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. 2021 Sep 7;3:630273. doi: 10.3389/fdgth.2021.630273

Figure 6.

Figure 6

Exemplar augmented e-obs chart from the Clinician Dashboard, showing wearable and e-obs vital-sign data from a COVID-19 patient in the isolation room. In this example, the wearable data from 10:44 to 19:12 is summarised in 15-min windows (i.e., the “15-min” view was activated, and only the most recent available 5-min median estimates within each window are displayed), and shown alongside the intermittent e-obs data. Only the e-obs data had scores associated with it, presented in the T&T row at the top and bottom of the chart. In this hospital setting an Early Warning Score (EWS) greater or equal to 3 was coloured red, denoting high risk. In the period displayed in the chart, the VitalPatch® was already fitted. The increase in the VitalPatch® RR, might have triggered the nurse review of the patient 1 h after the previous review (usually done 4-hourly when the previous total EWS is 2), as an additional e-obs set was entered by the nurse at this time, with high RR (24 rpm), low SpO2 (90%) values and a total EWS of 4 (1 h after the previous e-obs set, at 10:35 AM). We note that at this point the patient was receiving oxygen therapy via a nasal cannula (N) at 4 litres per minute. It is possible to observe that, in the subsequent 3 h, the VitalPatch® was removed and the Nonin pulse oximeter fitted to the patient to monitor the SpO2 while the oxygen therapy was escalated, by applying a Venturi Mask 40 (V40) at 10 litres per minute, at 14:14. A recovery trend can be observed, with HR and SpO2 estimates from the Nonin pulse oximeter stabilising in the evening at 72 bpm and 97%, respectively (displayed at the end of the chart). Note that a nurse e-obs set is absent during this period in the chart (i.e., between 14:14 and 21:23, the time at which the patient was removed from the vHDU system; the chart only shows up to 19:12). MRN, Medical Record Number; NHS, National Health Service; T&T, Track & Trigger; Sats, peripheral blood Oxygen Saturation; AVPU, Alert, Voice, Pain, Unresponsive scale; GCS, Glasgow Coma Scale; RA, Room Air; O2, Oxygen.