Accur Sound Electronic Stethoscope (AS101+AIRMO)
Continuous playback of breath sounds, visual sound spectrum, AI recognition technology, review and recording
AIRMOD solves the problem of continuous breath sound monitoring (in intensive care units and intravenous anaesthesia, IVGA) which is not possible in modern medicine and enhances patient safety. AIRMOD converts breathing sounds into a spectrum and uses artificial intelligence (AI) to help interpret them so that they can be accurately and immediately heard and alerted by the AI when a patient is experiencing respiratory distress. AIRMOD is the only method currently available for early detection of abnormal Partial Airway Obstruction (PAO) sounds under IVGA. It can confirm that the patient is ventilating well and prevent hypoxia due to apnea.
Hardware: Accusound AS-101
Continuous respiratory monitoring data is converted into a visual time-sensitive map, which allows the visual presentation of breath sounds to healthcare professionals
AI instantly marks inspiratory and expiratory spectrums or abnormal sound spectrums
AI support for "abnormality" alerts (airway narrowing, obstruction by secretions, pauses in breathing)
Reliable respiratory rate calculation
Respiratory arrest warning function
Monitoring regardless of technique limitations
Overcoming noise limits in various scenarios
Non-intubated anesthesia in clinical settings
1.Respiratory monitoring through painless gastrointestinal endoscopy
The market for painless gastrointestinal endoscopy in Taiwan is growing significantly year on year. More and more people are choosing this method of sedation and anesthesia, which has become almost routine in North America. However, fatal sudden cardiopulmonary complications under anesthetic drugs are the worst nightmare for healthcare professionals. The main respiratory monitoring tools currently in use are the Peripheral Oximeter and the End-Tidal Carbon Dioxide Partial Pressure Monitor. These tools cannot directly detect when a patient has airway obstruction due to increased secretions, an examination position that affects the airway structure, or when the respiratory rate is altered by medication. It is only when the oxygen level drops or the tidal volume changes to a certain level that the corresponding instrument will respond.
The AS-101 replaces the traditional stethoscope, allowing busy examiners and anesthetists to listen to a continuous breath sound without the need to keep the stethoscope on. In the event of partial airway obstruction, or when the respiratory rate begins to become unstable, appropriate and simple handling can be given to prevent the condition from progressing to severe hypoxia or respiratory arrest.
2.Respiratory monitoring for dental sedation and hypnotherapy
The use of sedation to assist with dental treatment allows patients (especially young children or those with special needs) who cannot tolerate dental treatment to quickly regain post-operative consciousness and eliminate the discomfort of intubation. However, without a proper respiratory monitoring system, the patient may suffer from airway obstruction, respiratory depression, hypoxia or even death at any time under the influence of anesthetic drugs. In particular, the airways of children are more likely to collapse and tolerate hypoxia for a very short period of time. The special needs patient is not usually susceptible to dental treatment and tends to accumulate a significant number of problem teeth in a single session, thus requiring a longer treatment time, which lengthens the duration of anesthesia and sedation, which increases the chance of respiratory complications.
The AS-101 provides a real-time playback of respiratory sounds during sedation and recovery, allows medical staff to know whether the airway is open or closed at any time, and through the visualization of the respiratory clock diagram, the respiratory status can be continuously controlled in the high-decibel environment where dental instruments are operated.
The AS-101 provides immediate warning of abnormal respirations or airway obstruction, allowing the anesthetist or surgeon to take the necessary action at the earliest opportunity.
3.Respiratory monitoring in plastic surgery / craniofacial surgery
The increasing sophistication of plastic surgery and craniofacial surgery has allowed patients to undergo intravenous anesthesia without the need for intubation and with a shorter recovery time. However, in the absence of appropriate monitoring tools under the influence of anaesthetic drugs, the operation is often successful while the patient suffers from serious cardiopulmonary complications. The main respiratory monitoring tools currently in use are the Peripheral Oximeter and the End-Tidal Carbon Dioxide Partial Pressure Monitor. These tools cannot directly detect when a patient has airway obstruction due to increased secretions, an examination position that affects the airway structure, or when the respiratory rate is altered by medication. It is only when the oxygen level drops or the tidal volume changes to a certain level that the corresponding instrument will respond.
The AS-101 replaces the traditional stethoscope, allowing the surgeon and anaesthetist to hear the continuous breath sounds. In the event of partial airway obstruction, or when the respiratory rate starts to become unstable, the surgeon can give appropriate and simple manipulation to avoid the consequences of severe hypoxia or respiratory arrest.
4.Respiratory monitoring in the Catheterisation Laboratory
More and more patients with cardiovascular disease are being treated by percutaneous catheterization instead of surgery. From coronary artery unblocking, electrophysiological testing and arrhythmia radiofrequency cautery to angiography, pacemaker replacement, heart valve replacement and prosthetic vessel placement, the number of treatments performed in the catheterisation suite is increasing.
Some procedures take longer to treat, so patients need sedation to avoid arrhythmias caused by agitation or discomfort, or require simultaneous invasive investigations. Increasingly, catheterised procedures are being performed with the assistance of anaesthetists to sedate patients non-intubated.
There have been many successful trials of complex catheterised procedures using ‘non-intubated intravenous sedation’ with the aid of MCR. The anaesthetists involved in the trial felt that having the equipment to assist with continuous respiratory monitoring gave them more confidence to treat patients in a non-intubated manner.
5.Respiratory monitoring in the obstetrics department
There are two main areas of obstetric surgery where intravenous anaesthesia is used: in general minor obstetric surgery and in the second half of a caesarean section when the woman is resting from the wound, where additional intravenous anaesthesia is used. In general outpatient obstetric minor operations, a standard monitor is sufficient as the operation is short and the drugs given are minimal and the patient is mostly covered by health insurance.
As for intravenous anaesthesia in the second half of a caesarean section, since most women have a higher BMI and sometimes NPO may not be sufficient for a caesarean section, respiratory monitoring is necessary during this period of time.
In addition to the difficulty of maintaining the respiratory tract of the parturient under intravenous anesthesia, it is also often too thunderous and has a high fatality rate. AS-101’s omnidirectional respiratory monitoring can continuously and instantly detect the patient’s breathing, and can also give medical staff sufficient warnings so that the mothers can be fully monitored and protected during the entire cesarean section.
6.Respiratory monitoring during cystoscopy or ureteroscopy
Cystoscopy or ureteroscopy accounts for the majority of surgical examinations in urology. A large proportion of patients come in for lithotripsy, pre- and post-operative follow-up of surgery or chemotherapy or for a double J tube.
In many cases, intravenous anaesthesia is used to ease the patient’s discomfort during the relevant medical examination. After the examination, the patient can rest in the recovery room for an hour or so and return home on the same day, without the need for hospitalisation.
During intravenous anaesthesia, the AS-101 allows for the best and safest care and monitoring of every patient undergoing outpatient surgery or examination with precision.
Applications in special settings
1.Respiratory monitoring in emergency medical/ambulance settings
In emergency care, respiratory status is often the first vital sign of a change in condition. However, in ambulances, ambulance helicopters or other emergency venues, there is often no time to continuously monitor breathing with conventional stethoscopes. In contrast, when the patient is minimally conscious, the patient may be choked and the airway may become obstructed unnoticed by bystanders. Even when airway identification is ensured, traffic and displacement may result in an incomplete, inaccessible airway or a slipped respirator, resulting in continued ineffective oxygen delivery.
The use of AIRMOD in conjunction with an oximeter has been highly praised by emergency caregivers. Trials have shown that using the two together at the scene of an emergency can really help the medical staff to keep track of the patient’s respiratory status. If respiration and oxygenation are good, the effect is almost equivalent to maintaining a proper heart rate and circulatory perfusion, so that the caregiver can attend to other wounds or conditions.
2.Assessment of AV fistula obstruction on dialysis
In emergency care, respiratory status is often the first vital sign of a There are several types of tubing that dialysis (dialysis) patients rely on for their survival. One of these is the arteriovenous fistula (AV fistula), which is the first choice for long-term treatment. Maintaining access to the fistula and avoiding infection is one of the main reasons for the successful completion of treatment. The most common complication of vascular access is embolism.
The physical examination to assess the accessibility of the pathway includes palpation and auscultation. A normal auscultation is a low-frequency, regular pulsating sound (bruit). If an obstruction is present, a higher frequency, discontinuous blood flow sound will be heard.
The AS-101 can be used to regularly assess the patency of the AV fistula, allowing changes in blood flow to be clearly heard at the arterial, venous and junctional points respectively. Simultaneous visualisation of the blood flow time graphs also allows the comparison of the blood flow waveforms before and after.