Medical Intensive Care Unit at St. Marys, which opened last December, is designed to care for the critically ill medical patient. Since it was expected that a good many of the patients admitted to the unit would be suffering from some type of heart ailment it was decided to install in three rooms (six beds) monitoring equipment which would instantly inform medical personnel at the nursing station or at the patient’s bedside of development of cardiac emergency.
The Clinic assumed responsibility for providing the monitoring system. While some of the equipment in the assembly is commercially available, other parts were made or modified in the Clinic’s Engineering Section and the system was installed by Clinic engineers.
The top photographs show the central monitor at the nurses’ station (left) and the installation in one of the three rooms where control panels are located between the two beds.
By means of small electrodes placed on the patient’s chest the ECG (electrical activity of the heart) can be observed both on the small round screen in the bedside unit and on the large 17” screen in the central monitor which will carry simultaneously ECG recordings from six patients.
The heart rate can be read on meters in both the central and bedside monitors. Increase or decrease of the rate beyond a pre-determined level will sound an alarm at the nurses’ station.
Provision is also made for a pacemaker to give electrical stimulation to the heart. This stimulation can be instituted automatically if the heart rate slows below a pre-determined level or stops. A defibrillator (to stop certain dangerous irregularities in heart action), can be operated at the bedside or can by synchronized with the ECG so that a particular wave pattern will trigger its operation.
ECGs on six patients can be recorded continuously on magnetic tape (lower photograph). This tape is erased except when an acute situation occurs which causes the alarm to sound. The recorder then automatically replays the previous minute of ECG so that the tracing made just prior to and during the acute episode is available.
Installation of the control monitor in its entirety was completed in recent weeks. Bedside monitors in two rooms were available when the unit was opened.
Two surveys (one of the first four weeks of operation of the unit, the second of the following twelve weeks) showed that 41 patients were “on monitor” during these sixteen weeks. During the twelve week period the diagnosis on admission in 83 of 144 patients was some type of heart ailment.