Classification & History of Patient Monitor

The role of patient monitors is receiving increasing attention.
With the continuous development of modern medicine, the monitors as the basic equipment configuration of hospitals at all levels are being widely used in hospitals’ ICU, CCU, anesthesia operating rooms and clinical departments.

Patient monitors provide important information on the vital signs of the patient by the medical staff. Using this information, the clinician can better analyze the patient’s condition, and then take appropriate treatment measures to obtain the best treatment effect.

Scientists use equipment to monitor the cardiovascular and central nervous systems of animals. 
Photo: Historical Collections, CMHSL, UVa.

The development of the monitoring system can be traced back to 1962, and the first batch of coronary heart disease ward (CCU) was established in North America. Since then, the monitoring system has developed rapidly. With the continuous development of computer and signal processing technology and the continuous improvement of clinical monitoring requirements for critically and potentially dangerous patients, the functional requirements of CCU / ICU monitoring systems have also continued to increase.

At present, in addition to the previous intelligent alarm with multi-parameter vital signs monitoring, the monitoring system also requires further improvements in the quality of monitoring and hospital monitoring networks to better meet the needs of clinical monitoring, drug evaluation, and modern hospital management.

Classification of Patient Monitor

I. Classification by Structure

According to the structure, the monitoring instruments can be divided into the following four categories: portable monitors, general monitors, telemetry monitors, Holter tape recording type ECG monitoring system.

  • Portable Monitor. It is convenient to carry, simple in structure, stable in performance, and can be powered by batteries. It is generally used in non-care rooms and out to rescue patients. Take the Space Monitor portable monitor 90308 as an example. It is fully functional, can display 4 waveforms, monitor up to 11 parameters, has network connection capability, can be powered by AC and DC power, and displayed on the LCD screen.
  • General Monitor. It usually refers to a bedside monitor and is most commonly used. It can be placed next to the bed to monitor some states of the patient (such as heart rate, breathing, pulse rate, temperature and blood pressure, etc.). It often forms a system with a central monitor for monitoring.
  • Telemetry Monitor. The telemetry method is suitable for patients who can move and belongs to the wireless method.
  • Holter Tape Recording ECG Monitoring System. This system can continuously record the ECG activity under the condition that the patient is walking, living or working, and capture the abnormal ECG of short-term onset.

II. Classification by Illness

According to the disease classification, there are automatic monitors for coronary heart disease, automatic monitors for critical patients, automatic monitors for operating rooms, automatic monitors for surgery, automatic monitors for childbirth, automatic monitors for premature babies, automatic monitors for radiation treatment rooms, etc.

patient monitor

Ⅲ. Classification by Application

According to their application, there are three types of bedside monitors, central monitors and out-of-hospital monitors, each of which is divided into intelligent and non-intelligent.

  • Bedside Monitor. It can be placed beside the bed, it can continuously monitor various physiological parameters of the patient or certain states, display alarms or records, and it can also form a whole with the central monitor to work.
  • Central Monitor. Called the central monitoring system, it is composed of the main monitor and several bedside monitors. Through the main monitor, the work of each bedside monitor can be controlled, multiple patients can be monitored simultaneously, and various abnormalities Automatic recording of physiological parameters and medical records.
  • Discharge Monitor. Generally, a small electronic monitor that the patient can carry with him can continuously monitor certain physiological parameters of the patient inside and outside the hospital for doctors to perform non-real-time inspections.

Development History of ECG Monitoring

Earliest, the need for medical staff to monitor ECG began with the rescue of critically ill patients.

  1. 1933: Hooker performed cardiac resuscitation in experimental animals for the first time, and summarized and judged the critical rescue effect of patients by closely observing the heart beating condition;
  2. 1943: Claude Beek first performed electrical defibrillation in the operating room, and began monitoring and clinical application of ECG
  3. 1952: Zoll introduced cardiac pacing for the first time, which enabled patients to recover through pacing and monitoring of patients whose cardiac function was not fully restored;
  4. 1956: The advent of external defibrillators increased survival rates for critically ill patients;
  5. 1960: Kauwenhoven reports that chest cardiac massage is effective, and cardiac resuscitation techniques are becoming more mature;
  6. 1960s: Continuous bedside ECG monitoring can continuously monitor the patient’s ECG status in a timely manner, enabling close and continuous observation of heart disease patients and critically ill patients, while helping medical staff to make continuous analysis and analysis of the patient’s ECG status Judgment
  7. 1970s: The emergence and clinical application of the Swan-Ganz pulmonary artery floating catheter, the introduction of hemodynamic monitoring (invasive pressure, cardiac output, etc.) into the clinic, more monitoring functions, and more objective monitoring information obtained by medical staff, Thus greatly promoting medical standards and scientific research;
  8. 1970s: Clinical application of continuous non-invasive blood pressure monitoring technology;

Blood Oxygen Saturation (SPO2) Monitoring Technology

This also developed in the 1970s, and it was not widely used in clinical until the mid-1980s. Due to the wide application of microprocessors and fast electronic systems, the monitoring parameters ECG, SPO2, NIBP, TEMP and other integrated monitors are increasingly recognized by medical staff and widely used in clinical applications.

The development of second-generation guardianship. In subsequent developments, cardiac output and EtCO2 monitors have also been developed and used in clinical settings as bedside monitors, especially in ICU, CCU, and anesthesia.

I. Display and Parameters

Patient monitors were initially used as the main vital parameter of patients in a timely manner, ECG, NIBP, and SPO2, from the earliest digital display to digital and waveform on-screen display.

The monitor screen display is also constantly updated and improved: from the initial LED display, CRT display, to the LCD display, until now more advanced color TFT display. It can guarantee high resolution and sharpness, eliminate perspective problems, and completely observe patient monitoring parameters and waveforms at any angle.

II. Networking Analysis

With the highly integrated circuit, the size of the monitor becomes more and more compact, and the functions are more complete. While monitoring basic parameters such as ECG, NIBP, SPO2, and TEMP, it can also continuously monitor parameters such as invasive blood pressure, cardiac output, and special anesthetic gas.

Based on this, the monitor has gradually developed to have powerful software analysis functions, such as arrhythmia analysis, pacing analysis, ST-segment analysis, etc., and monitoring information can be reviewed according to clinical needs, including information storage functions such as trend charts and tables.

With the rapid development of the communication network, monitoring a single patient with a single monitor can no longer satisfy the processing and monitoring of a large number of patient information. Networking multiple monitors in a hospital through a central network information system can improve work efficiency. Especially at night, when there are fewer workers, multiple patients can be monitored at the same time. Through intelligent analysis and alarm, each patient can get timely monitoring and treatment.

The central monitoring system, through networking with the hospital’s network system, aggregates, and stores the relevant data of patients in other departments of the hospital, so that all the examinations and conditions of patients in the hospital can be stored in the central information system. In this way, it is easier to better diagnose and treat patients.

Ⅲ. Operation Method

Initially, the monitoring function of the monitor used in hospitals was simple, but the operation was a button, the operation was tedious, and the size of the monitor was relatively large. With the improvement and improvement of technology, the current operation mode has developed from the original key mode to the touch mode, and the most popular operation mode of rotating the mouse button is convenient and fast, which is more suitable for clinical applications.

Ⅳ. Monitor Appearance

According to the needs of different departments, the purchase of monitor appearance is also different. Generally in clinical applications, multiple choices of solid-state monitors are used, and the monitoring parameters include ECG, breathing, non-invasive blood pressure, blood oxygen saturation, and body temperature. Plug-in monitors are mainly used in ICU, CCU, anesthesiology, etc.

The advantages of plug-in monitors are that they can select the corresponding functional modules according to patients with different conditions, and carry out selective parameter monitoring of patients. The patients monitored by these departments have complicated conditions, many diseases, and different requirements for monitoring parameters.

The modular design of the plug-in monitor can flexibly and conveniently combine monitoring parameters. For commonly used monitoring function modules, each instrument can be equipped with For special function modules, you can choose to equip them according to the use situation. This design method can not only meet the needs of clinical monitoring of various special cases but also reduce unnecessary capital investment for the hospital so that various functional modules can be fully and reasonably used.

Heal Force’s patient monitors have always been industry-leading.
Our patient monitors are complete with a variety of functions and parameters; they can be used with a variety of devices to perfectly reflect the state of the patient and assist the care and treatment of medical staff.

Heal Force iMD Series (Click to learn more)
Heal Force ZD120 Series (Click to learn more)

At present, the development of the monitor is very rapid. Looking forward to the future development trend of the monitor, the monitoring function of the monitor itself is only one aspect of many functions.
The monitor represents the concentrated embodiment of high-tech in medical electronic products. Through remote consultation, patients ‘information can be quickly transferred, and experts’ diagnosis and treatment recommendations can be made.

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