1.1 Introduction to Photoplethysmography
Heart, the key organ of the circulatory system, supplies blood to body parts by rhythmic contraction (systole) and relaxation (diastole) – the heartbeat. Heart rate is the number of beats per minute (BPM) is an important vital signs measurement for cardiovascular health and human’s wellbeing. There are many methods to measure heart rate (or pulse). One simple method is to manually count the pulse by placing finger on Radial pulse (Wrist) or the Carotid pulse (neck). The need for the ceaseless observation of the heart rate motivates for the invention of heart rate monitors. Another essential factor is the Oxygen saturation (So2 or SpO2), the oxygen concentration in hemoglobin. As the name says, we need oxygen to survive. To achieve this, the technique Pulse oximetry is employed. Pulse oximetry produces a graph, called Plethysmogram.
Plethysmograph is a Greek word in which plethynein means to increase and graphein means to record or to write. Photoplethysmograph is a Plethysmograph as a result of light. So, Photoplethysmograghy (PPG) means recording differential portion of blood in human tissue by optical means. Photoplethysmography technique was first described in 1930s [1]. It is a non – invasive method of quantitative extraction of Heart Rate (HR) and SpO2.
1.2 Clinical Relevance:
Heart rate variability (HRV) is one of autonomic responses. In case of ICU’s, Anesthesiology and in Emergency care continuous monitoring of heart rate variability and SpO2 is very essential for the assessment of patients’ health condition. HRV is due to physical, physiological, psycho-emotional activities [2] and other factors. In Pulmonary - respiratory, Cardiac – heart related, Trauma - injured, Paediatric -Ne...
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...e data from the camera is fed to the processing unit in a computer (PC). The raw data is processed and the heart rate and the PPG waveform are displayed on the screen.
[1] Yu Sun, Charlotte Papin, Vicente Azorin-Peris, Roy Kalawsky, Stephen Greenwald and Sijung Hu, Use of ambient light in remote photoplethysmographic systems: comparison between a high-performance camera and a low-cost webcam.
[3] Clinical Use of Pulse Oximetry – Pocket Reference 2010
[2] Anaesthesia Update, Volume 14, June, 2011
[4] Light Tissue Interaction
[5] Photoplethysmography: Beyond the Calculation of Arterial Oxygen Saturation and Heart Rate
[101] http://www.missionignition.net/bms/led_heal_clip_image008.jpg
[102] Oleg Kim, John McMurdy, Collin Lines, Susan Duffy, Gregory Crawford and Mark Alber, Reflectance spectrometry of normal and bruised human skins: experiments and modeling
The research problem is clearly stated in the introduction and various times during the literature review. While it is known that automatic sphygmomanometers are not as accurate when compared to the gold standard of manual sphygmomanometer during single blood pressure readings they are still being used a triage instruments in emergency departments (Dind, Short, Ekholm, & Holdgate, 2011, p. 526). Triage is an essential step in the emergency department and instruments used in triage need to be accurate. Little is known about the accuracy of automatic devices when assessing postural blood pressures. It is shown in this study that orthostatic hypotension is a direct link to what triage category the patient is assigned, which can affect variables such as wait time and care received, so accurate measurement of this is an important factor in the emergency setting (Dind et al., 2011, p. 531).
Noticeable indications of deterioration have been shown in numerous patients few hours prior to a critical condition (Jeroen Ludikhuize, et al.2012). Critical condition can be prevented by recognizing and responding to early indications of clinical and physiological deterioration ( kyriacosu, jelsma,&jordan (2011). According to NPSA (2007) delay in responding to deteriorating vital signs have been defined as an complication resulting in prolonged length of stay, disability or death, not attributed to the patient's underlying illness procedure along but by their health-care management ( Baba-Akbari Sari et al. 2006; Helling, Martin, Martin, & Mitchell, 2014). A number of studies demonstrate that changes or alterations in a patient’s
The first participant measured her pulse rate for 30 seconds before starting the exercise. Her pulse rate was calculated to determine the number of beats per minute. She then stepped on the platform (up and down) and continued at a slow pace for 3 minutes. After three minutes of the exercise, she measured her pulse rate every minute to determine her recovery time. This process was repeated until her pulse rate returned to normal.
A total of 22 patients were admitted for the study, with 11 on the BiPAP side and the other half on the BiPAP using the AVAPS. Every patient had to be in a select range of APACHE II score within 4, age within 10, pH within.04, Glasgow Coma Scale within 2, and BMI within 2 points; also referred by a doctor who did not know about the study. Both of the groups received the same parameters for their BiPAP machines, including an IPAP of 12 cmH2O, EPAP as 6 cmH2O, a tidal volume 8-12 ml/kg of ideal body weight, respiratory rate of 15 bpm, rise time 300-400 ms, and finally Helsinki-based inspiration time at a minimum of.6 seconds. Arterial blood gases, maximum tidal volumes and IPAP, EVT, leaks, respiratory and heart rates, and blood pressure were all assessed every 1, 3, 12, and then every 24 hours.... ... middle of paper ... ...
Pre-exercise: For this activity, each group member needed to be familiar with taking and reading another group member’s blood pressure. Many types of instruments exist for measurin...
Using the spectrophotometer, the absorption of each sample was measured by scanning the wavelengths. After calibrating the spectrophotometer with the blank test tube, each sample was placed into the spectrophotometer and read at 360nm. Observations were continued for each pigment sample increasing the wavelength by 20nm increments. Once these absorbance values were recorded, absorption spectra for each pigment were graphed.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
The study of cardio physiology was broken up into five distinct parts all centering on the cardiovascular system. The first lab was utilization of the electrocardiogram (ECG). This studied the electrical activities of the heart by placing electrodes on different parts of the skin. This results in a graph on calibrated paper of these activities. These graphs are useful in the diagnosis of heart disease and heart abnormalities. Alongside natural heart abnormalities are those induced by chemical substances. The electrocardiogram is useful in showing how these chemicals adjust the electrical impulses that it induces.
Anesthesiologists have many responsibilities. 3They measure the patient’s temperature, pulse, heart rate, and breathing rate while under the sedative. They have...
A pulse ox or oximeter is a device that is used to measure the blood’s level of oxygen. A stethoscope is used to hear a patient’s heartbeat. A saline flush is used to flush IV lines of any leftover medicines that were pushed through the IV at an earlier time. Tape and scissors are used to bandage wounds (“Health
Throughout this investigation, I will be conducting a number of experiments to help solve whether or not heart rate is affected by exercise. My aim is to identify the difference of every volunteer’s heart rate and take down how old they are so I can evaluate whether or not the age of a person make a difference in their bpm (beats per minute).
AIM: - the aim of this experiment is to find out what the effects of exercise are on the heart rate. And to record these results in various formats. VARIABLES: - * Type of exercise * Duration of exercise * Intensity of exercise * Stage of respiration
The heart is a pump with four chambers made of their own special muscle called cardiac muscle. Its interwoven muscle fibers enable the heart to contract or squeeze together automatically (Colombo 7). It’s about the same size of a fist and weighs some where around two hundred fifty to three hundred fifty grams (Marieb 432). The size of the heart depends on a person’s height and size. The heart wall is enclosed in three layers: superficial epicardium, middle epicardium, and deep epicardium. It is then enclosed in a double-walled sac called the Pericardium. The terms Systole and Diastole refer respectively and literally to the contraction and relaxation periods of heart activity (Marieb 432). While the doctor is taking a patient’s blood pressure, he listens for the contractions and relaxations of the heart. He also listens for them to make sure that they are going in a single rhythm, to make sure that there are no arrhythmias or complications. The heart muscle does not depend on the nervous system. If the nervous s...
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.