Avoiding ICU Admission in a Case of Septic Encephalopathy Through Enhanced Connected Care Monitoring: A Case Study
DOI:
https://doi.org/10.30953/thmt.v9.507Keywords:
biosensors, elderly, ICU, remote monitoring, septic encephalopathyAbstract
Aim: To report a case of an elderly patient with septic encephalopathy admitted in the wards. With the help of enhanced connected care monitoring, ICU admission was avoided.
Materials and Methods: An 81-year-old gentleman who is a known diabetic & hypertensive presented to the Emergency room with complaints of generalized weakness of bilateral upper & lower limbs and a recent history of acute gastroenteritis. The patient was evaluated and admitted to wards for further management. On examination, the patient is drowsy and arousable on call and hemodynamically stable. Stool biofire was sent, which was positive for Ecoli Shiga-toxin. A provisional diagnosis of septic encephalopathy was made. Because of background conditions and multiple issues, the patient was connected to Enhanced Care Monitoring (ECC). The patient was constantly monitored by a nurse and doctor from the command center. Three days after admission, the patient had an alert for desaturation with a low saturation of 74%, and immediately nursing staff was informed by the command center team. Shortly 2 hours later, one more critical alert was generated for Tachycardia HR 178/min. The nursing staff was informed by the command center team. Immediately bedside vitals were rechecked, and the doctor was informed, and the patient improved symptomatically with the management of sepsis and was discharged home.
Discussion: Remote patient monitoring can track vital signs, identify deteriorating patterns at an early stage, and alert healthcare staff, reducing ICU admissions. This is illustrated in an elderly patient with septic encephalopathy, where continuous wireless monitoring enabled avoiding ICU admission. Enhanced care monitoring was done through wearable biosensors. Vital data obtained helped identify potential emergencies. Appropriate real-time responses avoided an ICU admission.
Conclusion: Wearable and implanted sensors efficiently monitor elderly patients in wards without hindering mobility. The term "immediately" might be misleading, but it's crucial to emphasize that within two hours of observing consecutive signs of deterioration in the patient, swift action was taken. Addressing these concerning signs promptly prevented the need for the patient's transfer to the ICU, showcasing successful management within the ward setting.
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Copyright (c) 2024 Hima Bindu Kotamarthy, MBBS, MD, FNB, Sai Praveen Haranath, MBBS, MPH, FCCP Internal Medicine, Pulmonary and Critical Care Medicine, K. Subba Reddy, MBBS, MD, IDCCM, IFCCM, EDIC3
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