Patient monitor: which parameters for which department?

A patient monitor does not play the same role in the operating theatre, in intensive care or during a transfer between two departments. The choice starts with the parameters to be measured, followed by practical criteria: the option to add modules, screen size, networking with a central monitoring station, battery life. This article offers a department-by-department reading grid, illustrated with the Mindray ranges in our patient monitoring catalogue.

Start from the parameters to monitor

A common core is found in almost every department: ECG, SpO2, non-invasive blood pressure (NIBP) and temperature. Beyond that, each department adds what its activity requires: invasive blood pressure (IBP), capnography (EtCO2), anaesthetic gas analysis, depth of anaesthesia, advanced haemodynamic parameters. The lists below are not a standard: they are a basis for discussion, to be validated with the anaesthesiologists and heads of department who know their facility's protocols.

Operating theatre

In the operating theatre, the monitor follows the patient from induction to the end of the procedure. The usual requirements are:

• ECG, SpO2, NIBP and temperature, continuously throughout the procedure.
• Capnography (EtCO2) and, depending on the department's practice, anaesthetic gas analysis.
• Invasive blood pressure (IBP) for long procedures or high-risk patients.
• Depending on the activity, depth of anaesthesia (BIS) or neuromuscular transmission monitoring (NMT).

The BeneVision N22 / N19 illustrates this level of equipment: its description mentions NMT monitoring, AION multi-gas respiratory mechanics and INVOS rSO2 regional oxygenation measurement.

Recovery room

In the recovery room, monitoring is shorter, but a single team looks after several patients at once. The most common needs:

• ECG, SpO2, NIBP and temperature.
• Capnography where the department's protocols call for it.
• Alarm forwarding to the nurses' station, hence the value of a central monitoring station.

ePM monitors include a point-of-care EWS score calculator, designed to help track and document signs of deterioration in the patient's condition. Their interface is operated by swiping the screen to move from one function to another.

Intensive care

In intensive care, the monitor runs without interruption on unstable patients, often for several days. The need broadens:

• The core of ECG, SpO2, NIBP and temperature.
• Invasive pressure on several lines, arterial and central venous.
• Capnography for ventilated patients.
• Advanced haemodynamic monitoring: cardiac output, PiCCO, ScvO2.
• ST segment analysis and tissue oxygenation, depending on the conditions treated.

The BeneVision N17 / N15 / N12 are described with haemodynamic monitoring (PiCCO, ScvO2, cardiac output), the HemoSight analysis tool and volumetric capnography with metabolic measurement, intended to make ventilator settings and weaning easier. For all the equipment in this department, see the intensive care unit page.

Emergency department and in-hospital transport

In the emergency department, the monitor must start up quickly and stay readable for teams working in shifts. During a transfer to the operating theatre, imaging or intensive care, monitoring must not be interrupted. The points to cover:

• ECG, SpO2 and NIBP for every monitored patient.
• Capnography for intubated patients during transport.
• A lightweight, battery-powered device that keeps trends and alarms from one monitor to the next.

The BeneVision N1 follows this approach: it fits in the hand and, when connected to a bedside monitor, retains the advanced parameters collected, along with trends and alarm events, which can be reviewed even after disconnection. The BeneVision N22, for its part, connects wirelessly to the TM80 and BP10 modules worn by the patient.

Modularity, screen size and battery life

A modular monitor accepts parameter modules added as needs arise: a bed can be equipped for today without ruling out a measurement requested later. Mindray offers a range of parameter modules; their compatibility is checked bed by bed in the host monitor's datasheet.

Screen size determines readability from a distance and the number of waveforms displayed at once. For less demanding beds, a compact monitor may be enough. The uMEC datasheet gives an example: "uMEC10: colour LED 10.4”" for a weight of "≤ 3.5 kg", and "uMEC12: colour LED 12.1”" for "≤ 4 kg". As for battery life, the same brochure states "4 h (2 500 mAh), 8 h (5 000 mAh)" depending on the battery fitted.

Networking with a central monitoring station

As soon as several beds are monitored, the central monitoring station becomes a criterion in its own right: it brings waveforms and alarms together at the nurses' station. Mindray offers the TDS central station for this purpose. Before purchasing, check that the selected monitors can connect to it and that the department's network infrastructure allows it. A uniform fleet also simplifies staff training and maintenance.

Preparing the request

Before consulting suppliers, gather the following for each department:

• The list of essential parameters and of those that may be added later.
• The number of beds and how they are split between fixed beds and transport.
• Whether a central monitoring station is in place, and the devices the monitors will have to work with.
• Training and maintenance needs.

Available datasheets can be downloaded from the product pages, and a quote can be requested online from the request a quote page.