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Pulse rhythm

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...

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A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

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Pro-Con Debate: Universal Versus Selective Continuous Monitoring of Postoperative Patients.

George T Blike^1,2,3,4, Susan P McGrath^1,4, Michelle A Ochs Kinney⁵

¹From the Departments of Anesthesiology.

Anesthesia and Analgesia

|April 15, 2024

Summary

Continuous physiologic monitoring can detect postoperative respiratory depression. Proponents advocate 24/7 surveillance for all patients, while opponents suggest targeted monitoring for opioid users and high-risk individuals.

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Area of Science:

Anesthesiology and Critical Care Medicine
Biomedical Engineering
Health Services Research

Background:

Postoperative respiratory depression is a significant clinical concern.
Current intermittent vital signs assessments may fail to detect early signs of deterioration.
Hospitalization itself indicates a patient's risk for adverse respiratory events.

Approach:

This Pro-Con commentary examines the implementation of continuous physiologic monitoring for postoperative respiratory depression.
It analyzes arguments for universal 24/7 surveillance versus selective, risk-based monitoring strategies.
System-level factors such as cost, alarm fatigue, and staffing are considered.

Key Points:

The "Pro" side argues for continuous surveillance monitoring for all patients due to inadequate risk assessment and potential delays in detection in general care units.
The "Con" side advocates for a mixed approach: time-limited monitoring for all opioid recipients and remote monitoring for high-risk patients, citing concerns about alarm fatigue, resources, and cost.
Both sides agree on the need for postoperative respiratory monitoring, but differ on the extent and type of monitoring required.

Conclusions:

Continuous monitoring, when properly configured, can detect respiratory deterioration while minimizing alarm fatigue and costs.
Selective monitoring offers a targeted approach addressing resource limitations and cost-effectiveness.
Recommendations are provided for system design and implementation based on both perspectives.