Metaverse System for Patients` Safety

Introduction

The motivation of this work is constituted by a series of accidents, already established, that took place on the hospital premises, which according to the official statements could have been avoided. There are several eloquent instances in this regard. Among them, we can mention the fire at the “Constanța Emergency County Clinical Hospital” (Abe et al., 2016), ATI ward, on October 1, 2021, resulting in 15 deaths, and the one on January 29, 2021, at the “Matei Balș Institute in Bucharest” (Bubenek, 2021), resulting in 4 deaths. The consequence of the increasing number of patients suffering from COVID-19 and the need to use artificial or assisted breathing equipment, of any type, is the potentiation of a devastating level of the risk of fire, due to an abnormally high concentration of oxygen in the ambient air, declares the officials. The cases do not only revolve around patients with COVID-19, this being just a favorable setting that exposed an already existing problem in the hospital environment. The already existing volatile framework together with the well-synchronized environmental factors can cause a hazard-type event or the worsening of the health status of the hospitalized patients, respectively of the responsible medical team. In a situation where the existence of patients who require the administration of increased concentrations of oxygen, from 40% to 100% is unavoidable and the ambient air in that room has an oxygen concentration of over 23.5-25%, any spark can trigger a fire, a simple circuit board becoming a real torch at 30% oxygen in the air (Chen et al, 2019).

In this direction, a very big problem is related to the existence and especially the efficiency of the salon's ventilation. A grim statistic shows us that only 10% of hospitals in Romania benefit from a ventilation/AC system, in the rest the ventilation is carried out strictly by opening the windows at regular time intervals.

The press releases that followed placed these numbers in the class of immediate consequences of the lack of compliance with the lack of real-time monitoring devices for oxygen intubation of patients with respiratory failure, as well as the lack of sensors of gas placed in hospital rooms capable of timely alerting the exceeding of the maximum admissible gas concentration (Diaz-Lopez et al, 2018), (Espressif, 2020).

The measures with which we came to help through this application concern the tracking of instantaneous values, the storage and plotting over time of the magnitudes of the most important environmental parameters, using stations placed at the salon level. All stored information can be accessed by staff, who is alerted if there are problems (Manoukian, 2021). The ambient pressure must be higher, to ensure an airflow from the enclosure to the outside between 0.28-0.47 m/s. If we are talking about operating rooms, we are talking about an air exchange at a rate of 15-20 m3/h to maintain strict control of microorganisms. Also for operating rooms, a minimum of 15 air changes per hour, a temperature between 20 °C and 22 °C, and humidity between 30% and 60% are recommended, to inhibit the multiplication of bacteria. These parametric requirements can vary depending on the role of the enclosure in which they are placed, in the operating room a lower temperature is needed than in a patient room, for example. In this direction, two other sources can be specified that equally clearly place the legislative framework in which the parameters must be followed from the hospital rooms to the storage of food or medicines (Facciola et al, 2019), (Gasmet, 2020).

Several other applications are related to CO and CO₂ detection if for unknown reasons there are leaks or the air concentration is altered in other ways such as the existence of household waste storage areas in the vicinity of the hospital, correlated with insufficient ventilation. Smoke detection and alerting the responsible medical personnel is another functionality of the designed system.