Why wheelchair out of hospital

Not particularly healthy or safe. Then I wondered about the patient: how dignified is it to be pulled along through the hallways backwards? You cannot see where you are going, cannot prepare for bumps or corners, and in an unfamiliar environment, it is probably an altogether frightening experience.

And what about motion sickness? Each wheelchair had our hospital logo brightly stencilled on the back of the seat, so they were easy to spot. Driving through the city, it was not unusual to see former patients in our chairs wheeling themselves down the street, or to see mangled chairs abandoned in dark alleys after they had outlived their usefulness.

Sometimes, patients arrived in the ER already in one of our wheelchairs, almost as though they were bringing it back home. Send patient location : Sends the location of a specific patient to the wheelchair when requested. Send arrival message : When the server is informed that the CDW has reached its destination it also communicates this to the interface.

Cancel the request : If the order has to be canceled at any time, the server will receive this information through the interface and send it to the wheelchair. The HMI allows the exchange of information between the system, the patient, and the helping person.

This HMI was developed to have an intuitive use and to provide the information that makes this process easier and more pleasant [ 10 ]. For this application to be able to communicate with ROS nodes, and thus interact with the software presented in the previous subsections, Rosbridge was used. On the ROS side, it is launched the Rosbridge server. Through this server, the HMI obtains information about the CDW status and about the patient, namely, name, building, floor, room, bedroom and bed.

The application also gives information about the action that was performed on it, namely when the buttons are pressed Fig. The connection is performed automatically on application start. In the bottom right corner, there is a sign that shows whether the application is successfully connected green color or not red color Fig.

Once connected, the application is in a state in which it waits for a request to pick up a patient. There is always a white box where relevant information about the status of the system is shown. This way, the person helping to place the patient in the CDW must press the button before doing it, thus ensuring that the robot will not move during the process. This button should only be pressed when the patient is ready to be taken.

When the patient is ready, the CDW moves to the operating room. At this phase, the HMI returns to its initial state, waiting for a new request to pick up a patient. The risks that may arise from a motion of the CDW while the patient is being transferred in or out of it are: i the fall of the patient when he is transferring himself alone in or out of the CDW; and also, ii the risk of the patient being hit by the CDW if it starts moving and the patient has no time to move out of its way.

As mentioned, it was not possible to proceed with the integration in the hospital and several features had to be simulated. The hospital interface, which is the interface that exists in the operating room, through which the CDW would be requested, is part of these features. Thus, Lazarus [ 10 ] was used to develop this interface. It was also used a connection via TCP to the Rosbridge server. The hospital interface receives information about the status of the CDW and, when necessary, the user of this interface makes a request to pick up a patient through his Inpatient ID.

As in the HMI, the connection is performed automatically on application start and there is the same signal in the bottom right corner that indicates the status of the connection Fig. In this application, there is also a white box where relevant information about the status of the system is shown. After sending the order, an acknowledgement is presented in the message box.

Therefore, the request remains to be accepted by the CDW, which depends on whether the wheelchair is free to do so or not. When this feedback is provided, the robot starts processing the request, giving the option to cancel the order at any time.

In a normal situation order not canceled the interface will wait for the information indicating that the CDW has reached the operating room, and that it is waiting for the helping person to remove the patient. After receiving the information that the patient has been removed, the interface returns to its initial state and it is possible to make a new request. To carry out the tests in this environment, it was necessary to build the map shown in Fig.

Map of the centre for robotics in industry and intelligent systems building and main points of interest: charging station red , standby yellow , operating room orange , patient A green and patient B blue.

In a first stage, the tests of the normal system operation were carried out. In this way, the prototype was placed in its charging station and an order was sent through the HMI.

In Fig. Once this button is pressed, the CDW informed that it was waiting for the placement to finish. After the patient was installed, the robot went to the operating room. Next the CDW went to the standby point vertex 4.

This way, the CDW completed a full task, waiting in the end for new orders. The first test consisted of performing the same task as before, but after the wheelchair was at the standby point, another request was sent to pick up a different patient.

After receiving the order, the CDW went to vertex 1, thus making a shorter path compared to when it started at the charging station. Then, the behaviour was similar to that presented in the previous test, having successfully taken the patient to the operating room.

The second test consisted of sending the second order when the CDW was returning to the standby point. The wheelchair reacted immediately to this request, without going to the standby point. Finally, to test this response to a second request, this was done when the CDW was taking another patient to the operating room, that is, it had not yet completed its task. When the order was received, nothing changed in the behaviour of the wheelchair, which concluded the transport to the operating room.

The difference here was that once this transport was finished, the order already received was immediately processed and the CDW went straight to the patient location. The wheelchair behaviour in case the order is cancelled is also very important. Two tests were performed to validate this: one in which the order was cancelled while the CDW was going to the patient and another in which the cancellation was made when the wheelchair was transporting the patient. In the second test, the order was cancelled when the wheelchair was transporting the patient to the operating room.

The CDW went back to the place where the patient was picked up and waited for someone to remove the patient. Then, the CDW went to the standby point, waiting for new orders.

The most critical moments for cancelling the order are when the patient is being placed or removed from the wheelchair.

As previously stated, if the system is not prepared for this, the robot may move and hurt the patient. To test this behaviour, the order was cancelled while the CDW was in these states and, in both cases, the CDW did not move. An important component in the safety of the system is the emergency button, which can be pressed at any time by the patient or another person. Therefore, a test was performed in which the button was clicked 10 times during a task: in all cases, the CDW stopped its movement immediately and only moved again when the button was released.

To test the endurance of the system, a 9-hour test was carried out, during normal office hours a. During the first eight hours was performed one sequence of requests per hour, each sequence being composed of 4 requests. At the time of discharge, the patient was attended to by her children. The floor nurse went to find a wheelchair, but the patient and her family did not wish to wait. They escorted themselves to the hospital lobby, where the patient tripped and fell over a stanchion — a ceiling support post — in the hospital lobby.

She fractured her left, nondominant humerus in the fall. Her pre-existing left shoulder prosthesis did not require replacement from the incident.

The plaintiff sued the hospital for negligence by failing to provide her with a wheelchair, even though she admitted that a nurse had gone for one and that she and her family did not wait for it.

The patient also claimed that there should not have been a stanchion in the lobby. Receive notifications when the wheelchair assistance is needed and send a nurse to the right place to get it.

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