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Nursing

Continuous Electronic Monitoring

General Principles

Electronic monitoring is used to provide notification of a physiological change and is an adjunct to assessment and treatment. Monitors do not provide a substitute for direct clinical assessment.

The choice of appropriate physiologic monitoring depends on the disease process, current therapies and anticipated changes. Continuous electronic monitoring is indicated for patients who are at risk of  a clinically significant change and for whom knowledge of the change will result in an intervention. Prior to placing a patient on a monitor, the rationale for the monitoring should be identified and reassessed.

Setting Alarm limits

By setting appropriate alarm limits you will be alerted to changes. Alarm limits should be adjusted in order to ensure: 1) notification of clinically significant changes, and 2) minimal notification of clinically insignificant changes. Refer to SickKids Electronic Patient Monitoring policy for recommended alarm limits derived from the Bedside Paediatric Early Warning System (BPEWS).

If a Monitor Alarm Sounds…

  • Respond immediately
  • First assess the patient and determine if the patient requires any intervention; take manual vital signs as necessary
  • If the patient requires, attend to the needs as indicated and document relevant information - assessment, action taken and outcome
  • If the alarm was not triggered by a patient incident, check monitoring equipment and all connections, replacing electrodes (reposition as necessary), lead, or cable as required
    Contact Medical Engineering if the equipment is defective.
Reference: SickKids Policies and Procedures: Electronic Patient Monitoring