The Respiratory Rate: A Neglected Triage Tool for Pre‐hospital Identification of Trauma Patients

Yonge, John D.; Bohan, Phillip Kemp; Watson, Justin J.; Connelly, Christopher R.; Eastes, Lynn; Schreiber, Martin A.

doi:10.1007/s00268-017-4353-4

Cited by 11 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, the RR and temperatures still appear to be difficult to be measured reliably in several included studies. In fact, the optimal reference standard for measuring RR has still not been found, although it is considered to be the most important parameter for predicting clinical deterioration [ 78 - 81 ]. In addition, the optimal method for measuring temperature by using wearable wireless devices has yet to be found.…”

Section: Discussionmentioning

confidence: 99%

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Leenen¹,

Leerentveld²,

Dijk³

et al. 2020

J Med Internet Res

127

128

View full text Add to dashboard Cite

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

show abstract

Section: Discussionmentioning

confidence: 99%

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Leenen¹,

Leerentveld²,

Dijk³

et al. 2020

J Med Internet Res

127

128

View full text Add to dashboard Cite

show abstract

“…Therefore, respiratory rate is an important vital sign to monitor. However, respiratory rate is often assessed less frequently compared with other vital signs, and it is known in the medical community that respiratory rates are often estimated, rather than actually measured 1,4–7. Further, it is not feasible to obtain frequent respiratory rate measurements in busy clinical settings, such as the emergency department.…”

Section: Discussionmentioning

confidence: 99%

“…Respiratory rates and changes in respiratory rate have been found to be strong predictors of early clinical deterioration, making respiratory rate an important vital sign 1–3. However, evidence indicates that respiratory rate is assessed less frequently than other vital signs, and respiratory rates documented in the medical record are often erroneous due to estimation rather than actual measurement 1,4–7…”

Section: Introductionmentioning

confidence: 99%

<p>A pilot study of respiratory rate derived from a wearable biosensor compared with capnography in emergency department patients</p>

Li¹,

Divatia²,

McKittrick³

et al. 2019

OAEM

View full text Add to dashboard Cite

Purpose: Respiratory rate is assessed less frequently than other vital signs, and documented respiratory rates are often erroneous. This pilot study compared respiratory rates derived from a wearable biosensor to those derived from capnography. Methods: Emergency department patients with respiratory complaints were enrolled and had capnography via nasal cannula and a wireless, wearable biosensor from Philips applied for approximately one hour. Respiratory rates were obtained from both of these methods. We determined the difference between median respiratory rates obtained from the biosensor and capnography and the proportion of biosensor-derived respiratory rates that were within three breaths/minute of the capnography-derived respiratory rates for each patient. A Spearman correlation coefficient was calculated to assess the strength of the correlation between mean respiratory rates derived from both methods. Plots of minute-by-minute respiratory rates, per patient, for each monitoring method were shown to two physicians. The physicians identified time periods in which the respiratory rates appeared invalid. The proportion of time with invalid respiratory rates for each patient, for each method, was calculated and averaged. Results: We analyzed data for 17 patients. Median biosensor-derived respiratory rate was 20 breaths/minute (range: 7–40 breaths/minute) and median capnography-derived respiratory rate was 25 breaths/minute (range: 0–58 breaths/minute). Overall, 72.8% of biosensor-derived respiratory rates were within three breaths per minute of the capnography-derived respiratory rates. Overall mean difference was 3.5 breaths/minute (±5.2 breaths/minute). Respiratory rates appeared invalid 0.7% of the time for the biosensor and 5.0% of the time for capnography. Conclusion: Our pilot study suggests that the Philips wearable biosensor can continuously obtain respiratory rates that are comparable to capnography-derived respiratory rates among emergency department patients with respiratory complaints.

show abstract

“…After a review of 10 years (2004-2014) of data on adult trauma activations at a single institution, tachypnea (respiratory rate, >22 breaths per minute) and blunt thoracic injury were associated with undertriage and were added to higherlevel trauma activation criteria at the institution. 3 In this study, we sought to determine if other clinically relevant prehospital criteria could be used to accurately identify patients who are more likely to be undertriaged.…”

Section: Efficacy Of Prehospital Criteria In Identifying Trauma Patiementioning

confidence: 99%

Efficacy of Prehospital Criteria in Identifying Trauma Patients Susceptible to Undertriage

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

The Respiratory Rate: A Neglected Triage Tool for Pre‐hospital Identification of Trauma Patients

Abstract: Tachypnea with suspected thoracic injury is the strongest level 2 triage modification to reduce level 3 under-triage.

Cited by 11 publications

References 11 publications

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

<p>A pilot study of respiratory rate derived from a wearable biosensor compared with capnography in emergency department patients</p>

Efficacy of Prehospital Criteria in Identifying Trauma Patients Susceptible to Undertriage

Contact Info

Product

Resources

About