Medical Devices, Systems, and Methods for Alarm Management

Abstract

The medical devices 1A-1E, 2 comprise communication interfaces 10, 20 communicatively coupleable or coupled to other devices 2, 1A-1E, and controllers 11, 21 configured to selectively operate in one of a plurality of predetermined alarm modes, and the controllers 11, 21 are further configured to: determine in which of the plurality of predetermined operating setups A-E the medical devices 1A-1E, 2 are operating; determine a quality of service of communication with the other devices 2, 1A-1E via the communication interfaces 10, 20; select one of the plurality of predetermined alarm modes based on the determined operating setup A-E and the determined quality of service; and operate the medical devices 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 technology]

[0002] In the health field in general, and in hospitals in particular, patients and various medical devices are continuously monitored. Often, an alarm is generated to alert a caregiver, for example, when a monitored parameter of a patient exceeds a certain threshold or when a malfunction of a medical device is detected. The caregiver then notices the alarm, performs a corresponding action, and silences the alarm. To ensure that important alarms are not overlooked, many alarms are audible, for example, audible at the patient's bedside in a hospital room. Today, there is significant noise pollution from numerous alarms in general, especially in intensive care units. Such noise pollution can increase stress levels for patients and caregivers.

[0003] R.R. Vitoux et al., in Non-Patent Document 1, describe this noise pollution and propose potential solutions including identifying non-decibel noise-generating alternatives to alert nurses to patient alarming pumps, utilizing real-time dashboards, alarm prioritization, and patient-specific alarm customization techniques, and educating nurses on specific techniques and pump configurations to help reduce unnecessary alarms.

[0004] The '161 patent notes that in many cases, depending on the type of therapy being provided (including the type of medication being delivered by the infusion pump), certain alarms may not need to be activated even if an error condition is detected.

[0005] Although such solutions may contribute to reducing noise pollution in medical device use, their effectiveness is limited to certain types of alarms and clinical situations.

[0006] Patent Document 2 proposes reducing alarm fatigue by providing a mute button that can be selected by the user and applying an escalating mute override function that can escalately override the user-selected mute button or the "do not disturb" mode for the alarm, as follows: When a high-level alarm is triggered, an app generates an alarm and causes a vibration action generated by the smartphone. If the user does not acknowledge the alarm within a predetermined time (e.g., five minutes), the app generates a second alarm as a low-volume audio alarm generated by the smartphone. If the user does not acknowledge the high-level alarm associated with the second alarm within a second predetermined time (e.g., another five minutes), the app generates a third alarm as a high-volume audio alarm generated by the smartphone. This solution is limited to certain situations and may increase delays. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] International Publication No. 2021 / 207280 [Patent Document 2] International Publication No. 2017 / 173162 [Non-patent literature]

[0008] [Non-Patent Document 1] RR Vitoux et al. “Perceptions of Infusion Pump Alarms” (J Infus Nurs. 2018 Sep;41(5):309-318 (published September 14, 2018)) Summary of the Invention [Problem to be solved by the invention]

[0009] It is an object of the present invention to further reduce noise pollution in the context of medical device applications. [Means for solving the problem]

[0010] This object is achieved by a medical device with the features of claim 1.

[0011] Accordingly, there is provided a (first) medical device comprising a communication interface and a controller. The communication interface is communicatively coupleable or coupled to another (i.e., second) device, e.g., a point-of-care medical device. The controller is configured to selectively operate in one of a plurality of predefined alarm modes. The controller is further configured to determine in which of the plurality of predefined operating setups the (first) medical device is operating, determine a quality of service of communication with the other device (e.g., the point-of-care medical device) via the communication interface, select one of the plurality of predefined alarm modes based on the determined operating setup and the determined quality of service, and operate the (first) medical device in the selected alarm mode.

[0012] This is based on various findings. First, it was found that alarm reporting requirements may vary for each patient and corresponding operational setup, and that appropriate alarm configuration may be time-consuming for caregivers. Second, it was recognized that certain operational setups of a (first) medical device, such as an intensive care setup, require more rigorous alarm reporting and acknowledgment than other operational setups. Third, it was recognized that a limiting factor for automatic alarm mitigation, for example at the bedside, is the reliability of communication between the (first) medical device and another (second) device. A measure of the reliability of remote alarm generation is obtained by determining the service quality of communication with the other (second) device. For example, if a high service quality is determined, alarms may be muted in the (first) medical device and instead generated only in the other (second) device. As another example, if a medium service quality is determined, alarms may be muted in the (first) medical device only in less critical operational setups, such as an intensive care operational setup, and generated only in the other (second) device. Thus, the combination of automatic detection of the current operating setup and determination of the communication quality of service allows for automatic alarm mode selection, which allows for a significant reduction in noise pollution in the context of medical device applications, as well as a reduction in the caregiver's workload due to reduced setup requirements.

[0013] As one example, the plurality of predetermined operational setups may include an intensive care setup, an operating room setup, and a ward level setup. As another example, the plurality of predetermined operational setups may be defined to include a high acuity care setup (requiring a lot of caregiver attention), a low acuity care setup (requiring little caregiver attention), and optionally a medium acuity care setup (requiring a medium level of caregiver attention).

[0014] The (first) medical device may be an infusion device or infusion station for administering one or more fluids to a patient. Particularly for infusion devices and infusion stations, the alarm management described allows noise reduction with a high level of safety.

[0015] The controller may further be configured to delegate or distribute the alarm message to other (second) devices, for example depending on the determined operational setup and / or the determined quality of service. Thus, the corresponding alarm may be muted in the (first) medical device itself. Since the (first) medical device may be located at the bedside, this allows for reducing noise to the patient while maintaining a high level of security. In particular, handling alarm messages based on quality of service allows for noise reduction with a high level of security.

[0016] Optionally, the controller is further configured to receive, in case of a delegated message, a response to the communicated alarm message from the other (second) device. The generation of an alarm by the (first) medical device can depend on the receipt and / or content of the response, thereby making it possible to guarantee uninterrupted communication.

[0017] The controller may be further configured to generate a visual and / or audible alarm based on the delay in response to the communicated alarm message and / or based on the selected alarm mode, thereby making it possible to ensure a prompt response by the caregiver regardless of the quality of service of the communication.

[0018] The (first) medical device optionally comprises a display adapted to generate a visible alarm, thereby making it possible to visually indicate an alarm instead of an audible alarm, reducing the noise level and also generating an alarm that increases the level of attention.

[0019] The (first) medical device may be equipped with an audio emitting device, such as a loudspeaker or beeper, adapted to generate an audible alarm. Thus, the (first) medical device itself can generate an alarm if required.

[0020] For example, the plurality of predefined alarm modes includes a suppression mode in which alarms are suppressed and a perception mode in which alarms are perceptible. For example, in a ward-level setup with good service quality, the suppression mode may be selected such that alarms at the (first) medical device itself are suppressed.

[0021] Optionally, the plurality of predefined alarm modes further comprises an attenuation mode in which alarms are attenuated, for example in a ward-level setup with medium quality of service, the attenuation mode may be selected such that alarms of the (first) medical device itself are attenuated.

[0022] The controller may be configured to determine in which of a plurality of predefined operational setups the (first) medical device is operating by at least one of receiving a user input at the (first) medical device, receiving a message indicating the operational setup via the communication interface, and detecting the predefined device or predefined devices via the communication interface, thereby enabling easy (or fully automated) configuration of the (first) medical device.

[0023] The controller may be further configured to determine the quality of service of the communication with the other device (second device) by at least one of receiving a response from the other device, determining that the latency of the communication with the other device is above or below a predetermined latency threshold, and determining that the network bandwidth of the communication with the other device is above or below a predetermined network bandwidth threshold. This allows for automatic determination of the quality of service for selecting a respective alarm mode. Optionally, the controller is configured to determine the quality of service and, if necessary, periodically change the alarm mode accordingly. For example, the controller is configured to periodically repeat these steps, for example, at time intervals that may be predefined or determined based on the quality of service. This allows for ensuring that an appropriate alarm mode is always set.

[0024] The predetermined operating setups may include at least one wireless setup, in which the communication interface communicates with the other (second) device via a wireless connection, and at least one wired setup, in which the communication interface communicates with the other (second) device via a wired connection, thereby enabling a wide range of applications.

[0025] According to one aspect, there is provided a system including 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, see above description of the (first) medical device for advantages.

[0026] The system may include multiple (first) medical devices communicatively coupled to other (second) devices via the same network, such that the other (second) devices can obtain alarms from the multiple (first) medical devices and, for example, structure the alarms in a manner that is readily understandable.

[0027] The other (second) device may be a caregiver device adapted to visually display and / or audibly emit an alarm and / or transmit the alarm to a mobile device, thereby enabling a rapid response by the caregiver. The other (second) device may be a patient monitor, a nursing station, a ventilator, or a dedicated PC software application, etc.

[0028] According to one aspect, a method for operating a (first) medical device is provided. The (first) medical device comprises a communication interface communicatively coupleable or coupled to another (second) device. The (first) medical device further comprises a controller configured to selectively operate in one of a plurality of predefined alarm modes, the method including: determining (e.g., by the (first) medical device) in which of the plurality of predefined operating setups the (first) medical device is operating; determining (e.g., by the (first) medical device) a quality of service for communication with the other (second) device via the communication interface; selecting (e.g., by the (first) medical device) one of the plurality of predefined alarm modes based on the determined operating setup and the determined quality of service; and operating the (first) medical device in the selected alarm mode.

[0029] The method may use the (first) medical device and / or system according to any of the embodiments described herein, and reference is made to the above description of the (first) medical device and system for the advantages of the method.

[0030] Subsequently, the idea underlying the invention will be explained in more detail with reference to embodiments shown in the figures. [Brief explanation of the drawings]

[0031] [Figure 1] FIG. 1 illustrates a system for alarm management having various medical devices. [Figure 2] FIG. 2 illustrates a first medical device, a second device, and a mobile device of the system of FIG. 1. [Figure 3] 2A-2C illustrate various operational setups of several first medical devices and second devices of the system of FIG. 1. [Figure 4] 2A-2C illustrate various operational setups of several first medical devices and second devices of the system of FIG. 1. [Figure 5] 2A-2C illustrate various operational setups of several first medical devices and second devices of the system of FIG. 1. [Figure 6] 2A-2C illustrate various operational setups of several first medical devices and second devices of the system of FIG. 1. [Figure 7] 2A-2C illustrate various operational setups of several first medical devices and second devices of the system of FIG. 1. [Figure 8] 2 illustrates a method of operating one of the medical devices of FIG. 1. DETAILED DESCRIPTION OF THE INVENTION

[0032] Subsequently, certain embodiments of medical devices, systems and methods for operating medical devices, particularly with respect to alarm management, are described. The embodiments described herein should not be construed as limiting the scope of the present invention.

[0033] 1 shows a system 4 for hospital alarm management. The system 4 includes various medical devices, hereinafter referred to as first medical devices 1A-1D, and other devices, hereinafter referred to as second devices 2 (optionally second medical devices), which are communicatively coupled to each other via a monitoring network 6. The first medical devices 1A-1D and / or the second devices 2 may be located at a patient's bedside. The second devices 2 may be point-of-care medical devices.

[0034] System 4 further includes a hospital information system 40 (HIS). The hospital information system 40 is an information system designed to manage the medical, administrative, financial, and / or legal aspects of hospital operations and the corresponding service processes. System 4 also includes a picture archiving and communication system 41 (PACS). The picture archiving and communication system 41 provides image storage and access. System 4 also includes a clinical information system 42 (CIS). The clinical information system 42 is an information system for use in critical care environments, such as intensive care units (ICUs). The clinical information system is networked with various devices in system 4 and can import information from these devices into an electronic patient record that can be viewed by clinicians at the patient's bedside. System 4 also includes an examination device 43, such as a computer system that stores and / or processes examination data. The hospital information system 40, picture archiving and communication system 41, clinical information system 42, and examination device 43 are communicatively coupled to each other via a hospital network 5.

[0035] 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, gateway and / or bedside device data aggregator.

[0036] 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. Generally, the system 4 includes at least one first medical device 1A-1D and at least one second device 2. The system may also include one or more, for example all, of the other devices shown in FIG. 1.

[0037] Now, with reference to FIG. 2, the functions of the first medical device 1A, which is one of the first medical devices 1A to 1D, and the system 4 will be described in more detail.

[0038] As shown in Fig. 2, a first medical device 1A comprises a communication interface 10 communicatively coupleable or coupled to a second device 2. The first medical device 1A further comprises a controller 11 configured to selectively operate in one of a plurality of predetermined alarm modes, an optional display 12, and an audio emitting device 13. In this example, the audio emitting device 13 is a loudspeaker. The controller 11 is operatively coupled to the display 12 and the audio emitting device 13. The controller 11 is adapted to control the display 12 and / or the audio emitting device 13 to generate an alarm (visual and / or audible).

[0039] The second device 2, which in this example is a bedside patient monitor, comprises a communication interface 20 communicatively coupleable or coupled to the first medical device 1A. The second device 2 further comprises a controller 21 configured to be selectively operated in one of a plurality of predetermined alarm modes, an optional display 22, and an audio emitting device 23. In this example, the audio emitting device 23 is a loudspeaker. The controller 21 is operatively coupled to the display 22 and the audio emitting device 23. The controller 21 is adapted to control the display 22 and / or the audio emitting device 23 to generate an alarm (visual and / or audible).

[0040] The first medical device 1A and the second device 2 are communicatively coupled to each other via the monitoring network 6 by their respective communication interfaces 10, 20.

[0041] The controller 11 of the first medical device 1A (and optionally the controller 21 of the second device 2) is further configured to determine in which of a plurality of predetermined operational setups the first medical device 1A is currently operating. The various different operational setups A-E are described in more detail below with reference to Figures 3-7. In general, the predetermined operational setups may include, for example, setups having different demand levels (e.g., low and high, or low, medium and high), setups having, for example, different urgency of care, setups having different information flows, and / or setups having different communication connection setups.

[0042] The controller 11 of the first medical device 1A (and, optionally correspondingly, the controller 21 of the second device 2) is further configured to determine a quality of service (QoS) of 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 one of a plurality of different QoS levels (e.g., low and high, or low, medium, and high).

[0043] The controller 11 of the first medical device 1A (and optionally the controller 21 of the second device 2) is further configured to select one of a plurality of predetermined alarm modes based on the determined operational setup and the determined quality of service. For example, the controller 11 may access a (e.g., predefined) look-up table (LUT) that outputs one of a plurality of predetermined alarm modes in response to inputs of the determined operational setup and the determined quality of service.

[0044] The controller 11 of the first medical device 1A (and optionally the controller 21 of the second device 2) is further 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 each other by the amount, length, audio 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 may include a suppression mode in which alarms are suppressed, an attenuation mode in which alarms are perceptibly attenuated, and a perceptibility mode in which alarms are perceptible (not attenuated). As another example, the alarm modes may include a local alarm only mode and a remote alarm only mode. The alarm mode may be dynamically changed if QoS deteriorates.

[0045] For example, during setup of the system 4, the controller 11 of the first medical device 1A determines in which of a plurality of predetermined operational setups the first medical device 1A is operating. This may be done, for example, by receiving a user input at the first medical device 1A or the second device 2, by receiving a message by the controller 11 from, for example, the second device 2 via the communication interface 10 indicating the operational setup, and / or by detecting the predetermined device or predetermined devices, for example, via the communication interface 10.

[0046] The controller 11 of the first medical device 1A then 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 that the latency of the communication with the second device 2 is above or below a predetermined latency threshold, and by determining that the network bandwidth of the communication with the second device 2 is above or below a predetermined network bandwidth threshold. The controller 11 may also determine the QoS by determining whether the communication connection with the second device 2 is working, i.e., whether the second device 2 is reachable. Optionally, the controller 11 of the first medical device 1A then classifies the QoS into one of a set of predefined categories (e.g., low, average, high).

[0047] The controller 11 of the first medical device 1A then selects one of a plurality of predetermined alarm modes based on the determined operational setup and the determined QoS, for example based on a given rule that assigns alarm modes to operational setups and QoS. The first medical device 1A then operates in the selected alarm mode and generates alarms defined in the selected alarm mode. Optionally, the selected alarm mode is displayed on the first medical device 1A and / or the second device 2.

[0048] When the controller 11 of the first medical device 1A operates in the selected alarm mode and processes (e.g., receives or generates) the alarm message, an alarm is generated by the display 12 and / or the audio emission device 13 based on the alarm message and the selected alarm mode. For example, the alarm indicated in the alarm message may be generated only if the selected alarm mode is perceptual mode, and may be suppressed if the selected alarm mode is suppressed mode. Thus, if the QoS is good, depending on the operation setup, some or all of the alarm messages in the controller 11 may be delegated or distributed by the controller 11 to the second device 2. The second device 2 then generates an alarm according to the alarm message and / or forwards the alarm message to the mobile device 3 (or sends a corresponding message, e.g., SMS). 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 predefined time, depending on the selected alarm mode, the controller 11 of the first medical device 1A generates a visual alarm and / or an audible alarm.

[0049] 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 alarm standard IEC / EN606601-1-8.

[0050] Optionally, the controller 11 of the first medical device 1A periodically determines the QoS of the communication with the second device 2. For example, the controller 11 of the first medical device 1A determines the QoS of the communication with the second device 2 once per minute. The alarm mode may be dynamically adjusted according to the periodically determined QoS.

[0051] According to FIG. 2, the system includes a further first medical device 1A designed similarly to the first medical device 1A described above.

[0052] 3 illustrates a first exemplary operational setup A. The operational setup A is that of an operating room OR. Various first medical devices 1E, here in the form of centralized control devices each managing several infusion pumps, are communicatively coupled to second devices 2, e.g., monitoring devices, via a monitoring network 6. Here, the monitoring network 6 is a wired network with low latency, high bandwidth, and therefore high QoS.

[0053] The selected alarm mode takes into account the need for high QoS and a quiet operating room. The controller of the first medical device 1E is set to the selected alarm mode with limited noise and brightness. The QoS is monitored regularly. For bidirectional, secure, and timeout-limited information exchange, Service-oriented Device Connectivity (SDC), for example in accordance with IEEE 11073, is used, which allows near real-time, two-way communication. The selected alarm mode is compliant with a Distributed Alarm System (DAS), in which service is guaranteed, or with a Confirmation of a Distributed Alarm System (CDAS), in which confirmation of received alarms is provided.

[0054] FIG. 4 shows another exemplary operational setup B. The operational setup B is a wired connection at the ward level. Several first medical devices 1E are located in patient rooms PR, and second devices 2 are located in caregiver rooms CR. Here, a quiet patient room PR is desired, and infusion information including alarms is reported from the first medical devices 1E to the second devices 2. The second devices 2 generate visual and / or audible alarms. Due to the wired network connection, QoS is good. Therefore, the first medical devices 1E select an alarm mode in which the first medical devices 1E do not generate alarms. A distributed information system (DIS) is used as the alarm reporting system. Therefore, in connection with the alarm mode selection, the alarm reporting system may be selected from a set of predetermined alarm reporting systems, such as DIS, DAS, and CDAS, based on the determined operational setup and the determined QoS.

[0055] A proprietary communication protocol may be applied, for example through an OpenVPN server.

[0056] FIG. 5 shows another exemplary operational setup C. The operational setup C is of a wireless virtual switching system in a private network, but with a lower level of urgency. Several first medical devices 1A at the patient's bedside are wirelessly connected to a monitoring network 6. A second device 2 takes the form of a standard PC with a monitor. Due to the wireless connection, the QoS may be low. However, because the operational setup C is also low-urgency, an alarm mode with no or attenuated alarm level is selected in the first medical device 1A, and alarm forwarding to the second device 2 using the DIS alarm reporting system is selected. HTTPS may be used as the alarm reporting protocol. Communication may be controlled by a server 7.

[0057] Figure 6 shows another exemplary operational setup D. The operational setup D is a wireless setup using an HL7 network. For the HL7 protocol, the profile HL7 ACM may be used. In this example, a 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 the QoS. The operational setup is less urgent.

[0058] 7 shows another exemplary operational setup E. The operational setup E is of two bridged operational setups. Here, a patient room PR and a caregiver room CR with a first medical device and a second device are shown connected to a bridging server 7 via a network. Additionally, 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 delay in response is expected. Therefore, the first medical device will select an alarm mode that generates a perceptible alarm.

[0059] 8 illustrates a method for operating a first medical device, the first medical device comprising a communication interface communicatively coupleable or coupled to a second device, and a controller configured to selectively operate in one of a plurality of predetermined alarm modes, the method including the steps of: Step S10: Determine in which operating setup of a plurality of predetermined operating setups the first medical device is operating. Step S11: Determine the quality of service of the communication with the second device via the communication interface. Step S12: Select one of a plurality of predetermined alarm modes based on the determined operation setup and the determined quality of service. Step S13: Operate the first medical device in the selected alarm mode. Here, 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, generates or suppresses an alarm.

[0060] The described solution allows to increase patient comfort and optimize caregiver workload while maintaining a high level of security in accordance with alarm standard IEC / EN606601-1-8; the information exchange between the first medical device and the second device is secure; unexpected network QoS problems can be detected;

[0061] The inventive idea is not limited to the embodiments described above but can be implemented in different ways. [Explanation of symbols]

[0062] 1A~1E Medical Devices 10 Communication Interface 11 Controller 12 Display 13 Sound Emitting Device 2. Caregiver Device 20 Communication Interface 21 Controller 22 Display 23 Sound Emission Device 3. Mobile Devices 4. System 40 Hospital Information System 41 Image Storage and Communication System 42 Clinical Information System 43 Inspection equipment 44 Communication equipment 5. Hospital Network 6 Monitoring Network 7 Server A~E Operation Setup CR Caregiver Room OR operating room PR Hospital Room

Claims

1. A medical device (1A to 1E, 2) comprising a communication interface (10, 20) that can be coupled or is coupled to other devices (2, 1A to 1E) for communication, and a controller (11, 21) configured to be selectively operated in one of a plurality of predetermined alarm modes, wherein the controller (11, 21) To determine which of the multiple predetermined operation setups (A to E) the medical device (1A to 1E, 2) is operating under, To determine the quality of service for communication with the other devices (2, 1A to 1E) via the aforementioned communication interfaces (10, 20), Based on the determined operation setup (A to E) and the determined service quality, one of the plurality of predetermined alarm modes is selected. The medical device (1A to 1E, 2) is operated in the selected alarm mode. A medical device further configured to perform the following actions.

2. A medical device (1A to 1E) according to claim 1, wherein the medical device (1A to 1E) is an infusion device or infusion station for administering at least a fluid to a patient.

3. A medical device (1A to 1E, 2) according to claim 1 or 2, wherein the controller (11, 21) is further configured to delegate or distribute alarm messages to the other devices (2, 1A to 1E) depending on the operation setup (A to E) and the quality of service.

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

5. A medical device according to claim 3 (1A to 1E, 2), wherein the controllers (11, 21) are further configured to generate visible and / or audible alarms based on the delay in response to a communicated alarm message and based on the selected alarm mode.

6. A medical device according to claim 1 (1A to 1E, 2), comprising a display (12, 22) adapted to generate a visible alarm.

7. A medical device according to claim 1 (1A to 1E, 2), characterized by a sound emitting device (13, 23) adapted to generate an audible alarm.

8. A medical device (1A to 1E, 2) according to claim 1, wherein the plurality of predetermined alarm modes include a suppression mode in which the alarm is suppressed and a perception mode in which the alarm is perceptible.

9. A medical device according to claim 8 (1A to 1E, 2), wherein the plurality of predetermined alarm modes further include attenuation modes in which the alarm is attenuated.

10. A medical device (1A to 1E, 2) according to claim 1, The controllers (11, 21) determine which of the plurality of predetermined operation setups (A to E) the medical device (1A to 1E, 2) is operating under. The medical device (1A to 1E, 2) receives user input, The communication interface (10, 20) receives messages indicating the operation setup (A to E), To detect a predetermined device or a predetermined number of devices via the aforementioned communication interface (10, 20), A medical device characterized by being configured to be determined by at least one of the following.

11. A medical device (1A to 1E, 2) according to claim 1, The controllers (11, 21) determine the quality of service of communication with the other devices (2, 1A to 1E). Receiving a response from the other devices (2, 1A to 1E), It is determined that the waiting time for communication with the other devices (2, 1A to 1E) is above or below a predetermined waiting time threshold. It is determined that the network bandwidth for communication with the other devices (2, 1A to 1E) is above or below a predetermined network bandwidth threshold. A medical device characterized by being configured to be determined by at least one of the following.

12. A medical device (1A to 1E, 2) according to claim 1, wherein the predetermined operating setup (A to E) includes at least one wireless setup in which the communication interface (10, 20) communicates with the other devices (2, 1A to 1E) via a wireless connection, and at least one wired setup in which the communication interface (10, 20) communicates with the other devices (2, 1A to 1E) via a wired connection.

13. System (4), A medical device (1A to 1E, 2) according to claim 1 or 2, Other devices (2, 1A to 1E) that are communicatively coupled to at least one medical device (1A to 1E, 2), A system that includes this.

14. A system (4) according to claim 13, characterized by a plurality of medical devices (1A to 1E) that are communicably coupled with the other devices (2) via the same network.

15. The system (4) according to claim 13, wherein the other device (2) is a caregiver device adapted to visibly display and / or audibly emit an alarm and / or transmit an alarm to a mobile device (3).

16. A method for operating a medical device (1A to 1E, 2), wherein the medical device (1A to 1E, 2) comprises a communication interface (10, 20) that can be coupled or is coupled to communicate with other devices (2, 1A to 1E), and a controller (11, 21) configured to be selectively operated in one of a plurality of predetermined alarm modes, and the method is as follows: S10: Determine which of the multiple predetermined operation setups (A to E) the medical device (1A to 1E, 2) is operating under. Determining the quality of service of communication with the other devices (2, 1A to 1E) via the communication interfaces (10, 20) (S11), Based on the determined operation setup (A to E) and the determined service quality, select one of the plurality of predetermined alarm modes (S12), In the selected alarm mode, the medical device (1A to 1E, 2) is operated (S13), Methods that include...

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