Medical device, system and method for alert management

Abstract

A medical device (1A-1E, 2) comprising: a communication interface (10, 20) communicatively coupled with another device (2, 1A-1E) or communicatively coupled with another device (2, 1A-1E); and a controller (11, 21) configured to selectively operate in one of a plurality of predetermined alarm modes wherein the controller (11, 21) is further configured to: determine in which of a plurality of predetermined operational settings (A-E) the medical device (1A-1E, 2) is operating; determining a quality of service of a communication with the other device (2, 1A-1E) via the communication interface (10, 20); selecting one of a plurality of predetermined alarm modes based on the determined operational settings (A-E) and the determined quality of service; and operating the medical device (1A-1E, 2) in the selected alarm mode.

Description

Technical Field

[0001] The present invention relates to medical devices, systems and methods for alarm management. Background Art

[0002] Generally speaking, in the health sector and especially in hospitals, patients and various medical devices are continuously monitored. In many cases, for example, when a patient's monitored parameter exceeds a certain threshold or when a medical device failure is detected, an alarm is generated to alert the caregiver. The caregiver then notices the alarm, performs the corresponding action and stops the alarm. In order to ensure that the relevant alarm is not ignored, many alarms are audible alarms, which can be heard at the patient's bedside, for example, in a ward. Nowadays, many alarms usually cause serious noise pollution, especially in intensive care units. Such noise pollution can increase the stress level of patients and caregivers.

[0003] RR Vitoux et al., "Perceptions of Infusion Pump Alarms," ​​J Infus Nurs. 2018 Sep;41(5):309-318, published Sep 14, 2018, describe this noise pollution and propose potential solutions, including: identifying alternatives that produce non-decibel noise to alert nurses to a patient's alarm pump; using real-time dashboards, alarm prioritization, and patient-specific alarm customization techniques; and educating nurses about specific practices and pump configurations to help reduce unnecessary alarms.

[0004] WO 2021 / 207280 A1 describes that in many cases, depending on the type of therapy being provided (including the type of medication being provided by the infusion pump), it may not be necessary to enable a specific alarm when an error condition is detected.

[0005] Such solutions can help reduce noise pollution in medical device use, but their effectiveness is limited to certain types of alarms and clinical situations.

[0006] WO 2017 / 173162 A1 proposes reducing alert fatigue by providing a user-selected mute button and applying an escalating mute override function, which can override the user-selected mute button or the do not disturb mode of the alarm in an escalating manner as follows. When a high alarm is triggered, the application generates an alarm to cause a vibration action generated by the smartphone. If the user does not confirm the alarm within a predetermined time (e.g., 5 minutes), the application generates a second alarm as a low-volume audio alarm generated by the smartphone. If the user does not confirm the high reminder associated with the second alarm within a second predetermined time (e.g., another 5 minutes), the application generates a third alarm as a high-volume audio alarm generated by the smartphone. This solution is limited to certain situations and may increase latency. Summary of the invention

[0007] The object of the present invention is to further reduce noise pollution in the context of medical device applications.

[0008] This object is achieved by means of a medical device comprising the features of claim 1 .

[0009] Therefore, a (first) medical device is provided, comprising a communication interface and a controller. The communication interface is communicatively coupled to or communicatively coupled to another (i.e., second) device, such as a point-of-care medical device. The controller is configured to selectively operate in one of a plurality of predetermined alarm modes. The controller is also configured to: determine which of a plurality of predetermined operating settings the (first) medical device is operating under; determine the quality of service of communication with another device (e.g., a point-of-care medical device) via the communication interface; select one of a plurality of predetermined alarm modes based on the determined operating setting and the determined quality of service; and operate the (first) medical device in the selected alarm mode.

[0010] This is based on various findings. First, it has been found that for each patient and corresponding operating setting, the requirements for alarm reporting may vary, so that appropriate alarm configuration may be time-consuming for caregivers. Second, it has been recognized that certain operating settings of the (first) medical device, such as intensive care settings, require more stringent alarm reporting and confirmation than other operating settings; and third, the limiting factor for automatically reducing alarms, such as at the bedside, is the reliability of communication between the (first) medical device and another (second) device. By determining the quality of service of the communication with the other (second) device, a measure of the reliability of generating remote alarms is obtained. For example, if a high quality of service is determined, the alarm can be muted at the (first) medical device and only generated at the other (second) device. As another example, if a medium quality of service is determined, the alarm can be muted at the (first) medical device in an operating setting with only lower criticality, but an alarm can be generated, for example, in an intensive care operating setting. Therefore, the automatic detection of the current operating setting combined with the determination of the communication quality of service enables automatic alarm mode selection. This enables noise pollution to be significantly reduced in the context of medical device applications and also allows for a reduction in nursing staff workload through reduced configuration requirements.

[0011] For example, the plurality of predetermined operation settings may include intensive care settings, operating room settings, and ward-level settings. As another example, the plurality of predetermined operation settings may be defined to include a high-criticality care setting (requiring a high degree of caregiver attention) and a low-criticality care setting (requiring little caregiver attention), and optionally a medium-criticality care setting (requiring a medium level of caregiver attention).

[0012] The (first) medical device may be an infusion device or an infusion station for administering one or more fluids to a patient. In particular, for infusion devices and infusion stations, the described alarm management allows noise reduction at a high safety level.

[0013] The controller may also be configured to delegate or propagate the alarm message to another (second) device, for example, based on the determined operational settings and / or the determined quality of service. Thus, the corresponding alarm may be muted at the (first) medical device itself. Since the (first) medical device may be arranged at the bedside, this allows noise reduction for the patient while maintaining a high safety level. It is noteworthy that quality of service based alarm message processing particularly allows noise reduction at a high safety level.

[0014] Optionally, the controller is further configured to receive a response to the communicated alarm message from another (second) device in the case of a delegated message. The alarm generated by the (first) medical device may depend on the receipt and / or content of the response. This allows ensuring uninterrupted communication.

[0015] The controller may also be configured to generate a visible alarm and / or an audible alarm based on a delay in responding to the communicated alarm message and / or based on the selected alarm mode. This allows ensuring a quick response from the caregiver regardless of the communication quality of the service.

[0016] The (first) medical device optionally includes a display adapted to generate a visible alarm. This allows alarms that are not audible alarms to be displayed in a visual manner to reduce noise levels, and allows alarms to be additionally generated to increase the level of attention.

[0017] The (first) medical device may comprise a sound emitting device, such as a speaker or a buzzer, adapted to generate an audible alarm. Thus, if necessary, the (first) medical device itself may generate an alarm.

[0018] For example, the plurality of predetermined alarm modes include: a suppression mode, in which the alarm is suppressed; and a sense mode, in which the alarm can be sensed. For example, in order to obtain a good quality of service and in a ward-level setting, the suppression mode may be selected so that the alarm at the (first) medical device itself is suppressed.

[0019] Optionally, the plurality of predetermined alarm modes further comprises a decay mode, in which the alarm is decayed. For example, for a medium quality of service and in a ward level setting, a decay mode may be selected such that the alarm at the (first) medical device itself is decayed.

[0020] The controller may be configured to determine at which of a plurality of predetermined operating settings the (first) medical device is operating by at least one of: receiving a user input at the (first) medical device; receiving a message indicating an operating setting via the communication interface; and detecting a predetermined device or predetermined devices via the communication interface. This allows for a simple (even fully automatic) configuration of the (first) medical device.

[0021] The controller may also be configured to determine the quality of service of the communication with another device (second device) by at least one of the following: receiving a response from another (second) device; determining that the latency of the communication with another (second) device is above or below a predetermined latency threshold; and determining that the network bandwidth of the communication with another (second) device is above or below a predetermined network bandwidth threshold. This allows the quality of service to be automatically determined to select a corresponding alarm mode. Optionally, the controller is configured to determine the quality of service periodically and, if necessary, change the alarm mode accordingly. For example, the controller is configured to periodically repeat these steps, wherein the time interval may be, for example, predetermined or determined based on the quality of service. This allows ensuring that the appropriate alarm mode is always set.

[0022] The predetermined operation settings may include at least one wireless setting in which the communication interface communicates with another (second) device via a wireless connection and at least one wired setting in which the communication interface communicates with another (second) device via a wired connection. This enables a wide range of applications.

[0023] According to one aspect, a system is provided, comprising at least one (first) medical device according to any embodiment described herein and another (second) device communicatively coupled to the at least one (first) medical device. For advantages, reference is made to the above description of the (first) medical device.

[0024] The system may include multiple (first) medical devices that are communicatively coupled to another (second) device via the same network. Thus, another (second) device may obtain alarms from multiple (first) medical devices and construct the alarms, for example, in a quick and understandable manner.

[0025] The other (second) device may be a nursing device adapted to display an alarm visually and / or audibly, and / or send an alarm to a mobile device. This enables the nursing staff to react quickly. The other (second) device may be a patient monitor, a nursing station, a ventilator, a dedicated PC software application, etc.

[0026] According to one aspect, a method for operating a (first) medical device is provided. The (first) medical device includes a communication interface that is communicatively coupled to another (second) device or is communicatively coupled to another (second) device. The (first) medical device also includes a controller configured to selectively operate in one of a plurality of predetermined alarm modes, the method comprising: determining (e.g., by the (first) medical device) which of a plurality of predetermined operating settings the (first) medical device is operating under; determining (e.g., by the (first) medical device) a quality of service of communication with another (second) device via the communication interface; selecting (e.g., by the (first) medical device) one of a plurality of predetermined alarm modes based on the determined operating setting and the determined quality of service; and operating the (first) medical device in the selected alarm mode.

[0027] The method may use a (first) medical device and / or system according to any embodiment described herein. With regard to the advantages of the method, reference is made to the above description of the (first) medical device and system. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] The basic idea of ​​the invention will be described in more detail later with reference to the embodiments shown in the accompanying drawings. In this context:

[0029] Figure 1 A system for alarm management with various medical devices is shown;

[0030] Figure 2 Shows Figure 1 A first medical device, a second device and a mobile device of the system.

[0031] Figures 3 to 7 Shows Figure 1 Different operating settings of several first medical devices and second devices of the system; and

[0032] Figure 8 Shows the operation Figure 1 A method of a medical device in a medical device. DETAILED DESCRIPTION

[0033] Subsequently, a medical device, a system and method for operating a medical device, in particular for alarm management, will be described in certain embodiments.The embodiments described herein should not be interpreted as limiting the scope of the invention.

[0034] Figure 1 A system 4 for hospital alarm management is shown. The system 4 includes various medical devices, hereinafter referred to as first medical devices 1A to 1D, and another device, hereinafter referred to as second device 2 (optionally, second medical device), which are communicatively coupled to each other via a monitoring network 6. The first medical devices 1A to 1D and / or the second device 2 can be arranged at the patient's bedside. The second device 2 can be a point-of-care medical device.

[0035] In addition, system 4 includes a hospital information system 40, i.e., HIS. Hospital information system 40 is an information system designed to manage medical, administrative, financial and / or legal issues and corresponding processing of hospital operation services. System 4 also includes a picture archiving and communication system 41, i.e., PACS. Picture archiving and communication system 41 provides storage and access to images. System 4 also includes a clinical information system 42, i.e., CIS. Clinical information system 42 is an information system used in a critical care environment, such as an intensive care unit, i.e., ICU. Clinical information system 42 can be networked with different devices of system 4 and extract information from these devices into an electronic medical record, which can be viewed by clinicians at the patient's bedside. In addition, system 4 includes a laboratory device 43, such as a computer system that stores and / or processes laboratory data. Hospital information system 40, picture archiving and communication system 41, clinical information system 42, and laboratory device 43 are connected to each other via hospital network 5.

[0036] The hospital network 5 and the monitoring network 6 are communicatively coupled to each other via a communication device 44 , which may be a central station, a gateway, and / or a bedside device data aggregator.

[0037] The first medical device 1A is an infusion pump (alternatively, an infusion station) for administering at least one fluid to a patient. The first medical device 1B is a dialysis machine. The first medical device 1C is an anesthesia workstation. The first medical device 1D is a surgical device. In general, the system 4 includes at least one first medical device 1A to 1D and at least one second device 2. The system 4 may also include Figure 1 For example, one or more of all the other devices illustrated in the figure.

[0038] Reference Figure 2 , one of the first medical devices 1A to 1D, the first medical device 1A, and the functions of the system 4 will now be described in more detail.

[0039] like Figure 2 As shown in , the first medical device 1A includes a communication interface 10 that is communicatively coupled to the second device 2 or is communicatively coupled to the second device 2. The first medical device 1A also includes a controller 11, which is configured to selectively operate in one of a plurality of predetermined alarm modes; an optional display 12; and a sound emitting device 13. In this example, the sound emitting device 13 is a speaker. The controller 11 is operatively coupled to the display 12 and the sound emitting device 13. The controller 11 is suitable for controlling the display 12 and / or the sound emitting device 13 to generate an alarm (visible and / or audible).

[0040] In this example, the second device 2, which is a bedside patient monitor in this example, includes a communication interface 20 that can be communicatively coupled to the first medical device 1A or is communicatively coupled to the first medical device 1A. The second device 2 also includes a controller 21, an optional display 22, and a sound emitting device 23, and the controller 21 is configured to selectively operate in one of a plurality of predetermined alarm modes. In this example, the sound emitting device 23 is a speaker. The controller 21 is operatively coupled to the display 22 and the sound emitting device 23. The controller 21 is suitable for controlling the display 22 and / or the sound emitting device 23 to generate a (visible and / or audible) alarm.

[0041] The first medical device 1A and the second device 2 are communicatively coupled to each other via the monitoring network 6 by means of their respective communication interfaces 10 , 20 .

[0042] The controller 11 of the first medical device 1A (optionally, also the controller 21 of the second device 2) is further configured to determine which operating setting of a plurality of predetermined operating settings the first medical device 1A is currently operating under. Figures 3 to 7 A more detailed description of the various different operating settings A to E is provided. In general, the predetermined operating settings may include settings with different levels of requirements (e.g., low and high, or low, medium and high), such as settings with different criticality of care, settings with different information flows, and / or settings with different communication connection settings.

[0043] The controller 11 of the first medical device 1A (optionally, the controller 21 of the second device 2 in a corresponding manner) is also configured to determine a quality of service QoS (quality of service) of the communication with the second device 2 via the communication interface 10. The controller 11 of the first medical device 1A may be adapted to perform one or more quality measurements. For example, the controller 11 may be adapted to measure latency, bandwidth, signal strength, bit error rate, etc. to determine the QoS. Optionally, the QoS may be determined to be at one of a plurality of different QoS levels (e.g., low and high, or low, medium and high).

[0044] The controller 11 of the first medical device 1A (optionally, the controller 21 of the second device 2) is also configured to select one of the plurality of predetermined alarm modes based on the determined operation settings and the determined quality of service. For example, the controller 11 may access a (e.g., predetermined) look-up table LUT (look-up table) that outputs one of the plurality of predetermined alarm modes after inputting the determined operation settings and the determined quality of service.

[0045] The controller 11 of the first medical device 1A (optionally, the controller 21 of the second device 2 as well) is also configured to operate the first medical device 1A (or the second device 2) in a selected alarm mode. Two, three or more alarm modes may be provided that differ from one another in the number, length, sound frequency, repetition frequency, volume and / or brightness of alarms generated in response to the same type of alarm message. For example, the plurality of predetermined alarm modes include: a suppression mode, in which the alarm is suppressed; an attenuation mode, in which the alarm is attenuated in a perceptible manner; and a perception mode, in which the alarm can be perceived (not attenuated). As another example, the alarm mode may include a local-only alarm mode and a remote-only alarm mode. In the event of deterioration of QoS, the alarm mode may be changed dynamically.

[0046] For example, when setting up the system 4, the controller 11 of the first medical device 1A determines which of a plurality of predetermined operating settings the first medical device 1A is operating in. This may be performed, for example, by receiving user input at the first medical device 1A or the second device 2, by receiving a message indicating an operating setting, for example from the second device 2, by the controller 11 via the communication interface 10, and / or by detecting a predetermined device or predetermined devices, for example via the communication interface 10.

[0047] Then, the controller 11 of the first medical device 1A determines the QoS of the communication with the second device 2, for example, by receiving or not receiving a response to the query from the second device 2 (e.g., within a predetermined time period); by determining whether the latency of the communication with the second device 2 is above or below a predetermined latency threshold; and by determining whether the network bandwidth of the communication with the second device 2 is above or below a predetermined network bandwidth threshold. The controller 11 may determine the QoS by determining whether the communication connection with the second device 2 is functional, i.e., whether the second device 2 can be reached. Optionally, the controller 11 of the first medical device 1A then classifies the QoS according to one of a set of predetermined categories (e.g., low, average, high).

[0048] Then, the controller 11 of the first medical device 1A selects one of the plurality of predetermined alarm modes based on the determined operating settings and the determined QoS, for example based on a given rule for assigning alarm modes to operating settings and QoS. Then, the first medical device 1A operates in the selected alarm mode and generates an alarm as defined in the selected alarm mode. Optionally, the selected alarm mode is displayed at the first medical device 1A and / or the second device 2.

[0049] When the controller 11 of the first medical device 1A operates in the selected alarm mode and processes (e.g., receives or generates) an alarm message, an alarm is generated by means of the display 12 and / or the sound emission device 13 based on the alarm message and the selected alarm mode. For example, the alarm indicated in the alarm message can be generated only when the selected alarm mode is the perception mode, and the alarm indicated in the alarm message can be suppressed only when the selected alarm mode is the suppression mode. Therefore, if the QoS is good, and according to the operation settings, some or all of the alarm messages at the controller 11 can be delegated or propagated to the second device 2 by the controller 11. The second device 2 then generates an alarm based on the alarm message and / or forwards the alarm message (or sends a corresponding message, such as SMS) to the mobile device 3. However, the first medical device 1A may need to receive a response to the delegated alarm message. If the response is delayed, for example, for more than a predetermined period of time, and according to the selected alarm mode, the controller 11 of the first medical device 1A will generate a visible and / or audible alarm.

[0050] Optionally, the alarm mode may be changed remotely, for example via the second device 2. The first medical device 1A, the second device 2 and the system 4 may comply with the alarm standard IEC / EN 606601-1-8.

[0051] Optionally, the controller 11 of the first medical device 1A periodically determines the QoS of communication with the second device 2. For example, the controller 11 of the first medical device 1A determines the QoS of communication with the second device 2 once every minute. The alarm mode can be dynamically adjusted according to the periodically determined QoS.

[0052] according to Figure 2 The system comprises a further first medical device 1A, which is designed as the first medical device 1A described above.

[0053] Figure 3 A first exemplary operation setting A is shown. The operation setting A is an operation setting of an operating room OR. Various first medical devices 1E, each of which is in the form of a centralized management device managing several infusion pumps, are communicatively connected to a second device 2, such as a monitoring device, via a monitoring network 6. The monitoring network 6 is here a wired network with low latency, high bandwidth and therefore high QoS.

[0054] The selected alarm mode takes into account the needs of high QoS and quiet operating rooms. The controller of the first medical device 1E is configured to have limited noise and brightness in the selected alarm mode. QoS is monitored regularly. For example, according to IEEE11073, service-oriented device connectivity (SDC) is used for two-way security and timeout-limited information exchange. This allows near real-time two-way communication. The selected alarm mode complies with a distributed alarm system (DAS) that guarantees service, or a distributed alarm system (CDAS) that provides confirmation of received alarms.

[0055] Figure 4Another exemplary operation setting B is shown. Operation setting B is an operation setting of a wired connection at the ward level. Several first medical devices 1E are arranged in a ward PR (patient room), and a second device 2 is arranged in a caregiver room CR (caregiver room). Here, a quiet ward PR is required and the first medical device 1E reports the infusion information including the alarm to the second device 2. The second device 2 generates an alarm visually and / or audibly. Due to the wired network connection, the QoS is good. Therefore, the first medical device 1E selects the following alarm mode: the first medical device 1E does not generate an alarm according to the alarm mode. A distributed information system (Distributed Information System, i.e., DIS) is used as the alarm reporting system. Therefore, in combination with the alarm mode selection, the alarm reporting system can be selected based on the determined operation setting and the determined QoS, for example, from a set of predetermined alarm reporting systems such as DIS, DAS, and CDAS.

[0056] The proprietary communication protocol may be applied, for example, by an OpenVPN server.

[0057] Figure 5 Another exemplary operation setting C is shown. Operation setting C is an operation setting of a wireless virtual switching system in a private network, but with lower criticality. Several first medical devices 1A at the patient's bedside are wirelessly connected to the monitoring network 6. The second device 2 is in the form of a standard PC with a monitor. Due to the wireless connection, the QoS may be lower. However, since the criticality of operation setting C is also low, an alarm mode with no alarm level or with an attenuated alarm level at the first medical device 1A is selected, and an alarm forwarded to the second device 2 using the DIS alarm reporting system is selected. HTTPS can be used as a protocol for alarm reporting. The communication can be controlled by a server 7.

[0058] Figure 6 Another exemplary operation setting D is shown. Operation setting D is an operation setting of a wireless setting with an HL7 network. For the HL7 protocol, an HL7 ACM profile may be used. In this example, the second device 2 is wirelessly connected to the monitoring network 6. One or more servers 7 may provide DAS or CDAS functionality. Alternatively, DIS is used depending on QoS. The criticality of the operation setting is lower.

[0059] Figure 7Another exemplary operation setting E is shown. Operation setting E is an operation setting of two bridged operation settings. Therein is illustrated a patient room PR and a nursing room CR with a first medical device and a second medical device connected via a network to a bridge server 7. In addition, an operating room OR is connected to the server 7 via another monitoring network 6. Alarms can be exchanged between the two parts, but a response lag is expected. Therefore, the first medical device will select an alarm mode that produces a perceptible alarm.

[0060] Figure 8 A method for operating a first medical device is shown, the first medical device comprising a communication interface communicatively coupled to or communicatively coupled to a second device, and a controller configured to selectively operate in one of a plurality of predetermined alarm modes. The method comprises the following steps:

[0061] Step S10: Determine under which operating setting of a plurality of predetermined operating settings the first medical device is operating.

[0062] Step S11: Determine the quality of service of the communication with the second device via the communication interface.

[0063] Step S12: Based on the determined operation setting and the determined quality of service, one of a plurality of predetermined alarm modes is selected.

[0064] Step S13: Operate the first medical device in the selected alarm mode. In step S130, the controller of the first medical device determines whether an alarm message exists. If yes (Y), the method proceeds to step S131. If no (N), the method repeats step S130. In step S131, the controller of the first medical device processes the alarm message according to the selected alarm mode. For example, the controller generates an alarm, or suppresses the alarm.

[0065] With the described solution, the patient's comfort can be increased and the nursing staff's workload can be optimized while maintaining a high security level in accordance with the alarm standard IEC / EN 606601-1-8. The information exchange between the first medical device and the second medical device is secure. Unexpected network QoS problems can be detected.

[0066] The concept of the present invention is not limited to the embodiments described above, but can be implemented in different ways.

[0067] Reference numerals

[0068] 1A-1E Medical Devices

[0069] 10 Communication Interface

[0070] 11 Controller

[0071] 12 Display

[0072] 13 Sound emission device

[0073] 2 Nursing Devices

[0074] 20 Communication Interface

[0075] 21 Controller

[0076] 22 Display

[0077] 23 Sound emission device

[0078] 3 Mobile devices

[0079] 4 System

[0080] 40 Hospital Information System

[0081] 41 Picture Archiving and Communication System

[0082] 42 Clinical Information Systems

[0083] 43 Laboratory Equipment

[0084] 44 Communication devices

[0085] 5 Hospital Network

[0086] 6 Monitoring Network

[0087] 7 Server

[0088] AE Operation Settings

[0089] CR Nursing Room

[0090] OR Operating Room

[0091] PR Ward

Claims

1. A medical device (1A-1E, 2), comprising: A communication interface (10, 20), the communication interface (10, 20) being communicatively coupled to another device (2, 1A-1E) or being communicatively coupled to the another device (2, 1A-1E); and a controller (11, 21), the controller (11, 21) being configured to selectively operate in one of a plurality of predetermined alarm modes, wherein the controller (11, 21) is further configured to: - determining at which operating setting (AE) of a plurality of predetermined operating settings (AE) the medical device (1A-1E, 2) is being operated; - determining a quality of service of a communication with said other device (2, 1A-1E) via said communication interface (10, 20); - selecting one of said plurality of predetermined alarm modes based on said determined operational setting (AE) and said determined quality of service; and - operating said medical device (1A-1E, 2) in said alarm mode selected.

2. The medical device (1A-1E) according to claim 1, characterized in that The medical device (1A-1E) is an infusion device or an infusion station for administering at least one fluid to a patient.

3. The medical device (1A-1E, 2) according to claim 1 or 2, characterized in that: The controller (11, 21) is further configured to delegate or propagate an alarm message to the other device (2, 1A-1E) according to the operational setting (AE) and the quality of service.

4. The medical device (1A-1E, 2) according to claim 3, characterized in that The controller (11, 21) is further configured to receive a response to the communicated alarm message from the other device (2, 1A-1E) in the case of a delegated message.

5. The medical device (1A-1E, 2) according to claim 3 or 4, characterized in that: The controller (11, 21) is further configured to generate a visible and / or audible alarm based on a delay in a response to the communicated alarm message and based on the alarm mode selected.

6. The medical device (1A-1E, 2) according to any of the preceding claims, characterized in that A display (12, 22) is adapted to generate a visible alarm.

7. The medical device (1A-1E, 2) according to any of the preceding claims, characterized in that A sound emitting device (13, 23) is adapted to generate an audible alarm.

8. The medical device (1A-1E, 2) according to any of the preceding claims, characterized in that The plurality of predetermined alarm modes include a suppression mode in which the alarm is suppressed and a sense mode in which the alarm can be sensed.

9. The medical device (1A-1E, 2) according to claim 8, characterized in that The plurality of predetermined alarm modes also includes a decay mode in which the alarm is decayed.

10. The medical device (1A-1E, 2) according to any of the preceding claims, characterized in that The controller (11, 21) is configured to determine at which operating setting (AE) of the plurality of predetermined operating settings (AE) the medical device (1A-1E, 2) is operating by at least one of the following: - receiving user input at the medical device (1A-1E, 2); - receiving via said communication interface (10, 20) a message indicating an operational setting (AE); as well as - Detecting a predetermined device or predetermined devices via said communication interface (10, 20).

11. The medical device (1A-1E, 2) according to any one of the preceding claims, characterized in that The controller (11, 21) is configured to determine the quality of service of the communication with the other device (2, 1A-1E) by at least one of the following: - receiving a response from said other device (2, 1A-1E); - determining whether a latency of communication with said other device (2, 1A-1E) is above or below a predetermined latency threshold; and - determining that a network bandwidth for communication with said other device (2, 1A-1E) is above or below a predetermined network bandwidth threshold.

12. The medical device (1A-1E, 2) according to any of the preceding claims, characterized in that The predetermined operation settings (AE) include: at least one wireless setting, in which the communication interface (10, 20) communicates with the other device (2, 1A-1E) via a wireless connection; and at least one wired setting, in which the communication interface (10, 20) communicates with the other device (2, 1A-1E) via a wired connection.

13. A system (4), comprising: - at least one medical device (1A-1E, 2) according to any one of claims 1 to 12, and - another device (2, 1A-1E) communicatively coupled to the at least one medical device (1A-1E, 2).

14. The system (4) according to claim 13, characterized in that A plurality of medical devices (1A-1E) are communicatively connected to the another device (2) via the same network.

15. System (4) according to claim 13 or 14, characterized in that The further device (2) is a care device adapted to visually display and / or audibly emit an alarm and / or adapted to send an alarm to a mobile device (3).

16. A method for operating a medical device (1A-1E, 2), the medical device (1A-1E, 2) comprising: A communication interface (10, 20), the communication interface (10, 20) being communicatively coupled to another device (2, 1A-1E) or being communicatively coupled to the another device (2, 1A-1E); and a controller (11, 21) configured to selectively operate in one of a plurality of predetermined alarm modes, the method comprising: - determining (S10) at which operating setting (AE) of a plurality of predetermined operating settings (AE) the medical device (1A-1E, 2) is operating; - determining (S11) a quality of service of communication with said other device (2, 1A-1E) via said communication interface (10, 20); - selecting (S12) one of said plurality of predetermined alarm modes based on said determined operational setting (AE) and said determined quality of service; as well as - operating (S13) said medical device (1A-1E, 2) in said selected alarm mode.

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