Claire Dawson
Hospital monitors are devices used to track a patient's health in real-time. They measure vital signs such as heart rate, blood pressure, respiratory rate, and oxygen levels. The main screen displays these measurements with numbers and graphs, including beats per minute (BPM) for heart rate and systolic and diastolic numbers for blood pressure. Different colours are used to help healthcare providers quickly identify essential information, with each colour representing a specific type of vital sign or function. For example, the colour for ECG or heart rate is usually green.
| Characteristics | Values |
|---|---|
| Purpose | To keep track of a patient's health in real-time |
| Data Display | Numbers, graphs, and waveforms |
| Data Types | Heart rate, blood pressure, breathing rate, oxygen levels, body temperature, etc. |
| Heart Rate Display | Beats per minute (BPM), often with a heart icon |
| Blood Pressure Display | Two numbers: systolic (top) and diastolic (bottom), in mmHg |
| Oxygen Levels Display | Percentage, with normal levels between 95-100% |
| Respiration Rate Display | Breaths per minute, with normal rates between 12-16 or 12-20 breaths per minute |
| Temperature Display | Degrees Celsius or Fahrenheit, with normal body temperature around 98.6°F (37°C) |
| ECG | Electrocardiogram, typically from lead II with electrodes on the right arm and left leg |
| SpO2 Waveform | Blue or red wavy line under ECG, each crest matching a spike on ECG indicates efficient circulation |
| CO2 Waveform | Visualizes the amount of CO2 exhaled |
| IBP Waveform | Visualizes invasive blood pressure |
| Alerts | Sounds an alarm and flashes a warning on the screen if vital signs fall outside the normal range |
| Reset | Can be reset by a button on the screen/main menu or by turning the monitor off and on again |
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Heart rate
Hospital monitors can be intimidating due to their many numbers, waveforms, and sounds. However, almost all patient monitors will record the following key vital signs, including heart rate.
A Holter monitor is a type of portable electrocardiogram (ECG) that records the electrical activity of the heart over 24 hours or longer while the patient is away from the healthcare provider's office. It can be used to evaluate symptoms that may be heart-rhythm related, such as dizziness, fainting, and low blood pressure. It can also be used to monitor ongoing tiredness, palpitations, or when a resting ECG doesn’t show a clear cause.
There are also portable, battery-powered heart rate monitors available for personal use, as well as smartphone apps that can measure your pulse rate. However, these devices are no substitute for medical devices and approved medical devices should be used in hospitals.
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Blood pressure
Invasive and non-invasive methods are available for monitoring blood pressure. Non-invasive monitoring, which is safe and routine, typically involves applying a blood pressure cuff to the upper arm, wrist, finger, or thigh. This method provides a snapshot of the patient's blood pressure at specific points in time. In contrast, invasive blood pressure monitoring involves the use of a catheter placed in an artery, usually in the wrist, to continuously measure blood pressure.
Additionally, ambulatory blood pressure monitoring allows for continuous measurement over a 24-hour period, providing a broader picture of an individual's blood pressure patterns. This method involves wearing a cuff on the arm and a small recording device, capturing readings throughout the day and night. It is particularly useful for detecting abnormal changes in blood pressure and guiding treatment decisions.
On a hospital monitor, blood pressure readings are typically displayed on the right side of the screen, along with other numerical vital signs such as heart rate and body temperature. The left side of the monitor usually shows waveforms, including the SpO2 waveform, which indicates blood flow and oxygen saturation. By interpreting these waveforms and numerical values, healthcare professionals can monitor a patient's circulatory system and overall health.
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Oxygen levels
Hospital monitors display a variety of information, including heart rate, respiratory rate, and blood oxygen levels. Oxygen saturation levels, or SpO2, are typically found under "SpO2" on the monitor and are expressed as a percentage. This number indicates the amount of oxygen circulating in the blood, with normal levels ranging from 95 to 100. A level of 95% or above is considered healthy, while a drop below 90 may require supplemental oxygen.
Oxygen saturation can be monitored using a pulse oximeter, a small clip placed on the patient's finger or toe. The SpO2 waveform on the monitor is usually blue or red and displays the oxygenated blood flow. Each crest on the SpO2 waveform should correspond with a spike on the ECG waveform, indicating efficient circulation of oxygenated blood with each heartbeat.
The pulse oximeter measures oxygen saturation by passing small beams of light through the blood, typically in the finger. Deoxygenated and oxygenated hemoglobin absorb light at different wavelengths, and this information is processed to determine the saturation level. This non-invasive technique is widely used in hospitals and is recommended by organizations such as the World Health Organization. It is particularly useful for patients with respiratory issues or those receiving medications that may affect their breathing.
While pulse oximetry is generally accurate, it may not detect low oxygen levels (hypoxemia) accurately in all populations. For example, individuals with darker skin tones may receive inaccurate readings due to the way the technology was developed. As such, it is important to be aware of other signs of low oxygen levels, such as shortness of breath, fast heartbeat, and changes in skin colour. In such cases, seeking medical attention is crucial.
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Respiratory rate
On a hospital monitor, respiratory rate is usually displayed under the abbreviation "RR" or "RESP". It is reported in breaths per minute and is typically located on the right-hand side of the monitor, along with other numerical vital signs such as heart rate, body temperature, and blood pressure. The respiratory waveform, on the other hand, is usually found on the left side of the monitor, along with other waveforms such as the SpO2, CO2, and ECG waveforms. The respiratory waveform provides a visual representation of the patient's breathing pattern, allowing clinicians to monitor any respiratory issues.
In addition to the respiratory rate and waveform, hospital monitors may also display the patient's oxygen saturation level, also known as SpO2. This measures the amount of oxygen in the patient's blood and is typically located under "SpO2" on the monitor. Normal oxygen saturation levels are usually above 95%, but this can vary in certain populations such as those with COPD. If the oxygen saturation level drops below 90%, the patient may require supplemental oxygen.
There are also certified medical devices available for long-term contactless respiratory rate monitoring at home, such as the Sleepiz One+, RSpot 100, SleepMinder, C100, and XK300. These devices enable healthcare professionals to track a patient's health status over time and make decisions about hospital visits or diagnostic procedures.
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Body temperature
Hospital monitors display a patient's vital signs, including body temperature, which is typically the second number on the monitor, found on the right-hand side, and directly under the pulse rate. Body temperature is a critical indicator of a patient's health, and a normal range for adults is between 97.8 to 99 °F (36.6 to 37.2 °C). A body temperature reading above 99 °F (37 °C) indicates a fever, while a reading below 95 °F (35 °C) indicates hypothermia.
Hospital monitors provide real-time alerts when vital signs fall outside the normal range, including body temperature. These alerts can be in the form of audible alarms or flashing screen alerts. However, alarms may not always indicate a serious issue, as they can sometimes be triggered by factors such as loose sensors or patient movement.
In addition to patient monitoring, hospitals also implement environmental temperature monitoring systems to ensure the safety and efficacy of drugs, vaccines, blood, tissues, and medical equipment. Temperature control is critical in reducing the survival and transmission of viruses, bacteria, and fungal spores. Continuous monitoring systems automate data recording, enhancing staff efficiency and ensuring compliance with regulatory requirements.
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Frequently asked questions
Hospital monitors usually have a split-screen layout, with numerical vital signs on the right and waveforms on the left. The vital signs include heart rate, blood pressure, body temperature, and respiratory rate. The waveforms include the ECG, SpO2, CO2, and IBP.
ECG stands for electrocardiogram, which measures the electrical activity of the heart.
The SpO2 waveform shows the patient's blood flow. It is usually blue but can sometimes be red.
Normal oxygen saturation levels are between 95 and 100%. A level below 95% is usually okay, but below 90% may require supplemental oxygen.
Yes, you can adjust the monitor to slow down the rate, which can help distinguish faster rhythms and pull out the sawtooths of atrial flutter.
