Moving monitors, avoiding blind spots


Maintaining continuity of medical care is vital when moving a critically ill patient

Transporting sick patients can be a stressful task - and the sicker the patient, the greater the chance of problems during transportation.

Patient’s vital signs are monitored extensively and continuously in all care areas of the hospital. But, in the emergency room (ER), the operating room (OR), and the intensive care unit (ICU), it’s perhaps especially important as many patients in these units need very close surveillance and doctors need real-time information.

When transferring these patients, it’s important not to lose vital information when plugging and unplugging equipment - so-called blind spots.

It all starts with weighing the risks of patient transport against the benefits.

Transferring a sick patient from the ICU or the ER to another unit or department in the hospital can be risky – and it is often stressful for both the patient and the healthcare professionals responsible for the transfer.

Recent studies indicate that transported patients suffer two to four times more complications than non-transported ones, and about 46% of transported patients experience adverse events.

Transport within the hospital is also associated with a longer patient stay in the ICU.

For a critically-ill patient, the reduction or change of care, and the movement itself, can become the cause of serious complications and put their health at risk.

Airway-related and pulmonary complications can occur during transport, as well as hemodynamic alterations.

Cardiac arrest remains a concern for critically-ill patients undergoing transfer, and intra-hospital transport has been suggested as a potential risk factor for infection.

But intra-hospital transport can be necessary as patients need diagnostic or therapeutic procedures or tests that are vital for their treatment and which need to be conducted in another part of the facility.

Nurses play critical roles in helping to ensure that transfers go smoothly and without blind spots. But, as Tiina Matikainen, anaesthesia nurse in the Children’s Hospital of the Helsinki University Hospital in Finland, points out, it may require cumbersome set-ups.

“When moving sick patients, we currently use our biggest patient monitor,” she said.

“Because of its size, it is not very convenient for this purpose, but it is the only monitor we have today that provides all the data we need from these patients.

“Also, we often have to place transport monitors in patients’ beds. This means they sometimes get lost under the covers or may even drop on the floor.”

The new monitor provides me with all the data I need, so I don’t need to fetch any extra devices or equipment if I want to take more measurements

Monitors provide doctors with critical information such as a patient’s vital signs and they rely on this real-time information to identify changes and complications in a patient’s condition, especially with those patients that require close surveillance.

The monitors are also equipped with alarms to alert staff that something is wrong. Unplugging a patient from a monitor to be transferred, even for the shortest amount of time, means doctors lose some potentially-critical information.

Matikainen works in the operating room of the hospital, which treats patients from newborns to 15 years old, with the smallest patients being pre-term babies weighing less than 500 grams at birth.

Patients come to the hospital from all over Finland and abroad.

At the hospital, Matikainen transports patients between the OR and the ICU daily. For her, a simpler, more-convenient, and more-robust solution than what she uses today would help her transport her patients.

To address this, GE Healthcare launched CARESCAPE ONE this week at the Euroanaesthesia 2018 show in Copenhagen.

It is a lightweight plug-and-play transport monitor designed to reduce complexity and transport within the hospital, while being durable enough to withstand drops to the floor.

Matikainen was one of the first to try the new monitor and thinks it will render the larger monitors they previously used obsolete and enable them to maintain the standard of ICU level monitoring.

“The new monitor provides me with all the data I need, so I don’t need to fetch any extra devices or equipment if I want to take more measurements. They are all provided by this monitor,” she said.

Acute nurse, Inna Pennanen, who works at Peijas Hospital in Helsinki, added: “Patients don’t like it if we place the cables on the bed because they often end up under their back and it’s uncomfortable.

“The CARESCAPE ONE solves that problem with a cable mount that holds all the cables, improving patient comfort.”

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She added: “With our current monitoring system, the cables sometimes get twisted when plugging them in. The parameter connectors of the new monitor are much easier to attach. And as the USB ports are identical, you may plug any parameter into any port.”