Evolution And Trends In Patient Monitoring
Evolution of patient monitoring started when the first patient monitor was released in 1964. However, it was only for monitoring of ECG; subsequently, it was extended to non-invasive blood pressure (NIBP), saturated peripheral capillary oxygen (SpO2), and temperature. Further to this, the next evolution in patient monitors was monitoring of invasive parameters like invasive blood pressure (IBP) and so on.
If we focus on segmentation of patient monitors, we have preconfigured patient monitors with fixed basic parameters for low and mid acuity areas that now come with touchscreen facility or non-touch rotatory knob operated facility. We also have semi-modular patient monitors in the market which have a set of fixed parameters and also the flexibility to upgrade it with 1-2 parameters by inserting a module, and are limited to use EtCo2, IBP, temp, BIS, AGM etc. specifically for operating rooms to mid- to high-acuity areas. We also have fully modular patient monitors which have shown that nothing is impossible to measure in patient vitals using advanced measurement capabilities.
Patient monitors have comprehensive clinical measurements available for ECG, NIBP, Spo2, invasive pressures like CVP, arterial, dual temperatures (core and skin) as basic parameters which can further have advanced parameters like EtCo2 (micro, main, and side stream), BIS, AGM, CO, PICCO, ICG, SVo2, Scvo2, NMT, EEG, and respiratory mechanics. rSO2 as a single width insertable module and the innovation continues on patient monitors.
We also have patient’s vital information flow from patient monitors to other devices, that is data is on the move. When monitors are connected to the central monitoring station (it can be via wi-fi or wired networking). The viewing of live and trend data is not limited within the hospital but it can also be viewed from any part of the world through an internet browser or mobile phone. including in hospital telemetry devices.
With so much research on artificial intelligence, we now have smarter clinical tools for the user to enable them to take faster decisions, the advancements are toward clinical assistive applications to summarize and graphically visualize the complex clinical data into uncomplicated simple view such as ST graphics, 24 hours ECG full disclosure, sepsis information, ventilation and nutrition data, anesthesia balance, early warning scores like – coma scale, OxyCRG for neonatal patients, neuro trends etc. Data interpretation and analysis has become easier for doctors now so that they can make quick decisions.
Apart from connecting external equipment data like ventilators, anesthesia workstation, and syringe infusion pumps through linking modules, cables to display all data at bedside on the patient monitor itself are also available. On the integration part now, patient monitors are capable to extract the data from any EMR like CT/MRI images from RIS, patient demographics from HIS, lab data from LIS to display all information on main patient monitor without compromising the vital monitoring making the basic patient monitoring in to a clinical informatics workstation.
