Research : Richard McNeer, MD., PhD

Richard McNeer, MD, Ph.D.

Dr. McNeer has perceived significant and fundamental gaps in the ability of the medical field to assess and monitor critically ill patients since he was a medical resident. During his more than ten years as a trauma anesthesiologist, Dr. McNeer has experienced firsthand the frenetic, noisy, and stressful environment that surrounds the attempts to save the lives of critically ill patients, as well as the alarm/listener fatigue (ALF) that accompanies this environment. From this exposure, he has focused on developing an effective way to detect ALF in caregivers (or patients), with an ultimate goal of being able to prevent ALF. Dr. McNeer currently emphasizes the study of ALF in a systematic and scientific way that uses psychoacoustics, technology and simulation The goal is to help resolve this pressing and much publicized patient safety issue, and to promote an environment in which clinicians are able to devote their clinical skills and knowledge to patient care without the unnecessary and deleterious stress that is currently generated in critical care settings due to the cacophonous auditory milieu. Completion of this research will have an immediate impact on management of the auditory environment in critical care settings.

Research Interests

  • Characterization and reduction of alarm/listener fatigue in critical care settings
  • Human factors in medical alarm design and function
  • Role of auditory evoked potentials in assessment of sedation and anesthetic depth
  • Hemodynamic monitoring of critically-ill patients

Recent Presentations

Abstracts

Simulation Testing for Medical Device Alarms
Association for the Advancement of Medical Instrumentation (AAMI) Medical Device Alarms Summit, Herndon, VA, October, 2011
http://www.aami.org/alarms/Materials/T_agenda.html

Peer-Reviewed Publications

  1. Edworthy JR, Schlesinger JJ, McNeer RR, Kristensen MS, Bennett CL. Classifying Alarms: Seeking Durability, Credibility, Consistency, and Simplicity. Biomed Instrum Technol 2017;51:50-7.
  2. McNeer RR, Bennett CL, Bodzin D, Dudaryk R. Factors affecting acoustics and speech intelligibility in the operating room: Size matters. Anesth Analg. 2017 124(6):1978-1985.
  3. Dudaryk R, Bodzin, DK, Ray J, Jabalay CS, McNeer RR, Epstein RH. Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated With Nonsurvival: A Case Series. Anesth Analg. 2017 Oct;125(4):1261-1266.
  4. McNeer RR, Bennett CL, Dudaryk R. Intraoperative noise increases perceived task load and fatigue in anesthesiology residents: A simulation-based study. Anesthesia & Analgesia 2016; 122(2):512-523.
  5. Benitez-Lopez J, Rao SR, McNeer RR, Dudaryk R. Intraoperative auto-triggered pressure support ventilation resistant to increased flow rigger threshold. Anesthesia & Analgesia Case Reports 2016; 7(1):9-12.
  6. McNeer RR, Dudaryk R, Nedeff NB, Bennett CL. Development and testing of screen-based and psychometric instruments for assessing resident performance in an operating room simulator. Anesthesia Research and Practice 2016; 2016:9348478.
  7. Bennett CL, Dudaryk R, Ayers AL, McNeer RR. Simulating environmental and psychological acoustic factors of the operating room. Journal of the Acoustical Society of America 2015; 138(6):3855-3863.
  8. McNeer RR, Varon AJ. Pitfalls of hemodynamic monitoring in patients with trauma. Anesthesiology Clinics 2013; 31(1):179-194.
  9. Castro-Llanos A, Bohorquez J, McNeer RR, Ozdamar O. Simultaneously extracted transient and steady-state evoked responses during general anesthesia: Variability of different rates. IEEE Engineering in Medicine & Biology Society 2012; 3472-3475.
  10. Bennett, McNeer RR. PT-SAFE: A software tool for development and annunciation of medical audible alarms. Anesthesia & Analgesia; 114(3):576-583, 2012.
  11. Bennett CL, McNeer RR, Leider CN. Urgency Analysis of Audible Alarms in The Operating Room. International Society for Music Information Retrieval 2011; 771-775
  12. McNeer RR, Bohorquez J, Ozdamar O. Influence of auditory stimulation rates on evoked potentials during general anesthesia: relationship between the transient auditory middle-latency response and the 40-Hz auditory steady-state response. Anesthesiology 110:1026-1035, 2009.
  13. McNeer RR, Bohorquez J, Ozdamar O, Varon A, Barach P. A new paradigm for the design of audible alarms that convey urgency information. Journal of Clinical Monitoring and Computing; 21:353-363, 2007.
  14. Rong M, Rossi EA, Zhang J, McNeer RR, Van Den Brande JMH, Yasin M, Weed DT, Carraway CAC, Thompson JF, Carraway KL. Expression and localization of Muc4/sialomucin complex (SMC) in the adult and developing rat intestine: implications for Muc4/SMC Function. Journal of Cellular Physiology; 202:275-284, 2005.
  15. McNeer RR, Carraway CA, Fregien NL, Carraway KL. Characterization of the expression and steroid hormone control of sialomucin complex in the rat uterus: implications for uterine receptivity. Journal of Cellular Physiology; 176(1):110-119, 1998.
  16. McNeer RR, Huang D, Fregien NL, Carraway KL. Sialomucin complex in the rat respiratory tract: a model for its role in epithelial protection. Biochemical Journal; 330:737-744,1998.
  17. McNeer RR, Price-Schiavi S, Komatsu M, Fregien NR, Carraway KL. Sialomucin complex in tumors and tissues. Frontiers in Bioscience;15;2:D449-D459,1997.
  18. Rossi EA, McNeer RR, Price-Schiavi SA, Van den Brande JM, Komatsu M, Thompson JF, Carraway CA, Fregien NL, Carraway KL. Sialomucin complex, a heterodimeric glycoprotein complex. Expression as a soluble, secretable form in lactating mammary gland and colon. Journal of Biological Chemistry; 27;271(52):33476-33485,1996.

Grants and Contracts
Anesthesia Patient Safety Foundation
Investigation into reduction of alarm/listener fatigue:

Total Funding: $150,000
01-Jan-2013 -31-Dec-2013
Role on Project: PI

Association for the Advancement of Medical Instrumentation
Perception and Efficacy of Novel Auditory Alarms in Simulated Perioperative or Intensive Care Unit Environment.
Total Funding: $85,000
01-Nov-2016 -31-Oct-2017