Cork University Hospital Living Lab

Dr Des MurphyConsultant Respiratory Physician CUH

National Clinical Lead for Respiratory Medicine

AUTUMN DIGITAL ACADEMY FORUM-INNOVATING WITH DIGITAL HEALTH LIVING LABS

Respiratory Rate

• Number of breaths per minute.

• Problem;

– too many

– too few

• A Vital sign.

NCP/ITS CRS

• How do you measure Respiratory Rate?

• Manually count!

RespiraSense – Continuous monitoring of respiratory rate

• RespiraSense is a wireless wearable continuous respiratory rate (RR) monitor

• It operates by measuring movements of the chest and abdomen to calculate RR

• This approach enables Motion Tolerant measurements than produce reliable results to trigger timely action e.g. ABG testing

• Its can talk remotely to a single display so that Respiratory Compromise patients can be assessed should they decompensate in between intermittent vital sign observations.

• RespiraSense use in COVID-19 in Beaumont Hospital.

• Over 41.6% of EWS scores changed when RespiraSense measurements were used.

• Manual respiratory rate can impact the accuracy of Early warning Scoring

• Patients compensating with increased RR can mask signs of respiratory failure e.g. Hypoxia SpO2>92% events

• Respiratory Rate, with PaCO2 are strong markers of respiratory compromise, earlier than SpO2 measured desaturation.

• When respiratory rate was continuously monitored, future events of Hypoxia (>92% SpO2) and Pyrexia (>38 degrees) occurred12 hrs after patients RR elevated past 24 breaths per minute. Manual RR showed no prognostic power.

• What about other Respiratory Disease?

• Also while manual RR may cause problems with EWS, conversely all EWS scores were validated with manual RR.

• 20 Beds

• 4 High Dependancy

• 8 Centrally monitored

• 8 side rooms

To date…..

• 49 patients

• 51% male

• 53%>65 years

• Average duration wearing Respirasense=129 hours

• Diagnosis;

COPD 17

Asthma 12

Pneumonia 14

PH 3

Pulmonary Fibrosis 3

PE 2

• Ethics submitted

Acknowledgements

• 5B

• Deirdre Byrne

• Dr Anne Marie Sweeney

• PMD/Respirasense

Implementation of RespiraSenseHealthcare Professions are a multi-disciplinary team working with IT leads and

Executives to deliver safe and effective care.

Transforming healthcare requires a collective and collaborative approach to

ensure success and realize maximum impact.

Key preparation

activities pre-

launch of

RespiraSense

included:

WhyWe all need a purpose or a ‘Why’ so the team can align and push through

challenging hurdles.

WhoHealthcare professionals,

committees, IT teams, Executives, and patients are part developing the ‘Why’ we embark to Transform Care

WhatShared goals and a clear definition

of success ensure there is a destination

Secure system with minimum IT overhead

IT Teams

- Open Port

- Establish VNP

Estates

- Install Power and PoE Outlets

With clear objectives and goals, implementation is swift

1-day: Site survey to place routers

1-day: Front Line staff training, and clinical protocol setting

1-day: go live and ensure follow-on support is available