Intensive care units (ICUs) commonly include patient monitoring systems for monitoring patient status and condition. Typical patient monitoring systems include a monitor having one or more detectors attached to a patient for detecting parameters, such as electrocardiogram (ECG) signals, blood pressure, blood oxygen, blood glucose, and temperature. The output from the detectors is sent to a system processor, which subsequently processes the measured values. These values may then be displayed on a display screen or stored for later analysis. Data representing the measured physiological parameters can be displayed as waveforms and/or numerical values. ICUs provide advanced monitoring capabilities for enabling medical practitioners to evaluate the clinical status of patients and track their response to a wide range of interventions.
One of the important functions of an ICU is to provide advanced monitoring capabilities to evaluate the clinical status of patients and to track their responses to a wide range of interventions. Morbidity and mortality have diminished dramatically in PICUs across the United States due to advancements in medical and surgical therapeutics, life saving pharmaceuticals, and training of medical practitioners. Standard monitoring systems present physiological data such as intermittent or continuous core temperature, invasive arterial blood pressure, continuous invasive central venous pressure, continuous pulsed oximetry, and continuous end tidal carbon dioxide concentrations. However, current monitoring systems do not present these data in a format that fosters understanding of the complex dynamic changes occurring instantaneously or over time in a biological system. Simple, time domain measures of heart rate and respiratory rate are typically displayed as: 3-5 second mean values; mean values of parameters plotted against time; or alarms for out of range values determined by manufacturers or modified by medical practitioners. These values are often not scaled to reflect age or diagnosis adjusted norms for children. For these reasons, the need for advancement of monitoring devices is great.
A variety of advanced organ specific monitoring devices have emerged over recent years with mixed utility and acceptance in the PICU. Measurements made with these devices include: continuous cardiac output measurements; thoracic electrical bioimpedance continuous cardiac output; continuous in vivo arterial blood gas analysis; continuous pulmonary mechanics and ventilator parameters; continuous venous oxygen saturation measurement; and continuous processed electroencephalographic analysis. These measurements have provided additional information to the bedside clinician, but most have failed to demonstrate improvement in patient morbidity or mortality. Each of these monitoring devices provides a unidimensional time domain appraisal of a specific organ function that must be assimilated, interpreted, and acted upon by the bedside physician, nurse, or allied health care worker. It is desirable to provide improvements for presenting this information and analysis of this information to medical practitioners.
As mentioned above, some PICU monitoring equipment generates alarms when patient physiological data falls outside of an excepted range. However, because these alarms are often based on individual parameters and not based on accurately weighted groups of parameters, false positives often occur. Because of the high frequency of false positives, alarms generated based on individual physiological measurements are often ignored by PICU staff.
Software tools are available for evaluating a patients risk of mortality. However, conventional tools only evaluate a patient's risk of mortality based on parameters collected upon admission to the PICU. There is no updating of the risk of mortality based on physiological measurements after the patient has been admitted to PICU. As a result, conventional tools do not provide any post care evaluation of a patient's risk of mortality.
Accordingly, there exists a long felt need for methods, systems, and computer program products for evaluating a patient in a PICU.