1) Mobility: There are so many patient transfers that go on in the hospital everyday - to and from surgeries/deliveries, across the floors, and between the units. It may seem somewhat trivial but the capability of a critical care device to function during transport is a huge deal. A company was promoting a new warmer for NICU with enhanced features, including procedure lights, motion sensors, hourglass heating, in-built sensors and respiratory aids, etc. The new features were exciting but in the end, it came down to whether the product could function at full capability (without wall power) in the time it takes to bring a baby from the delivery room to the ICU. It turned out that it was not able to do that by itself, and it was significant drawback. You can buy an additional universal power supply box at an exorbitant rate for 15min of offline power, but that may not always be sufficient.

2) Speed: This is where lab-on-a-chip technologies will come in. It is surprising to know how the results a relatively simple genetic test can take several weeks to return. This can be dangerous for a patient that requires immediate treatment based on a positive result of the test. This is a very real issue, and there are already lab-on-a-chip technologies used in the hospital. If you look around, you may notice that the blood gases of the patient are obtained at the bedside.

3) Accuracy & Verification: I learnt in a conference that dosing errors are very common in any hospital. Usually, the error is noted before it causes any irreparable damage but sometimes it is not. The source of this error is either from the human (doctor, pharmacist, nurse etc.) or from the machine (dosing and prescription order systems). Fortunately, there are checks that go on at each level to make sure the prescription is right. It would be great if there was a system that could somehow eliminate all the forms of dosing errors.