Joel J. Nobel

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Joel Judovich Nobel (December 8, 1934 – August 13, 2014) [1] was an American anesthesiologist and patient safety advocate best known for founding the crash cart and ECRI Institute. [2]

Patient safety

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting, and analysis of medical error that often leads to adverse effects. The frequency and magnitude of avoidable adverse events experienced by patients was not well known until the 1990s, when multiple countries reported staggering numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety. The resulting patient safety knowledge continually informs improvement efforts such as: applying lessons learned from business and industry, adopting innovative technologies, educating providers and consumers, enhancing error reporting systems, and developing new economic incentives.

Crash cart

A crash cart or code cart or "MAX cart" is a set of trays/drawers/shelves on wheels used in hospitals for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support protocols (ACLS/ALS) to potentially save someone's life. The cart carries instruments for cardiopulmonary resuscitation and other medical supplies while also functioning as a support litter for the patient.

ECRI Institute organization

ECRI Institute is an independent nonprofit organization authority on the medical practices and products that provide the safest, most cost-effective care.

Contents

Early life and education

Nobel was born in Pennsylvania, one of three children born to Philadelphia doctors Dr. Golda R. Nobel and Dr. Bernard D. Judovich. [3] His mother was a psychiatrist who lived to age 107, while his father was a general practitioner. [4]

Philadelphia Largest city in Pennsylvania, United States

Philadelphia, sometimes known colloquially as Philly, is the largest city in the U.S. state and Commonwealth of Pennsylvania, and the sixth-most populous U.S. city, with a 2017 census-estimated population of 1,580,863. Since 1854, the city has been coterminous with Philadelphia County, the most populous county in Pennsylvania and the urban core of the eighth-largest U.S. metropolitan statistical area, with over 6 million residents as of 2017. Philadelphia is also the economic and cultural anchor of the greater Delaware Valley, located along the lower Delaware and Schuylkill Rivers, within the Northeast megalopolis. The Delaware Valley's population of 7.2 million ranks it as the eighth-largest combined statistical area in the United States.

He graduated from Friends Select School in 1952. He earned an undergraduate degree in English from Haverford College in 1956, followed by a masters in international relations from the University of Pennsylvania in 1958 and a medical degree from Jefferson Medical College in 1963. His residency was interrupted by the Vietnam War, when he served in the Navy. [2]

Haverford College college in Pennsylvania

Haverford College is a private liberal arts college in Haverford, Pennsylvania. All students of the college are undergraduates and nearly all reside on campus.

University of Pennsylvania Private Ivy League research university in Philadelphia, Pennsylvania

The University of Pennsylvania is a private Ivy League research university located in the University City neighborhood of Philadelphia, Pennsylvania. It is one of the nine colonial colleges founded prior to the Declaration of Independence and the first institution of higher learning in the United States to refer to itself as a university. Benjamin Franklin, Penn's founder and first president, advocated an educational program that trained leaders in commerce, government, and public service, similar to a modern liberal arts curriculum. The university's coat of arms features a dolphin on its red chief, adopted from Benjamin Franklin's own coat of arms.

Career

In 1968, a 4-year-old patient of his at the Presbyterian Hospital at University of Pittsburgh Medical Center died due to a faulty bag valve mask. Nobel, who had alerted others on the staff several times that it was not working properly, was deeply affected by the child's death. "Anger is a great source of energy," he later wrote of the reaction to the incident. [2]

University of Pittsburgh Medical Center

The University of Pittsburgh Medical Center (UPMC) is a $19 billion integrated global nonprofit health enterprise that has 85,000 employees, 40 hospitals with more than 8,000 licensed beds, 600 clinical locations including outpatient sites and doctors’ offices, a 3.4 million-member health insurance division, as well as commercial and international ventures. It is closely affiliated with its academic partner, the University of Pittsburgh. It is considered a leading American health care provider, as its flagship facilities have ranked in US News & World Report "Honor Roll" of the approximately 15 to 20 best hospitals in America for over 15 years. As of 2016, UPMC is ranked 12th nationally among the best hospitals by US News & World Report and ranked in 15 of 16 specialty areas when including UPMC Magee-Womens Hospital. This does not include UPMC Children's Hospital of Pittsburgh which ranked in the top 10 of pediatric centers in a separate US News ranking.

Bag valve mask

A bag valve mask, abbreviated to BVM and sometimes known by the proprietary name Ambu bag or generically as a manual resuscitator or "self-inflating bag", is a hand-held device commonly used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately. The device is a required part of resuscitation kits for trained professionals in out-of-hospital settings (such as ambulance crews) and is also frequently used in hospitals as part of standard equipment found on a crash cart, in emergency rooms or other critical care settings. Underscoring the frequency and prominence of BVM use in the United States, the American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care recommend that "all healthcare providers should be familiar with the use of the bag-mask device." Manual resuscitators are also used within the hospital for temporary ventilation of patients dependent on mechanical ventilators when the mechanical ventilator needs to be examined for possible malfunction or when ventilator-dependent patients are transported within the hospital. Two principal types of manual resuscitators exist; one version is self-filling with air, although additional oxygen (O2) can be added but is not necessary for the device to function. The other principal type of manual resuscitator (flow-inflation) is heavily used in non-emergency applications in the operating room to ventilate patients during anesthesia induction and recovery.

Nobel tested others of those devices on the market and found many to be ineffective. After failing to find anyone to publish his findings, he set up the Emergency Care Research Institute in the 1960s (now ECRI Institute) to publish the Health Devices Journal which shared information about medical devices. [2]

Nobel invented the MAX cart, which was a new type of crash cart. [5]

He was married first to Bonnie Sue Goldberg [3] and second to Qingqing Lu. He died at his Gladwyne, Pennsylvania home from complications of cancer and diabetes, age 79. He was survived by his sons Joshua and Adam and daughter Erika.<ref name="Philly obituary">

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References

  1. ↑ Social Security Death Index, 1935-2014. Social Security Administration.
  2. 1 2 3 4 Vitez, Michael (August 20, 2014). "Joel J. Nobel, 79, patient-safety advocate". articles.philly.com. Retrieved August 21, 2014.
  3. 1 2 "Weddings" (PDF). The Philadelphia Inquirer. July 3, 1960. p. 4.
  4. ↑ Cook, Bonnie L. (January 27, 2014). "Golda R. Nobel, 107, psychiatrist in Phila". The Philadelphia Inquirer. p. B6.
  5. ↑ National Museum of American History (August 31, 2010). "National Museum of American History Collects Prototype Medical Emergency Crash Cart". americanhistory.si.edu. Retrieved August 21, 2014.
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