![]() ![]() Descriptive statistics and prediction models are used to explore differences between study groups and within the PEA cohort over time. ![]() ![]() Characteristics of continuous pulse oximetry data obtained from PEA patients and a control group are analyzed and compared. This study examines the role that analysis of continuous pulse oximetry data can have in early recognition of patient deterioration with focus on detecting impending PEA events. Horizontal lines indicate the threshold for audible alarms. Intermittent vital signs are typically collected every 4 hours (Q4), while pulse oximetry data shown here are collected once every second. The figure shows continuous SpO2 and pulse rate (PR) values over a 12-hour period with an overlay of the intermittent vital sign values (shown as dots) connected by lines. 12Ĭomparison of data from Pulse Oximetry compared to intermittent vital signs Early recognition of such patterns of patient deterioration is recognized as an important aspect of reducing preventable patient deaths 10 (also known as failure to rescue events 11), which are a primary driver of inpatient mortality. The figure illustrates the limitations of current patient assessment approaches to detect actionable signals of deterioration present, such as repeated episodes of desaturation and pulse rate variability. Values for intermittent vital signs collected per the standard in this setting are superimposed on the continuous data. Consider, for example, Figure 1 where continuous data from a pulse oximetry-based surveillance system is shown for a patient over a 12-hour period leading to a significant deterioration. Such is not the case with intermittent physiologic data collection which is the predominant approach in the general care setting. 8, 9 Analysis of physiologic data made available with surveillance monitoring provides additional opportunities to improve early recognition of patient deterioration. Previous studies have demonstrated the positive impact of surveillance monitoring in the inpatient medical/surgical general care setting using continuous monitoring with threshold-based alarm notifications and automated escalation procedures. 5 While some efforts have been made to support early warning or prediction of PEA, 2, 6, 7 these approaches are not easily supported in the medical/surgical areas where specialized monitoring is not common. Such thinking is consistent with other studies indicating that patients who suffer sudden cardiac arrest and are monitored or witnessed have a higher survival rate due to early recognition. 3 PEA events may have sudden onset, but are thought to be induced by reversible conditions, 4 suggesting early warning of impending arrest may increase survival. Chances of survival after PEA are low, with survival at discharge reported at 9.9% and one-year survival at 6.2%. 2 reported that PEA is present in 25–42% of in-hospital cardiac arrests. Pulseless Electrical Activity (PEA) cardiac arrest is a high-mortality cardiovascular condition where no palpable rhythm is present, in spite of the presence of sufficient electrical activity in the heart.
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