[ad_1]
This new system, which constantly monitors and collects patient data, has recently gone wireless. They are being tested with patients at a hospital in Birmingham, England, but may use it in the future and similar remote systems in patients’ homes. The more I read about the topic, the more I realized that remote patient monitoring could radically change medicine: speed up medical responses and improve health outcomes; re-mapping of health care areas; but maybe we can also transform how doctors like me think, in ways we might not take so easily.
Close observation patients have been a universal duty of all physicians over time. For thousands of years, doctors used their senses to assess a patient’s condition. Even now, doctors are trained to know the sweet breath of diabetic patients, the cloning sound of an intestine obstructed by glass bottles, and the cold, tingling sensation of the skin that is closing the patient’s circulation. But the systematic record of numerical observations is a surprisingly recent phenomenon.
In the late 1800s, the instruments were designed to measure a standardized set of health indicators. These are the four main signs: heart rate, respiratory rate, temperature, and blood pressure. These early signs, also known as observations, were systematically documented before the turn of the last century. By World War II they were commonly used. Examination of these tables revealed that people never died when these signs of life were normal; hearts do not stop completely. But for the best part of a century, the art of interpreting these untrained diagrams was as mysterious to the untrained as reading tea leaves.
Then, in 1997, a team located at James Paget University Hospital (Norfolk, England) developed an early warning system so that a nurse could immediately convert life signs into scores. If the score exceeded the threshold, it was a signal to seek medical help. Such systems were constantly expanding for adult patients, but it was not clear that they would work in children compared to the physiological responses to the disease compared to adults.
Heather Duncan learned of early warning systems for adult patients in 2000 while working as a general practitioner with a strong interest in children’s health in South Africa. Typically, observations made in a hospital are not related to those made in primary care clinics. But Duncan tried to link these two data sets — from the community and the hospital — to create a more meaningful and ongoing story of what was happening to patients. He took the effort to examine the records of his sickest children, depicting their key signs from the time they were registered in primary care to hospital discharge or death. “I realized that the kids were having cardiac arrests or intensive care admissions, and we should really miss out on more of the opportunities that were lost,” she recalls.
The appalling feeling that more could be done for such children was later confirmed by the UK Confidential consultation on child deathsMore than a quarter of children in National Health Service hospitals were seen dying for preventable reasons. In 2003, Duncan was awarded a Critical Care Fellowship at Toronto Children’s Hospital, where he, along with Chris Parshuram, a pediatric intensive care physician, developed a Pediatric Early Warning System or PEWS for a bed scoring system designed for sick children.
Duncan now works as a pediatric intensive care consultant at Birmingham Children’s Hospital. I caught it last October at Zoom. Duncan was working from home, wrapped in a creamy leather jacket wrapped against the English fall, wrapped his hair in a rolled-up cake and wearing blue edges that matched his eyes. She speaks with an elegant South African accent and has peace of mind, an asset that surely works in this stressful specialty. His hospital accepted the PEWS score in 2008 and saw it download in the number of children who died after a cardiac arrest — from 12 to 2010 in 2005 without death.
[ad_2]
Source link
