Tessa Quinn
Hospital bedside monitors can be confusing, with their many numbers, waveforms, and sounds. However, understanding the basics of reading these monitors can help you better understand your or your loved one's condition. The common layout of a patient monitor is split, with numerical vital signs on the right and waveforms on the left. These vital signs include heart rate, blood pressure, body temperature, respiratory rate, and oxygen saturation. The monitor will alert caregivers by sounding an alarm and flashing a warning if any of these vital signs fall outside the normal range. While only a medical professional can make a diagnosis from this data, knowing how to read a hospital bedside monitor can help you understand the patient's real-time vitals and when to seek help.
| Characteristics | Values |
|---|---|
| Heart rate | Displayed in green numbers in the right corner of the screen in beats per minute (BPM) |
| Pulse rate | Typically in the top right-hand corner of the screen, with a normal resting rate of 60-100 BPM |
| Body temperature | Second number on the screen, under the pulse rate; normal range is 97.8-99 °F (36.6-37.2 °C) |
| Blood pressure | Expressed as a ratio with systolic blood pressure over diastolic blood pressure, e.g. "110 over 75"; systolic should be between 90-120 and diastolic between 60-80 |
| Oxygen saturation | Measure of the amount of oxygen in the patient's blood; normal levels are between 95-100% |
| Carbon dioxide | Reports in mmHg |
| Invasive blood pressure | Reports in mmHg |
| Non-invasive blood pressure | Reports in mmHg |
| Respiratory rate | Reported in breaths per minute, with normal values between 12-20 or 12-16 |
| ECG readout | Represents one lead, most commonly lead II; not intended for detailed ECG analysis but useful for guiding acute resuscitations or managing arrhythmias |
| Respiratory waveform | Useful for monitoring respiratory issues like apnea or dyspnea |
| SpO2 waveform | Helps determine issues with circulation or peripheral perfusion |
| CO2 waveform | Visualizes how much CO2 a patient is exhaling |
| IBP waveform | Visualizes invasive blood pressure |
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Heart rate
An electrocardiogram (ECG) records the electrical activity of the heart and is usually displayed as the top wavy line on the hospital monitor. Each spike or peak on the ECG corresponds to a heartbeat. If the patient has a regular heartbeat, these spikes will occur the same number of little blocks apart from each other. The ECG waveform can be used to identify any irregularities in the patient's heartbeat.
In addition to the ECG, healthcare professionals are trained to interpret the waveforms on the monitor. These waveforms help them visualize how well the heart is pumping blood, especially to the patient's extremities. By examining the waveforms, doctors and nurses can identify any issues with the patient's heart rhythm or circulation.
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Blood pressure
It is important to note that increases in systolic pressure are more closely associated with increases in disease risk compared to diastolic pressure. However, elevated diastolic pressure is also a risk factor for disease. For example, if an individual has normal systolic pressure but stage 1 diastolic hypertension, they would be diagnosed with stage 1 hypertension.
At-home blood pressure monitoring can be useful for tracking cardiovascular disease risk and confirming a diagnosis of high blood pressure. The American Heart Association recommends home monitoring for individuals with high blood pressure to help their healthcare providers determine if treatments are effective. It is important to use proper technique and an accurate device when monitoring blood pressure at home. This includes finding a monitor that has been validated and ensuring the cuff fits properly. Additionally, individuals should refrain from smoking, drinking caffeinated beverages, or exercising within 30 minutes before taking their blood pressure.
Ambulatory blood pressure monitoring involves recording blood pressure readings over a 24-hour period, providing data on both blood pressure and heart rate throughout the day and night. This method can detect abnormal changes in blood pressure that may otherwise go unnoticed and is especially useful for individuals with risk factors for high blood pressure or related conditions. While ambulatory monitoring can provide valuable information, it does not replace regular doctor visits and individuals should not adjust their medication without consulting a healthcare professional.
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Body temperature
When reading a hospital bedside monitor, the body temperature reading will typically be displayed in degrees, either in Celsius or Fahrenheit. Normal body temperature is generally considered to be within the range of 97.8° to 99° Fahrenheit (36.6° to 37.2° Celsius). This temperature range is often used as a reference, and a temperature above 37.2° Celsius is usually considered suspicious, possibly indicating an infection or another medical condition.
The hospital bedside monitor helps medical professionals quickly assess a patient's condition and make informed decisions. It provides real-time data, allowing healthcare providers to identify signs of deterioration and take immediate action. This is particularly crucial for critically ill patients or those undergoing surgery. Additionally, the monitor can automatically send data to the patient's electronic medical record, reducing manual errors and facilitating efficient patient care and monitoring.
It is important to remember that a single number on the monitor, including body temperature, should not be the sole focus. Doctors and nurses consider all the vital signs together and take the context into account. A slight deviation from the normal temperature range may not always be a cause for concern, as various factors can influence body temperature. However, if the monitor sounds an alarm or displays a warning, it is essential to carefully check the readings and follow the instructions provided by medical staff.
In addition to body temperature, hospital bedside monitors track other vital signs such as heart rate, blood pressure, and oxygen saturation levels. These parameters provide valuable information about a patient's overall health and help healthcare professionals make diagnoses and treatment decisions. By understanding the basics of reading a hospital monitor, you can stay informed about your loved one's health and well-being during their hospital stay.
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Oxygen saturation
Pulse oximetry is a non-invasive method for monitoring blood oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy (within 4% accuracy in 95% of cases) of the more accurate (and invasive) reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis. Pulse oximeters are small, painless devices that can be clipped onto a body part, usually a finger, toe, or fingernail/toenail bed. They pass light through the skin, measuring changes in light absorption in oxygenated or deoxygenated blood. This is because deoxygenated and oxygenated haemoglobin absorb light at different wavelengths. The absorbed light is then processed by a proprietary algorithm in the pulse oximeter to display a saturation value. Pulse oximeters can also measure heart rate.
Pulse oximetry is particularly useful in settings where a patient's oxygenation is unstable, such as intensive care, operating rooms, recovery rooms, emergency departments, hospital wards, ambulances, and aircraft. Pulse oximetry is also used to monitor patients receiving medications that may impair their respiration, such as opioids, and all patients with acute respiratory disease should be monitored with pulse oximetry. Pulse oximetry is sometimes referred to as the fifth vital sign, and its use has helped decrease the rate of undiagnosed hypoxic events leading to adverse outcomes.
Pulse oximeters can be used at home, and over-the-counter oximeters are available directly to consumers. However, these products do not undergo FDA review and should not be used for medical purposes. They are intended for estimating oxygen saturation for general wellness purposes. Prescription pulse oximeters, on the other hand, have been vetted by the FDA and are much more accurate.
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Warning signals
Most hospital bedside monitors are equipped with sensors attached to the patient's body that continuously monitor vital signs such as heart rate, blood pressure, and body temperature. If any of these vital signs deviate from healthy levels, the monitor will typically emit a warning, often in the form of a beeping noise and a flashing colour. This warning is designed to prompt caregivers to take immediate action and check on the patient.
The intensity of the warning signal may vary depending on the severity of the situation. For instance, if a vital sign spikes or drops sharply, the alarm may become louder, faster, or change in pitch to indicate a critical condition. In such cases, multiple caregivers may rush to the patient's aid, as seen in life-threatening emergencies.
It's important to note that false alarms can also occur. One common reason for a false alarm is a loose or malfunctioning sensor, which may cause the monitor to sound an alert due to a lack of incoming data. In such cases, nurses or other medical staff can address the issue by adjusting or replacing the sensor.
While the general public may find the beeps and flashing lights concerning, it's important to remember that only medical professionals are qualified to interpret the data and make diagnoses. The monitors are designed to assist caregivers in providing timely and informed care, allowing them to efficiently monitor patients and make necessary adjustments to their treatment plans.
Additionally, different hospitals may have varied setups, and the interpretation of monitor readings may differ slightly. Bedside nurses are often a valuable resource for understanding these nuances, as they have experience in setting up, interpreting, and modifying patient monitors. They can provide insights into specific tricks or adjustments that enhance the accuracy and effectiveness of patient monitoring.
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Frequently asked questions
Two common readings on a hospital bedside monitor are heart rate (measured by electrocardiogram) and blood pressure. Other readings include respiratory rate, oxygen saturation, and carbon dioxide levels.
The numerical vital signs are usually displayed on the right side of the monitor, while the waveforms are on the left. The heart rate is typically in the top right corner of the screen, with the body temperature and blood pressure below it. The waveforms can indicate irregular heartbeat or breathing.
If the monitor starts beeping, it means that one or more vital signs have spiked or dropped sharply. Check that all wires and probes are properly attached and secured. If the issue persists, notify a nurse or doctor immediately.
A healthy systolic blood pressure (the top number) should be between 90 and 120, while a healthy diastolic blood pressure (the bottom number) should be between 60 and 80.
