#Monitoring equipment

-MONITORING EQUIPMENT
-Dr Nisar Ahmed Arain
-Assistant Professor
-Anesthesia/Critical Care/ER
-AND PATIENT MONITORING SYSTEM

-INTRODUCTION OF PATIENTS
MONITORING SYSTEMS
-CRITICAL MONITORING SYSTEMS
-It is used for monitoring physiological signals like
--Electrocardiography (ECG)
--Respiration
--Invasive and non invasive Blood Pressure
--Oxygen saturation in Human Blood (SpO2)
--Body Temperature and Other Gases etc.
--ECG electrodes
--SpO2finger sensor
-Blood Pressure cuff
--Temperature signals

-INTRODUCTION OF PATIENTS MONITORING
-SYSTEMS
---During treatment it is highly important to
continuously monitor the vital
physiological signs of the patient.
Therefore patients monitoring system
has always been occupying a very
important position in the field of
medical devices
---The continuous improvement of
technologies not only helps us transmits
the vital physiological signs to the medical
personnel but also simplifies the
measurement and as a result raises
the monitoring efficiency of patients

-CLASSES OF PATIENTS
MONITORING SYSTEM
--1-Single parameter Patients
Monitoring System
These are mainly used for single
parameter measurement
--2-Multi Parameter Patients
Monitoring system
Now a days however a Multi parameter
patients monitor is commonly used

-SINGLE PARAMETERS
MONITORING SYSTEMS
--The single Parameter monitoring
system is available for measuring
Blood pressure of a human body
--ECG (Electro-cardio-graphy) monitor
and also
--Oxygen saturation measurement
of the blood (SpO2)

-MULTI-PARAMETER PATIENTS
MONITORING SYSTEM
--A multi-parameter patients monitoring
system (PMS) is used for recording of
multiple critical physiological signs of the
patient to transmit the vital information
Like Electro-cardiograph, Respiratory
rate, and Blood pressure etc. Therefore
multiparameter PMS has always been
occupying a very significant position in
the field of Medical devices

--MULTI-PARAMETER PATIENTS
MONITORING SYSTEM Cont.
--Most diseases of the heart and of
the circulatory system , refer to as
cardio-vascular diseases, strike out
a warning and very important
treatment is required if death is
to be averted.
--Such treatment is best provided in
a specialized area of a hospital
reffered to as “Critical care unit
OR intensive care unit”
--These specialized hospital units
provide constant observation of
the patients vial signs and a
content monitoring of the patients
general condition ass well and to
provide immediate emergency
treatment whenever it is required

-THREE IMPORTANT INTENSIVE CARE UNITS
1.Coronaryintensive care units usedfor the
treatment of diseasesof the heart such
asthe heart attacks
2.Stroke intensive care Units usedfor
treatment of diseasesof the circulatory
systemsuchas stroke.
3.Pulmonaryintensive care units Pulmonary
intensive care units are usedfor
treatment of Respiratory diseases

-PHYSIOLOGICALFUNCTIONS
TOBE MONITORED DURING
STAYINTHEINTENSIVECAREUNIT
1.ECGMonitoring
2.Bloodpressure
3.Respiratorymonitoringand
4.Bodytemperatureonitoring

--ECG MONITORING OF THIS PATIENT

--ECG MONITORING
--The principal physiological signal monitored in an intensive
care unit is often the Electro-Cardio-Gram.
--The electro-cardio-gram is usually monitored in the
lead 11 configuration with has two electrodes
--These two electrodes are placed approximately 12 inches
a part along the maximum potential axis of the patients
heart.
--A third electrode (ground) should be located elsewhere
on the chest. This electro-gram monitoring configuration
is reffered to as three lead chest cluster (ECG)
--The electrodes used for ECG monitoring during stay in the
intensive care unit must be suited for long term
monitoring applications.
--The set of leads used for monitoring purpose is called
‘rhythm’
--The strip and its purpose is just to note the heart beat and
not for analyzing it

-BLOOD PRESSURE MONITORING SYSTEM
--This parameter is often of prime importance in
the in intensive care monitoring is blood
pressure.
--Blood pressure can be monitored using the
automatic cuff pump and Korotkoff
microphone blood-pressure measurement
system.
-- This system is occasionally used in intensive
care units.
--It also possesses the disadvantage of it does
not provide a continuous record of the
subject’s blood pressure
--Thus, if for some reason the subjects blood
pressure were to suddenly drop, this system
may take some minutes or so to detect this
pressure drop

-BLOOD PRESSURE MONITORING
-PLETHYSMOGRAPH
--Blood pressure monitoring with
Plethysmograph offers the least discomfort
to the subject however, it provides only a
relative indication of the well being of the
circulatory system rather than providing
absolute values for the diastolic and systolic
pressure.
--Digital blood pressure monitors are
now-a-days often used in many intensive
care units.
--Any intensive care unit may employ one or
more of these techniques and indeed all
three may be available if required

-RESPIRATION AND ITS MONITORING
--It is often desirable to monitor the
subject’s respiratory activity during
intensive care, This may be accomplished
with Thermistor Pneumograph placed in
the subject’s Nostril
BODY TEMPERATURE
--It is often also desirable to monitor body
temperature in intensive care subjects
via a Rectal or Armpit thermistor probe

-CENTRAL NURSE’S STATION
--Multi connector cable connects the output form the
four subject monitoring sites located beside each
intensive care bed to the central Nursing station.
--Each Patients ECG is continuously displayed via a
four channel CRT display., and also these signals
are being recorded continuously on memory loop
tape recorder
--This tape recorder contains the previous one minute
ECG history for each subject and by recording the
ECG on a tape loop “one minute” in length

-CENTRAL NURSE’S STATION
--Some central Nursing stations duplicate
physiological indicators for relative
Blood pressure, respiratory activity and
body temperature.
--These indicators can be manually switched
between the four beds or the switching may
be activated by the alarm system with the
monitors being automatically switched to
the bed providing the alarm system
--WHEN THE ALARM IS RECEIVED IN THE
CENTRAL NURSE’S STATION, IT may also be
used to connect the appropriate ECG signal
to ECG chart recorder and to start the
recording on the chart.

-PRESENT PARAMETERS
IN PATIENTS MONITORING SYSTEM
--ECG 3 / 5 / 10 leads
--Respiration
--Invasive Blood pressure
Measurement (IBP)
--Non Invasive Blood Pressure
Measurement (NIBP)
--Pulse Oximeter (SpO2)

--SOME MACHINE ARE
USED AT PRESENT FOR
MEASUREMENT OF
DIFFERENT ELEMENTS
IN THE BODY ACCORDING
TO THEIR PHYSIOLOGICAL
LEVELS

-PULSE OXIMETERY
--A Pulse oximeter is a medical
device that indirectly monitors
the oxygen saturation of a
patient’s blood ( as opposed to
measuring oxygen saturation
directly through a blood sample)
and changes in blood volume in
the skin, producing a photo
plethysmo-gram that may
be further processed into other
measurements

-CAPNOGRAPHY
--This is monitoring of the concentration
OR Partial pressure of Carbon Di Oxide
(CO2) in the respiratory gases.
--Its main development has been as a
monitoring tool for use during
Anesthesia and in critical care unit.
--It is usually presented as a graph of
expiratory Carbon Di Oxide in the
expired gases

-ELECTRO-CARDIO-GRAPHY
--An electro-Cardio-Gram (ECG or EKG) is
a test that checks how your heart is
functioning by measuring the electrical
activity of the heart
--With each heart beat, an electrical impulse
(wave) travels through your heart
--This wave causes the muscle to squeeze
and pump blood from the heart to all
the parts (Tissues) of the body.

INVASIVE
Intra-Arterial-Blood-Pressure
Monitoring (IBP)
--This is a commonly used technique in
the intensive care units (ICU)and is
also often used in the Operation
theatre.
--This technique involves direct
Measurement of arterial Blood
pressure by inserting a canula
needle in a suitable artery.

-NON INVASIVE
Blood pressure measurement
--This provides either intermittent or
continuous readings.
--Most commonly an occluding upper
arm cuff is used for intermittent non
-invasive monitoring.
--Blood Pressure values are then obtained
either manually ( by auscultation or
Korotkoff sounds or palpation) or
automatically (e.g. oscillometry)

-NON INVASIVE
Blood pressure measurement

-PATIENT UNDERGOOIG EKG MONITORING

-BRAUN Ear
Thermometer
Themo -Scan with age precision

-FUTURE TRENDS IN
PATIENTS MONITORING SYSTEM
--Drug Dosage Calculator
--Drug Management System
--RFID in PMS
--Real time patients location
system
--Wear able PMS
--Telemetry / Telemedicine

#Monitoring equipment

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#Monitoring equipment