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748. CoVETED Study: Contactless Vitals for Effective Triaging in Emergency Department – A System to Reduce Cross-Infection

BACKGROUND: Accuracy and speed of recording vitals are crucial for emergency department (ED) triaging. Traditionally, vital signs measurements are either skipped or recorded using non-standardized contact-based devices. ED visits sharply dropped during the COVID pandemic due to fear of cross-infecti...

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Detalles Bibliográficos
Autores principales: VARMA, D A N T U L U R U M U R A L I D H A R, Abrol, Sidharth, Rocque, Mukul, Balmaekers, Benoit, Krishnan, Navaneetha, Gajwani, Kunal, Poojary, Nagaraj, Bhat, Nanda Krishna, Karanth, Nisarg, Badagabettu, Sulochana, Pai, Reshma, Ravindra, Prithvishree
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677618/
http://dx.doi.org/10.1093/ofid/ofad500.809
Descripción
Sumario:BACKGROUND: Accuracy and speed of recording vitals are crucial for emergency department (ED) triaging. Traditionally, vital signs measurements are either skipped or recorded using non-standardized contact-based devices. ED visits sharply dropped during the COVID pandemic due to fear of cross-infection risk among patients and healthcare workers. To address this issue, we developed the "Contactless MONitoring (CMON) Spot-check Health kiosk" as a first-line screening tool to measure body temperature (T), pulse rate (PR), and respiration rate (RR) to triage patients accurately and quickly. METHODS: A prospective observational study with 326 walk-in ED patients was conducted to compare the effectiveness of contactless vitals-based triaging to the current standard of care. After consent, a sitting subject's PR, RR, and T were recorded for 1 minute in a closed kiosk using non-contact cameras. For comparison, the FDA-approved contact-based PR and RR from the Philips Alice NightOne and T from an oral digital thermometer were used. Recorded data was annotated by 3 expert doctors to retrospectively triage subjects and create ground truth based on consensus. Other contact-based vitals (SpO2 and blood pressure, BP) were also included in the data annotated by the doctors. The ED nurse triaged the patients in real-time, which served as the baseline compared to the ground truth. Cohen’s Kappa (K) was used to evaluate triaging accuracy. RESULTS: Contactless vitals (PR,RR,T) with or without patient history (Figure 1) had better triaging accuracy than the current practice of ED entrance nurse (K=0.42or 0.49 vs K=0.16). Also, patient history, when included with vitals, improves accuracy across all sets annotated, compared to vitals alone. The study also showed that CMON had good accuracy in measuring PR, RR and T (non-contact K=0.42vs contact-based K=0.43), while being acquired 20% faster. [Figure: see text] CONCLUSION: Contactless monitoring can improve patient triaging by providing more frequent and accurate vital sign monitoring, allowing for better-informed decisions about patient care. When combined with patient information and integration with Electronic Medical Record systems, it can efficiently manage patient footfall and reduce cross-infection risk. DISCLOSURES: Sidharth Abrol, PhD, Philips: Employed by Philips|Philips: Stocks/Bonds Mukul Rocque, MS, Philips Electronics Nederland B.V.: Multiple patents in the field of patient monitoring|Philips Electronics Nederland B.V.: Employee|Philips Electronics Nederland B.V.: Stocks/Bonds Benoit Balmaekers, MSc, Philips Electronics Nederland B.V.: Patent in the field of respiration measurement|Philips Electronics Nederland B.V.: Employee|Philips Electronics Nederland B.V.: Stocks/Bonds Navaneetha Krishnan, MS, Philips: Employee Kunal Gajwani, MS, PHILIPS: EMPLOYEE