Identification of dynamic prehospital changes with continuous vital signs acquisition

Peter Hu, Samuel M. Galvagno, Ayan Sen, Richard Dutton, Sean Jordan, Douglas Floccare, Christopher Handley, Stacy Shackelford, Jason Pasley, Colin MacKenzie

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective In most trauma registries, prehospital trauma data are often missing or unreliable because of the difficult dual task consigned to prehospital providers of recording vital signs and simultaneously resuscitating patients. The purpose of this study was to test the hypothesis that the analysis of continuous vital signs acquired automatically, without prehospital provider input, improves vital signs data quality, captures more extreme values that might be missed with conventional human data recording, and changes Trauma Injury Severity Scores compared with retrospectively compiled prehospital trauma registry data. Methods A statewide vital signs collection network in 6 medevac helicopters was deployed for prehospital vital signs acquisition using a locally built vital signs data recorder (VSDR) to capture continuous vital signs from the patient monitor onto a memory card. VSDR vital signs data were assessed by 3 raters, and intraclass correlation coefficients were calculated to test interrater reliability. Agreement between VSDR and trauma registry data was compared with the methods of Altman and Bland including corresponding calculations for precision and bias. Results Automated prehospital continuous VSDR data were collected in 177 patients. There was good agreement between the first recorded vital signs from the VSDR and the trauma registry value. Significant differences were observed between the highest and lowest heart rate, systolic blood pressure, and pulse oximeter from the VSDR and the trauma registry data (P<.001). Trauma Injury Severity Scores changed in 12 patients (7%) when using data from the VSDR. Conclusion Real-time continuous vital signs monitoring and data acquisition can identify dynamic prehospital changes, which may be missed compared with vital signs recorded manually during distinct prehospital intervals. In the future, the use of automated vital signs trending may improve the quality of data reported for inclusion in trauma registries. These data may be used to develop improved triage algorithms aimed at optimizing resource use and enhancing patient outcomes.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalAir Medical Journal
Volume33
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Vital Signs
Registries
Wounds and Injuries
Injury Severity Score
Blood Pressure
Sorbitol
Aircraft
Triage

ASJC Scopus subject areas

  • Emergency
  • Emergency Medicine
  • Medicine(all)

Cite this

Hu, P., Galvagno, S. M., Sen, A., Dutton, R., Jordan, S., Floccare, D., ... MacKenzie, C. (2014). Identification of dynamic prehospital changes with continuous vital signs acquisition. Air Medical Journal, 33(1), 27-33. https://doi.org/10.1016/j.amj.2013.09.003

Identification of dynamic prehospital changes with continuous vital signs acquisition. / Hu, Peter; Galvagno, Samuel M.; Sen, Ayan; Dutton, Richard; Jordan, Sean; Floccare, Douglas; Handley, Christopher; Shackelford, Stacy; Pasley, Jason; MacKenzie, Colin.

In: Air Medical Journal, Vol. 33, No. 1, 2014, p. 27-33.

Research output: Contribution to journalArticle

Hu, P, Galvagno, SM, Sen, A, Dutton, R, Jordan, S, Floccare, D, Handley, C, Shackelford, S, Pasley, J & MacKenzie, C 2014, 'Identification of dynamic prehospital changes with continuous vital signs acquisition', Air Medical Journal, vol. 33, no. 1, pp. 27-33. https://doi.org/10.1016/j.amj.2013.09.003
Hu, Peter ; Galvagno, Samuel M. ; Sen, Ayan ; Dutton, Richard ; Jordan, Sean ; Floccare, Douglas ; Handley, Christopher ; Shackelford, Stacy ; Pasley, Jason ; MacKenzie, Colin. / Identification of dynamic prehospital changes with continuous vital signs acquisition. In: Air Medical Journal. 2014 ; Vol. 33, No. 1. pp. 27-33.
@article{9dd4a43e81094cc6b7e8274883ad4ac8,
title = "Identification of dynamic prehospital changes with continuous vital signs acquisition",
abstract = "Objective In most trauma registries, prehospital trauma data are often missing or unreliable because of the difficult dual task consigned to prehospital providers of recording vital signs and simultaneously resuscitating patients. The purpose of this study was to test the hypothesis that the analysis of continuous vital signs acquired automatically, without prehospital provider input, improves vital signs data quality, captures more extreme values that might be missed with conventional human data recording, and changes Trauma Injury Severity Scores compared with retrospectively compiled prehospital trauma registry data. Methods A statewide vital signs collection network in 6 medevac helicopters was deployed for prehospital vital signs acquisition using a locally built vital signs data recorder (VSDR) to capture continuous vital signs from the patient monitor onto a memory card. VSDR vital signs data were assessed by 3 raters, and intraclass correlation coefficients were calculated to test interrater reliability. Agreement between VSDR and trauma registry data was compared with the methods of Altman and Bland including corresponding calculations for precision and bias. Results Automated prehospital continuous VSDR data were collected in 177 patients. There was good agreement between the first recorded vital signs from the VSDR and the trauma registry value. Significant differences were observed between the highest and lowest heart rate, systolic blood pressure, and pulse oximeter from the VSDR and the trauma registry data (P<.001). Trauma Injury Severity Scores changed in 12 patients (7{\%}) when using data from the VSDR. Conclusion Real-time continuous vital signs monitoring and data acquisition can identify dynamic prehospital changes, which may be missed compared with vital signs recorded manually during distinct prehospital intervals. In the future, the use of automated vital signs trending may improve the quality of data reported for inclusion in trauma registries. These data may be used to develop improved triage algorithms aimed at optimizing resource use and enhancing patient outcomes.",
author = "Peter Hu and Galvagno, {Samuel M.} and Ayan Sen and Richard Dutton and Sean Jordan and Douglas Floccare and Christopher Handley and Stacy Shackelford and Jason Pasley and Colin MacKenzie",
year = "2014",
doi = "10.1016/j.amj.2013.09.003",
language = "English (US)",
volume = "33",
pages = "27--33",
journal = "Air Medical Journal",
issn = "1067-991X",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Identification of dynamic prehospital changes with continuous vital signs acquisition

AU - Hu, Peter

AU - Galvagno, Samuel M.

AU - Sen, Ayan

AU - Dutton, Richard

AU - Jordan, Sean

AU - Floccare, Douglas

AU - Handley, Christopher

AU - Shackelford, Stacy

AU - Pasley, Jason

AU - MacKenzie, Colin

PY - 2014

Y1 - 2014

N2 - Objective In most trauma registries, prehospital trauma data are often missing or unreliable because of the difficult dual task consigned to prehospital providers of recording vital signs and simultaneously resuscitating patients. The purpose of this study was to test the hypothesis that the analysis of continuous vital signs acquired automatically, without prehospital provider input, improves vital signs data quality, captures more extreme values that might be missed with conventional human data recording, and changes Trauma Injury Severity Scores compared with retrospectively compiled prehospital trauma registry data. Methods A statewide vital signs collection network in 6 medevac helicopters was deployed for prehospital vital signs acquisition using a locally built vital signs data recorder (VSDR) to capture continuous vital signs from the patient monitor onto a memory card. VSDR vital signs data were assessed by 3 raters, and intraclass correlation coefficients were calculated to test interrater reliability. Agreement between VSDR and trauma registry data was compared with the methods of Altman and Bland including corresponding calculations for precision and bias. Results Automated prehospital continuous VSDR data were collected in 177 patients. There was good agreement between the first recorded vital signs from the VSDR and the trauma registry value. Significant differences were observed between the highest and lowest heart rate, systolic blood pressure, and pulse oximeter from the VSDR and the trauma registry data (P<.001). Trauma Injury Severity Scores changed in 12 patients (7%) when using data from the VSDR. Conclusion Real-time continuous vital signs monitoring and data acquisition can identify dynamic prehospital changes, which may be missed compared with vital signs recorded manually during distinct prehospital intervals. In the future, the use of automated vital signs trending may improve the quality of data reported for inclusion in trauma registries. These data may be used to develop improved triage algorithms aimed at optimizing resource use and enhancing patient outcomes.

AB - Objective In most trauma registries, prehospital trauma data are often missing or unreliable because of the difficult dual task consigned to prehospital providers of recording vital signs and simultaneously resuscitating patients. The purpose of this study was to test the hypothesis that the analysis of continuous vital signs acquired automatically, without prehospital provider input, improves vital signs data quality, captures more extreme values that might be missed with conventional human data recording, and changes Trauma Injury Severity Scores compared with retrospectively compiled prehospital trauma registry data. Methods A statewide vital signs collection network in 6 medevac helicopters was deployed for prehospital vital signs acquisition using a locally built vital signs data recorder (VSDR) to capture continuous vital signs from the patient monitor onto a memory card. VSDR vital signs data were assessed by 3 raters, and intraclass correlation coefficients were calculated to test interrater reliability. Agreement between VSDR and trauma registry data was compared with the methods of Altman and Bland including corresponding calculations for precision and bias. Results Automated prehospital continuous VSDR data were collected in 177 patients. There was good agreement between the first recorded vital signs from the VSDR and the trauma registry value. Significant differences were observed between the highest and lowest heart rate, systolic blood pressure, and pulse oximeter from the VSDR and the trauma registry data (P<.001). Trauma Injury Severity Scores changed in 12 patients (7%) when using data from the VSDR. Conclusion Real-time continuous vital signs monitoring and data acquisition can identify dynamic prehospital changes, which may be missed compared with vital signs recorded manually during distinct prehospital intervals. In the future, the use of automated vital signs trending may improve the quality of data reported for inclusion in trauma registries. These data may be used to develop improved triage algorithms aimed at optimizing resource use and enhancing patient outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84891611900&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891611900&partnerID=8YFLogxK

U2 - 10.1016/j.amj.2013.09.003

DO - 10.1016/j.amj.2013.09.003

M3 - Article

C2 - 24373474

AN - SCOPUS:84891611900

VL - 33

SP - 27

EP - 33

JO - Air Medical Journal

JF - Air Medical Journal

SN - 1067-991X

IS - 1

ER -