What if the doctor sees it but never sees it?
This new system for continuous monitoring and collection of patient data has recently become wireless. Patients are being tested at a hospital in Birmingham, England, but in the future this system and similar remote systems may be used at patients homes. The more you read about this topic, the more you realize that remote patient monitoring can radically change medicine. Replanning the healthcare sector; but it may change in ways we may not welcome the thoughts of doctors like me. Look carefully From ancient times, patients have been a universal duty of all doctors. For thousands of years, practitioners have used their senses to assess a patients condition. Even today, doctors are trained to recognize the hard candy breathing of diabetics, the clicking of a glass bottle when intestinal obstruction occurs, and the cold and clumsy sensations of the patients skin when blood circulation ceases. However, the systematic record of numerical observations is a surprising new phenomenon. In the late 1800s, this device was designed to measure a set of standardized health indicators. These are the four major vital signs of heart rate, respiratory rate, body temperature and blood pressure. Just before the turn of the last century, these vital signs (also called observations) were systematically recorded for the first time. World War I They are often used. According to a survey of these charts, people basically do not die if these vital signs are normal. The heart does not stop suddenly. But for most of the century, the technique of interpreting these so-called obs charts was as mysterious as reading tea to an untrained person. Then, in 1997, a team at James Paget University Hospital in Norfolk, England, developed an early warning system that nurses could use to quickly convert vital signs into scores. If your score exceeds the threshold, it indicates that you need help from your doctor. Although such systems are steadily being promoted for use in adult patients, it is not clear whether they are suitable for children because children have different physiological responses to the disease than adults. Heather Duncan knew about the early warning system for adult patients in 2000, when he worked as a general practitioner in South Africa and had a keen interest in child health. Observations made in hospitals are usually not related to observations made in early primary care clinics. However, Duncan sought to connect these two datasets from the community and the hospital to create a more meaningful and ongoing story about what happened to the patient. She struggled to scrutinize the records of her most seriously ill children by plotting their vital signs, from initial records in primary care facilities to discharge or hospital death. I noticed that the children had cardiac arrest or entered the intensive care unit. In fact, we missed the opportunity to take further action, she recalled. Her persistent feeling that she could do more for these children was later confirmed by the British Government. Confidential investigation of child mortalityIt turns out that more than a quarter of the children at the National Health Service Hospital died from avoidable causes. In 2003, Duncan completed an intensive care study at the Torontosick Childrens Hospital. So she and pediatric intensivist Crispal Shram have developed the Pediatric Early Warning System (PEWS), a bedside scoring system designed for sick children. Duncan is currently a pediatric intensive care unit at Birmingham Childrens Hospital. Last October I found her on the zoom. Duncan was working from home, wearing an oversized cream wool sweater, welcoming the fall of England, combing his hair into loose buns, and wearing blue-rimmed glasses that matched his eyes. She speaks with elegant South African accents and a calm attitude. 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