Surveillance of Patients in the Waiting Area of the Department of Emergency Medicine

Abstract

Many patients visiting an emergency department are in reduced general condition of health and at risk of suffering further deterioration during their stay. We wanted to test the feasibility of a new monitoring system in a waiting area of an emergency department.In an observational cross-sectional single-center study, patients with acute cardiac or pulmonary symptoms or in potentially life-threatening conditions were enrolled. Monitoring devices providing vital signs via short range radio (SRR) at certain time points and compliance evaluation forms were used.Out of 230 patients, 4 wanted to terminate their participation prematurely. No data was lost due to technical difficulties. Over a median monitoring period of 178 (118–258) min per patient, 684 h of vital sign data were collected and used to assist managing those patients. Linear regression analysis between clinical symptom category groups of patients showed significant differences in the respiratory rate and noninvasive blood pressure courses. Feedback from patients and users via questionnaires showed overall very good acceptance and patients felt that they were given better care.To assist medical staff of an emergency department waiting area to rapidly response to potentially life-threatening situations of its patients, a new monitoring system proved to be feasible and safe.

Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis

“…Recording frequencies for all studies were greater than once per 15 min, except heart rate and blood pressure in Kanaoka et al 42 and blood pressure in Hubner et al 41 were measured only once per 30 min. Hubner et al 41 enrolled patients from the waiting area of the Emergency Department while Nowak et al 27,28 enrolled patients in the Emergency Department who were able to give informed consent. Zimlichman et al 43 and Kanaoka et al 42 recruited patients from medical wards.…”

“…Patient information such as presenting complaint (chest pain, dyspnoea, collapse, palpitations and hypertension) and kidney function (urine albumin excretion rate and estimated glomerular filtration rate) were found to correlate with continuously monitored vital signs; in particular, the course of four parameters (heart rate, blood pressure, respiratory rate and SpO 2 ) were found to be dependent on the patient's presenting complaint such as dyspnoea, chest pain and collapse. 41,42 Data from changes in continuously monitored blood pressure and heart rate were also found to be predictive of potential cardiac arrest, transfer to intensive care unit and need for mechanical ventilation. 43 Diagnostic data from continuously monitored blood pressure and heart rate also helped to identify patients with acute heart failure, sepsis or stroke and were used in sub-clustering septic patients into groups with different prognosis.…”

Emergency department waiting room nurses in practice: An observational study

“…The sequential design used in this study enabled data collected from an integrative literature review and Phase One to inform data collection in this current observational phase (Creswell, ; Creswell & Plano Clark, ). The results from the integrative review (Innes et al., ) and Phase One (Innes et al., ) have been reported elsewhere. The aim of this phase of the research was to identify the activities and behaviours of WRNs in ED settings.…”

“…One model of this post‐triage waiting room‐based care is a waiting room nurse (WRN); the role is separate and distinct from the triage nurse, but acts as an adjunct and in concert with the triage role. The scope of practice includes post‐triage assessments, commence early interventions, reassessments for waiting patients and to improve communication for patients and families in the waiting room who have yet to be allocated a treatment space in the ED (Innes, Jackson, Plummer, & Elliott, ).…”

A Robust Fusion Model for Estimating Respiratory Rate From Photoplethysmography and Electrocardiography

“…However, continued advances in photoplethysmography (PPG) and electrocardiography (ECG) have led to their widespread use both in and out of the hospital [10]- [12]. In particular, there is substantial interest in incorporating reflectance PPG technology into smart sensors and wearable devices, such as consumer-grade smart watches [13].…”