Key To Clinical Measurement System

We need to calibrate medical devices as per theNABL126 guidelines to ensure precision and accuracy of measurement

- Deepak Agarkhed

Although a tertiary care hospital had implemented early warning score system for clinical response, an erroneous score computation had led to delayed shifting of the patient to the ICU from the ward. The reason for wrong computation was later found out due to improper oxygen saturation measurement. The normal ranges for a person's vital signs vary with age, weight, gender, and overall health condition. There are four primary vital signs: body temperature, blood pressure, pulse (heart rate), and breathing rate (respiratory rate). The oxygen saturation is considered as an additional parameter.

Measuring and recording a patient's vital signs accurately is important as this gives an indication of the patient's physiological state. The patient vital parameters temperature, blood pressure, pulse and respiration play a crucial role in monitoring and diagnosing the course of illness.

The target temperature management post a cardiac arrest should have an accurate temperature measurement. An inaccurate thermometer measuring with an error of ±2°F for patients may lead to either over investigation like blood culture, increasing anti biotic or suspecting too late to investigate and accuracy of ABG report. The accuracy of mean arterial pressures at intensive care decides patients care plan. An inaccurate measurement may lead to either unnecessary medication given to increase BP or no medication may affect kidney or brain function.

The similar measurement-related mistakes can happen on account of usage of infusion of medication, during measurement of oxygen saturation. Are clinical measurements, decisive to patients, captured correctly in any hospital set-up? Unfortunately, the focus of clinician and nursing staff is on patient clinical management with broad assumption that all the measurements are accurate.