Monitoring Trauma Patients in the Prehospital and Hospital Environments: The Need for Better Monitors and Advanced Automation
Abstract
Current monitoring systems used for both civilian and military patients may not provide adequate measures for reliably determining the true injury status and severity of trauma injuries. Natural physiologic compensatory mechanisms for hemorrhage found in many patients will prevent normal vital signs from changing beyond normal parameters and therefore mislead the care providers using standard of care vital sign monitors. Current monitoring systems used both in the field and in the emergency department provide some set of vital signs that are used for patient assessment. Vital signs such as blood pressure, heart rate, SpO2 have been historically used during diagnosis and treatment of trauma injuries. However, these vital signs have been shown to provide little if any value for diagnosis when a patient is compensating for a hemorrhagic injury. However new advances in digital signal processing as well as better understanding of physiological responses to trauma insults has resulted in development of a new advanced vital signs that may provide earlier and more accurate diagnosis of injury severity in trauma patients. These include heart rate variability measures as well as nonlinear dynamic systems measures such as heart rate complexity. Using a combination of these new vital signs together with standard variables may provide more sensitive measures of injury status. Advanced vital signs can also serve as inputs into decision support algorithms and systems that provide better care in an open loop fashion. Once system reliability can be validated, than a closed loop approach will allow for full automation of patient care. [TATRC website, 16 Dec 2008]
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 05, 2008
- Accession Number
- ADA490362
Entities
People
- Josè Salinas
Organizations
- United States Army Medical Research and Development Command