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The early detection of clinical deterioration could be the next significant step in enhancing patient safety in general hospital wards. Most patients do not deteriorate suddenly; instead, their vital signs are often abnormal or trending towards an abnormal range hours before severe adverse events requiring rescue intervention and/or ICU transfer. To date, at least 10 large clinical studies have demonstrated a significant reduction in severe adverse events when heart rate, blood pressure, oxygen saturation and/or respiratory rate are continuously monitored on medical and surgical wards. Continuous, silent, and automatic monitoring of vital signs also presents the opportunity to eliminate unnecessary spot-checks for stable patients. This could lead to a reduction in nurse workload, while significantly improving patient comfort, sleep quality, and overall satisfaction. Wireless and wearable sensors are particularly valuable, as they make continuous monitoring feasible even for ambulatory patients, raising questions about the future relevance of "stay-in-bed" solutions like capnography, bed sensors, and video-monitoring systems. While the number of wearable sensors and mobile monitoring solutions is rapidly growing, independent validation studies on their sensitivity and specificity in detecting abnormal vital signs in actual patients, rather than healthy volunteers, remain limited. Additionally, further research is needed to evaluate the cost-effectiveness of using wireless wearables for vital sign monitoring both within hospital wards and at home.
DeclarationsInstitutional review board statement not applicable. Informed consent Not applicable. Competing interests FM is the founder and managing director of MiCo, a Swiss consulting firm. MiCo does not sell any medical device. BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA). BS is a consultant for Philips North America (Cambridge, MA, USA) and has received honoraria for giving lectures from Philips Medizin Systeme Böblingen (Böblingen, Germany). BS has received institutional restricted research grants and honoraria for giving lectures from Baxter (Deerfield, IL, USA). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from GE Healthcare (Chicago, IL, USA). BS has received institutional restricted research grants and honoraria for giving lectures from CNSystems Medizintechnik (Graz, Austria). BS is a consultant for Maquet Critical Care (Solna, Sweden). BS has received honoraria for giving lectures from Getinge (Gothenburg, Sweden). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Pulsion Medical Systems (Feldkirchen, Germany). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Vygon (Aachen, Germany). BS is a consultant for and has received institutional restricted research grants from Retia Medical (Valhalla, NY, USA). BS has received honoraria for giving lectures from Masimo (Neuchâtel, Switzerland). BS is a consultant for Dynocardia (Cambridge, MA, USA). BS has received institutional restricted research grants from Osypka Medical (Berlin, Germany). BS received honoraria for giving lectures from Ratiopharm (Ulm, Germany). BS was a consultant for and has received institutional restricted research grants from Tensys Medical (San Diego, CA, USA). BS is an Editor of the British Journal of Anaesthesia.
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