Shopping for a patient vital signs monitor?

You don’t need to be told the basic departure points for choosing vital sign monitors.  The first is to ask yourself what you need your equipment to do, and the second is to decide how much money you want to spend. 

You know what you want it to do, because you know what you and your staff do.  You know how much money you have, too, and browsing prices will update you on what things cost these days, and then you’ll know how much you’re really going to spend.  Done. 

These two things are a function of the size of your unit, and what your unit’s purpose is. 

You might see a wide range of conditions in the course of your workday, or you may see only a few.  If you see only a few, you may be a neighbourhood wellness center, where there isn’t that much to see.  Or you might be a specialised interventional unit in a big hospital, where the range isn’t large, but you’re expected to deep-drill, with equipment that’s specialised to detect subtle and complicated things. 

So it is that your needs may run, if it’s a simple mission, to EKG, NIBP, and SpO2.  Maybe you also want respiration, end-tidal CO2, and some internal thermal recording.  A recorder is helpful, and most modern monitors have this, so you see trends, or spot events that happened when your back was turned.  A neat feature is to have a monitor start printing on alarm.  There are regulations about required features in some places, a point worth keeping in mind. 

Or maybe you’re doing terrifying hospital procedures, and you need real power tools.  Maybe your patients are so sick that you need really accurate hemodynamic data, and you’re willing to get invasive.  If you’ve got someone in septic shock, the usual arterial waveform-derived output measures aren’t so useful, being affected by vascular tone and in need of repeat recalibration, at least in the resuscitation phase.  Or if you’ve got someone at risk of pulmonary edema, you start thinking about monitoring by transpulmonary dilution and measuring extravascular lung water.  You don’t want them overhydrated.  And so on.  ‘Monitor’ can mean a lot of things. 

You can see just how much things can vary in our after-market pages here. 

Well done, by the way, for considering reconditioned equipment.  You’re doing an end-run around the problem of ultra-new devices suddenly going obsolete.  These are established brands here, everybody uses them, everybody is familiar with them, and they’re comparatively cheap and easy to upgrade. 

Here are now two more things you might want to think about as you browse.  They both have to do with the future of your practice, whatever it is.  This is not an injunction to buy super-advanced tools, but it is an alert about how the industry is beginning to think about patient monitoring in general.  It’s good for you to know about these, if you don’t already. 

One isn’t really so new.  It’s the problem of what to do as your needs expand.  This doesn’t mean necessarily seeing more patients.  It can just as easily mean integrating your monitoring into network medicine.  The idea these days is to monitor along every stage of the patient journey, from triage to transfer of care.  You also want this tracking to be part of the ‘seamless’ record system, to use the managerial jargon lately.  Major vendors of monitoring devices like to sell central nursing monitoring stations that go with the individual bedside devices.  Hospitals buy over-arching systems from single vendors – and you might think about this as you look at brand names – because of concerns over connectivity during this whole-patient journey.  In time, there will be universal healthcare computer language formats, like HL7 for data entry and DICOM for big dumps like radiology images.  But keep an eye on this seamlessness idea.  Also know that WiFi is more and more the biomed way of doing things.  Companies run courses, by the way, on keeping devices connected.  If you’re part of a big unit, you might want to talk to your procurement people carefully as you buy.  Having said that, it’s sometimes surprisingly what they’ll say back.  It’s no bad thing, some of them feel, to have extra monitors around that don’t depend on network connectivity at all – just in case there are problems with the network. 

Network integration is the way of the future, nevertheless, and you might want to keep it in mind as you go down our aisles with your shopping cart, looking for monitors. 

More broadly, there’s something else.  There’s a group of trends in monitoring patients, that isn’t all the way here yet, but it’s coming, and it absolutely will change the way you shop for monitoring devices. 

One of them is the speeding-up of the seamlessly-connected world.  Engineers are talking about electronic patient portals these days, for sharing information, and also for management of other content, like hook-ups to social services, patient profiles, blogs, and discussion boards.  It’s a privacy nightmare for someone else to figure out.  But for you, it’s something to be aware of as you shop for the gadgets that compile the patient vitals data. 

Another is remote patient monitoring, big stuff in the age of older populations and expensive hospitals.  People are more and more likely to be monitored off site, and the strong trend is to outsource all this monitoring.  It’s undeniably good for patients, and it’s something into which your collection of appliances needs to fit, eventually. 

The third and fourth trends are wearable sensors, an extension of the WiFi idea, and predictive use of Big Data, which probably will change the way monitors like yours will work, though it’s not clear how yet. 

It’s an expanding world out there, in patient-monitoring.  It’s good to be aware of the world’s changes as much as those within your own practice. 

Have a look at our shelves with all these things in mind.  If your needs are modest, you might be interested in the Dinamap ProCare Auscultatory 400.  It’s a simple blood pressure monitor, non-invasive, that also tells you mean arterial, and temperature, and O2 saturation. 

If you’re after scarier stuff, see what you think of the Datascope Passport 2 and Datascope Gas Module 2.  This is a fully featured anesthesia monitor with sidestream Co2.  It does absolutely everything you need, from NIBP on, and it’s got a simplified way of navigating, with a game-like monitoring knob instead of layers of menus.  It’s got quick-action keys for frequently used functions, too.  And you can automatically reconfigure three waveforms to six when you want.  It’s about the easiest sophisticated monitor in the business.

Remember as you look around:  Don’t buy more than you need.  But don’t underestimate your needs either.  We’ll help you find something to fit. 

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