A poster originally presented at the "MEC Annual Meeting and Bioengineering14" conference (Imperial College London, 8th - 9th September 2014)

Alastruey, Jordi

Beale, Richard

Bonnici, Timothy Alexander

Charlton, Peter

Tarassenko, Lionel

Watkinson, Peter

English

Bonnici, Timothy

Peter H Charlton

Watkinson, Peter J

NEUROSURGERY ENTHUSIASTIC WOMEN SOCIETY

Continuous Physiological Monitoring of Ambulatory Patients

ZENODO

King's Research Portal

                       King’s Research Portal  DOI:10.5281/zenodo.572579Document VersionPublisher's PDF, also known as Version of recordLink to publication record in King's Research PortalCitation for published version (APA):Bonnici, T. A., Charlton, P., Alastruey, J., Tarassenko, L., Watkinson, P., & Beale, R. (2014). ContinuousPhysiological Monitoring of Ambulatory Patients. In MEC Annual Meeting and Bioengineering14 Programme andAbstracts (pp. 38-38). MECbioeng14, Imperial College London. https://doi.org/10.5281/zenodo.572579Citing this paperPlease note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this maydiffer from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination,volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you areagain advised to check the publisher's website for any subsequent corrections.General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyrightowners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain•You may freely distribute the URL identifying the publication in the Research PortalTake down policyIf you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access tothe work immediately and investigate your claim.Download date: 08. Oct. 2023Ambulatory patients are monitored intermittentlyClinical deteriorations of hospital patients must be recognised early to maintain patient safety and minimise treatment costs. Routine practice on UK wards is to measure physiological parameters intermittently every 4-6 hours to aid recognition of deteriorations. Thus there may be a prolonged period of deterioration prior to recognition.Deteriorations may be detected earlier by continuous monitoring Wireless sensors, combined with risk prediction algorithms, may enable earlier detection of deteriorations by continuously monitoring physiology. However, such systems depend on reliable data acquisition. We assessed the proportion of patient stay for which continuous ECG and pulse oximetry data could be captured using wireless sensors.References[1] Bonnici T et al. Testing of wearable monitors in a real-world hospital environment: what lessons can be learnt? In Ninth international conference on wearable and implantable body sensor networks, 2012. Washington DC: IEEE, 2012; 79–84.AcknowledgementsThis research was supported by the EPSRC [Grant EP/F058845/1], the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre at Guy’s & St Thomas’ NHS Foundation Trust, and the NIHR Oxford Biomedical Research Centre Programme. The views expressed are those of the authors and not necessarily those of the EPSRC, the NHS, the NIHR or the Department of Health.ContactT. Bonnici and P.Charlton contributed equally to this work:Timothy.Bonnici [at] ndm.ox.ac.ukPeter.Charlton [at] gstt.nhs.ukContinuous Physiological Monitoring of Ambulatory PatientsT. Bonnici12 and P. Charlton12, J. Alastruey1, L. Tarassenko3, P.J. Watkinson4, R. Beale121King’s College London 2Guy’s and St Thomas’ NHS Foundation Trust 3University of Oxford 4Oxford Biomedical Research CentreFor what proportion of patient stay can continuous ECG and pulse oximetry data be captured using wireless sensors?222 patients were monitored wirelessly during their recovery from cardiac surgery on a general ward. ECG data were acquired for the majority of patient stay, whereas pulse oximetry data were acquired for less than a fifth of the time. Furthermore, over a third of patients requested to stop wearing sensors. Therefore, there is room for improvement to the design of wireless sensors, particularly the pulse oximetry component.MethodA post-surgical cardiac ward was equipped with wireless sensors which transmitted data to a central monitor in real time. 222 patients consented to wear a sensor whilst recovering from cardiac surgery.Results196 patients wore a sensor (22 did not stay on the ward, 3 requested not to wear a sensor, and 1 was not given a sensor for clinical reasons). 122 wore a sensor until discharge, 66 requested to stop wearing the sensor early, 6 had the sensor removed for clinical reasons, and 2 were transferred elsewhere. The median length of ward stay was 4.5 days. The 196 patients wore sensors for 898 out of 1344 days. ECG and pulse oximetry data were acquired from each patient for 62% (52) and 18% (41) of their stay respectively.Conclusions ECG data were acquired for the majority of patient stay, whereas pulse oximetry data were acquired for less than a fifth of the time. Furthermore, over a third of patients requested to stop wearing sensors. Therefore, there is room for improvement to the design of wireless sensors, particularly the pulse oximetry component.Using wireless sensors for earlier detection of physiological derangements than routine observations.Patients’ tolerance of wireless sensors is unknownIn a previous assessment of patients’ tolerance of wireless sensors, none acquired data consistently for 24 hours [1]. Therefore, wireless sensors which are routinely used in the NHS were chosen for this study. Whilst more cumbersome than state-of-the-art sensors, they may be more reliable.Future WorkThis trial aims to determine the proportion of physiological derangements detected by wireless sensors over an hour before standard monitoring. Two examples are shown above.The dataset will also be used to design risk prediction algorithms.

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Continuous Physiological Monitoring of Ambulatory Patients

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NEUROSURGERY ENTHUSIASTIC WOMEN SOCIETY

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