scholarly journals Battlefield Vital Sign Monitoring in Role 1 Military Treatment Facilities: A Thematic Analysis of After-Action Reviews from the Prehospital Trauma Registry

2020 ◽  
Author(s):  
Brandon M Carius ◽  
Jason F Naylor ◽  
Michael D April ◽  
Andrew D Fisher ◽  
Ian L Hudson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hemodynamic Monitoring ◽  
Vital Sign ◽  
Trauma Registry ◽  
Vital Signs ◽  
Medical Officer ◽  
Pressure Cuff ◽  
Treatment Facilities ◽  
Combat Casualties ◽  
After Action Reviews

ABSTRACT Introduction The Prehospital Trauma Registry (PHTR) captures after-action reviews (AARs) as part of a continuous performance improvement cycle and to provide commanders real-time feedback of Role 1 care. We have previously described overall challenges noted within the AARs. We now performed a focused assessment of challenges with regard to hemodynamic monitoring to improve casualty monitoring systems. Materials and Methods We performed a review of AARs within the PHTR in Afghanistan from January 2013 to September 2014 as previously described. In this analysis, we focus on AARs specific to challenges with hemodynamic monitoring of combat casualties. Results Of the 705 PHTR casualties, 592 had available AAR data; 86 of those described challenges with hemodynamic monitoring. Most were identified as male (97%) and having sustained battle injuries (93%), typically from an explosion (48%). Most were urgent evacuation status (85%) and had a medical officer in their chain of care (65%). The most common vital sign mentioned in AAR comments was blood pressure (62%), and nearly one-quarter of comments stated that arterial palpation was used in place of blood pressure cuff measurements. Conclusions Our qualitative methods study highlights the challenges with obtaining vital signs—both training and equipment. We also highlight the challenges regarding ongoing monitoring to prevent hemodynamic collapse in severely injured casualties. The U.S. military needs to develop better methods for casualty monitoring for the subset of casualties that are critically injured.

Advance Monitoring of Blood Pressure and Respiratory Rate Using De-Noising Auto Encoder

2021 ◽  
Author(s):  
Seung-Ho Park ◽  
Kyoung-Su Park
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Vital Sign ◽  
Superficial Temporal Artery ◽  
Vital Signs ◽  
Pulse Signal ◽  
Temporal Artery ◽  
Sinus Arrhythmia ◽  
Vital Signs Monitoring ◽  
Vital Sign Measurement

Abstract As the importance of continuous vital signs monitoring increases, the need for wearable devices to measure vital sign is increasing. In this study, the device is designed to measure blood pressure (BP), respiratory rate (RR), and heartrate (HR) with one sensor. The device is in earphone format and is manufactured as wireless type using Arduino-based bluetooth module. The device measures pulse signal in the Superficial temporal artery using Photoplethysmograghy (PPG) sensor. The device uses the Auto Encoder to remove noise caused by movement, etc., contained in the pulse signal. Extract the feature from the pulse signal and use them for the vital sign measurement. The device is measured using Slope transit time (STT) method for BP and Respiratory sinus arrhythmia (RSA) method for RR. Finally, the accuracy is determined by comparing the vital signs measured through the device with the reference vital signs measured simultaneously.

scholarly journals The effect of alternate nostril breathing exercise in vital signs of congestive heart failure patients

2019 ◽  
Vol 7 (1) ◽  
pp. 67
Author(s):  
Tiurmaida Simandalahi ◽  
Honesty Diana Morika ◽  
Puteri Fannya
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Congestive Heart Failure ◽  
Vital Sign ◽  
Vital Signs ◽  
Pharmacological Therapy ◽  
T Test ◽  
P Value ◽  
Breathing Exercise ◽  
Paired T Test

Background: Changes in vital signs such as tachycardia, dyspnea, tachipnea, decreased oxygenation, caused by the inability of the heart to pump enough blood to meet the needs of oxygen and nutrients needed by the tissue, so that alternative therapies are needed: alternate nostril breathing exercise (ANBE) as a companion to pharmacological therapy for congestive heart failure (CHF) patients. The purpose of this study was to see the effect of ANBE on the vital sign of CHF patients.Methods: This Quasy experimental study was used one group pretest and Posttes design, conducted at one of the Padang City Hospitals from March to August 2019. Study population includes CHF sufferers, with a sample of 16 people, using accidental sampling technique. Univariate data analysis to get the mean of vital sign and bivariate measurements using parametric test i.e. Paired t-test to see the effect of this therapy.Results: Mean vital signs pretest and posttest was given in a row The observations are: respiratory rate (RR): 5.4978; 4.6078, pulse: 10.1804; 8,7770, systolic blood pressure (SBP): 12,5963; 11,1481, and diastolic blood pressure (DBP): 10,3009; 8.8606. Paired t-test obtained p-value of RR, pulse, SBP and DBP: 0.000, and existing t count> from t table (t count> 2.13145), so that there is an effect of ANBE on vital signs.Conclusions: ANBE affects the vital sign of CHF patients and can be continued as an intervention that can be carried out independently by CHF sufferers.

Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm

2005 ◽  
Vol 14 (3) ◽  
pp. 232-241 ◽  
Author(s):  
Kathleen Schell ◽  
Elisabeth Bradley ◽  
Linda Bucher ◽  
Maureen Seckel ◽  
Denise Lyons ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Pressure ◽  
Vital Signs ◽  
Stable Condition ◽  
Correlation Coefficients ◽  
Upper Arm ◽  
Mean Values ◽  
Noninvasive Measurements ◽  
Measure Blood Pressure ◽  
Pressure Cuff

• Background When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure. • Objective To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm. • Methods A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level. • Results Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P < .001 for both). Mean systolic pressures, but not mean diastolic pressures, in the upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure). • Conclusions Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.

scholarly journals Vital Signs Changes of Brick Industry Workers Exposed to Heat Pressure in Sukarami Palembang

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Syokumawena Syokumawena ◽  
Marta Pastari ◽  
Rahmad A. Juliansyah ◽  
Hanna S.W. Kusuma ◽  
Dwi D. Rihibiha
Keyword(s):  
Blood Pressure ◽  
Health Status ◽  
Body Temperature ◽  
Environmental Factors ◽  
Cardiovascular System ◽  
Vital Sign ◽  
Vital Signs ◽  
Chemical Substances ◽  
Pulse Heat

Brick workers are exposed to dust contained of mixtures of chemical substances andhigh temperature. Those environmental factors can affect the health status of the workers;mainly the cardiovascular system. The aim of this research was to observe the effect of heatpressure on vital sign of brick factory manufacturing workers in Sukarami Palembang. Theresearch was conducted in RT 07/13 Sungai Durian, Kecamatan Sukarami, Palembang. Thesubjects were 40 people brick workers; 20 workers were exposed to heat pressure and 20workers did not. We found that in the workers with heat pressure exposure,the average vitalsigns before working are blood pressure of 117/76 mmHg, pulse of 77 x/minutes, and bodytemperature of 36,5°C and after working are blood pressure of 130/84 mmHg, pulse of 92x/minutes, and body temperature of 38°C. In the workers without heat pressure exposure, theaverage vital signs before working are blood pressure of 107/80 mmHg, pulse of 75 x/minutes,and body temperature of 36°C and the average vital signs after working are blood pressure of112/81 mmHg, pulse of 79 x/minutes, and body temperature of 37°C. Conclusion, heat pressurehas effects on vital sign of brick factory manufacturing workers in Sukarami Palembang.Keywords: blood pressure, body temperature, brick factory pulse, heat pressure

scholarly journals Accuracy of Vital Signs Measurements by a Smartwatch and a Portable Health Device: Validation Study

10.2196/16811 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16811 ◽  
Author(s):  
Christina Hahnen ◽  
Cecilia G Freeman ◽  
Nilanjan Haldar ◽  
Jacquelyn N Hamati ◽  
Dylan M Bard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vital Sign ◽  
Vital Signs ◽  
Final Analysis ◽  
University Hospital ◽  
Health Concern ◽  
Absolute Difference ◽  
Mean Absolute Difference ◽  
The Mean ◽  
Performance Monitor

Background New consumer health devices are being developed to easily monitor multiple physiological parameters on a regular basis. Many of these vital sign measurement devices have yet to be formally studied in a clinical setting but have already spread widely throughout the consumer market. Objective The aim of this study was to investigate the accuracy and precision of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO2) measurements of 2 novel all-in-one monitoring devices, the BodiMetrics Performance Monitor and the Everlast smartwatch. Methods We enrolled 127 patients (>18 years) from the Thomas Jefferson University Hospital Preadmission Testing Center. SBP and HR were measured by both investigational devices. In addition, the Everlast watch was utilized to measure DBP, and the BodiMetrics Performance Monitor was utilized to measure SpO2. After 5 min of quiet sitting, four hospital-grade standard and three investigational vital sign measurements were taken, with 60 seconds in between each measurement. The reference vital sign measurements were calculated by determining the average of the two standard measurements that bounded each investigational measurement. Using this method, we determined three comparison pairs for each investigational device in each subject. After excluding data from 42 individuals because of excessive variation in sequential standard measurements per prespecified dropping rules, data from 85 subjects were used for final analysis. Results Of 85 participants, 36 (42%) were women, and the mean age was 53 (SD 21) years. The accuracy guidelines were only met for the HR measurements in both devices. SBP measurements deviated 16.9 (SD 13.5) mm Hg and 5.3 (SD 4.7) mm Hg from the reference values for the Everlast and BodiMetrics devices, respectively. The mean absolute difference in DBP measurements for the Everlast smartwatch was 8.3 (SD 6.1) mm Hg. The mean absolute difference between BodiMetrics and reference SpO2 measurements was 3.02%. Conclusions Both devices we investigated met accuracy guidelines for HR measurements, but they failed to meet the predefined accuracy guidelines for other vital sign measurements. Continued sale of consumer physiological monitors without prior validation and approval procedures is a public health concern.

scholarly journals An effect of physical exercise-induced fatigue on the vital sign parameters: A preliminary study

2019 ◽  
Vol 15 (2) ◽  
pp. 173-177
Author(s):  
Zulkifli Ahmad ◽  
Mohd Najeb Jamaludin ◽  
Kamaruzaman Soeed
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Temperature ◽  
Physical Exercise ◽  
Vital Sign ◽  
Vital Signs ◽  
Health Condition ◽  
The Body ◽  
Physical Movement ◽  
Exercise Induced

Vital sign monitoring is an important body measurement to identify health condition and diagnose any disease and illness. In sports, physical exercise will contribute to the changes of the physiological systems, specifically for the vital signs. Therefore, the objective of this study was to determine the effect of physical fatigue exercise on the vital sign parameters. This is significant for the fitness identification and prediction of each individual when performing an exercise. Five male subjects with no history of injuries and random BMI were selected from students of biomedical engineering, Universiti Teknologi Malaysia. Based on the relationship between physical movement and physiology, the parameters considered were heart rate, blood pressure, and body temperature. Subjects were required to run on the treadmill at an initial speed of 4 km/h with an increase of 1 km/h at every 2 minutes interval. The effect of exercise was marked according to the fatigue protocol where the subject was induced to the maximum condition of performance. All parameters were measured twice, for pre and post exercise-induced protocol. The analysis of relationship of each parameter between pre and post fatigue was p<0.05. The results revealed that the heart rate and gap between blood pressure’s systolic and diastolic were greater for all categories except underweight, where the systolic blood pressure dropped to below 100mmHg at the end of exercise. Also, the body temperature was slightly declined to balance the thermoregulatory system with sweating. Hence, the vigorous physical movement could contribute to the active physiological system based on body metabolism. Heart rate and blood pressure presented significant effects from the fatiguing exercise whereas the body temperature did not indicate any distinguishable impact. The results presented might act as the basis of reference for physical exercise by monitoring the vital sign parameters.

scholarly journals Evaluating the Accuracy of the VitalWellness Device

Iproceedings ◽  
10.2196/16250 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e16250
Author(s):  
Nicole Polanco ◽  
Sharon Odametey ◽  
Neda Derakhshani ◽  
Mark Khachaturian ◽  
Connor Devoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Standard Deviation ◽  
Body Temperature ◽  
Respiratory Rate ◽  
Linear Relationship ◽  
Vital Sign ◽  
Skin Color ◽  
Vital Signs ◽  
Mean Difference

Background Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments The VitalWellness device is a portable wellness device that can potentially aide vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the performance of the VitalWellness device, a wireless, compact, non-invasive device that measures four vital signs (blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature using the index finger and forehead. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited participants with vital signs that fell within and outside of the normal physiological range. A sub-group of eligible participants were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device’s performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results 265 volunteers enrolled in the study and 2 withdrew before study completion. Majority of the volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P<.05) and VitalWellness RR and reference RR measurements (r=0.7, P<.05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P<.05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P<.05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR, and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.

Abstract TP83: Ischemic Volume Enlargement and Control of Vital Signs Within First 24 Hours After Admission in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hee Jin Chang ◽  
Seo Hyun Lee ◽  
Ki Wan Jeon ◽  
Yun Kyong Hyon ◽  
Tae Young Ha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Coefficient Of Variation ◽  
Vital Sign ◽  
Vital Signs ◽  
Lesion Volume ◽  
Control Parameters

Background and objectives: The present study evaluated relationships of volume enlargement with patterns of vital sign control within 24 hours after admission in acute ischemic strokes. Methods: We analyzed clinical and radiological data of 130 patients, who were diagnosed as lacunes or branch atheromatous disease occurred in basal ganglia (n=83, 63.8%) or pons (n=47, 36.2%) on initial diffusion weighted image (DWI) within 72 hours of symptom onset and followed-up another DWI within 2 weeks. Ischemic lesion volume on the initial and follow-up DWI images were measured by using a program (ITK-SNAP). Vital signs including systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), body temperature, and peripheral oxygen saturation were checked every hour to 4 hours for 24 hours after admission for individual patients. Control parameters of each vital sign was evaluated with average, coefficient of variation, t-value of slope of regression line for pattern change, and coefficient of determination for predictability of the t-value of slope of the 24-hour data of the individual vital signs. Then, we evaluated whether the ratio of the follow-up/initial volume relates with not only the control parameters of the 5 vital signs but also known clinical and laboratory cardiovascular risk factors using the regression analysis. Results: The ratio of volume enlargement was 2.1 from initial (1300 mm 3 ) to follow-up ischemic lesions of DWI (2792 mm 3 ). Coefficient of variation (β=19.61, p=0.0033) and t-value (β=0.02, p=0.0052) of SBP, average of HR (β=0.06, p=0.0122) and RR (β=-0.25, p=0.0087), of the parameters for vital sign control, and smoking history (β=1.37, p=0.0384), uric acid (β=0.26, p=0.0483), hemoglobin A1c (β=-0.41, p=0.0054), age (β=-0.03, p=0.0544), and serum glucose (β=0.01, p=0.0966) of the cardiovascular risk factors were shown to be significant in explanation of the change of the volume enlargement ratio. Conclusion: The present study showed that the control of blood pressure, heart and respiratory rate of vital signs works together with the known cardiovascular risk to increase the lesion volume factors within 24 hours of admission for acute ischemic stroke patients.

scholarly journals Web-Based Wireless Monitoring System on Patient’s Vital Sign

2019 ◽  
Vol 125 ◽  
pp. 25003
Author(s):  
Mery Subito ◽  
Alamsyah ◽  
Ardi Amir
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Vital Sign ◽  
Vital Signs ◽  
Medical Personnel ◽  
Health Condition ◽  
The Body ◽  
Body Type ◽  
Administrative Costs ◽  
Long Time

Examination of vital signs such as blood pressure, heart rate, and body temperature is the most basic essential function of the body in determining the health status of the patient. In general, examining vital signs performed by a doctor or nurse uses an electrocardiogram, thermometer, and sphygmomanometer. However, this tool has a weakness in terms of time efficiency and accuracy of reading vital sign data. The process of taking vital sign data for a long time, the limited number of medical personnel in handling patients, and increasing administrative costs certainly become a concern for management in improving health services. To overcome this problem, we proposed a design that can monitor the health condition of patients' vital signs efficiently and in real time. The system used in this study consisted of an HRM-2511E type heartbeat sensor in pulse units per minute (bpm), DS18b20 body type temperature sensor in degrees Celsius (0C), and MPX5700AP sensor in mmHg units. This research is fundamental and is useful in helping medical personnel in monitoring patients' vital sign health conditions. The results of the proposed design showed that the heart rate, temperature, and blood pressure devices worked well with respective accuracy of 97.64%, 99.51%, and 97.53%.

scholarly journals Effects of Methylprednisolone Infusions on Vital Signs in Children With Headaches

2013 ◽  
Vol 18 (1) ◽  
pp. 39-44
Author(s):  
Elaine Heidrich ◽  
Gail Greene ◽  
Jessica Weberding ◽  
Li Lin ◽  
Susan McGee
Keyword(s):  
Blood Pressure ◽  
Patient Safety ◽  
Vital Sign ◽  
Hospital Admissions ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Cardiovascular Effects ◽  
Sign Changes ◽  
Institutional Review ◽  
Specific Order

OBJECTIVES Intravenous methylprednisolone (IVMP) infusions have been associated with adverse cardiovascular effects. Inconsistent monitoring practices in a pediatric hospital led to questions about patient safety and allocation of nursing resources. This study describes vital sign changes in children and monitoring practices related to IVMP. METHODS This retrospective chart review received Institutional Review Board approval. Children aged 5 to 17 years receiving IVMP from January 2006 to January 2009 were included. Seventy-four patients with 94 hospital admissions were evaluated. Data collected included systolic blood pressure, diastolic blood pressure, and heart rate, as well as the time and dosage of IVMP. Frequency of vital sign monitoring as ordered and as performed was described. Interrater reliability was calculated, and descriptive statistics were used in the data analysis. RESULTS At baseline, about half of the patients had vital signs out of normal range for age. After the first dose, vital signs fluctuated, with a majority having greater than 10% changes from baseline as increases, decreases, or both. Time of initial 10% change in vital signs ranged from immediately after the dose to 135.5 hours later. Increased vital sign changes were seen in the older patients and in patients receiving higher doses. Monitoring of vital signs occurred more frequently than was ordered. Only 1 patient had a specific order for monitoring with IVMP. CONCLUSIONS The patients included in this study experienced documented fluctuations in vital signs. A prospective study to evaluate the relationship of IVMP and patient safety will assist in standardizing vital sign monitoring guidelines.

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