Advances in Patient Monitoring Systems for Prehospital and Resource-Limited Settings

TL;DR

This paper reviews recent patient monitoring technologies for prehospital and resource-limited settings, highlighting their potential and current limitations.

Contribution

A systematic review of patient monitoring systems in prehospital and resource-limited settings, focusing on their capabilities and clinical impact.

Findings

Wearable and contactless systems showed high accuracy but had delayed responsiveness and unreliable temperature measurements.

AI-based platforms outperformed traditional scoring systems in predicting patient outcomes.

Most systems lacked comprehensive cost analyses and real-world testing.

Abstract

Vital sign monitoring is essential to the management of critically ill and injured patients. Recent advances in patient monitoring systems have the potential to improve outcomes by providing real-time data and predictive insights, which are particularly valuable in prehospital and resource-limited settings. We conducted a systematic review of the literature to assess the capabilities, performance, and clinical impact of patient monitoring technologies designed for these environments.

In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review using PubMed and Scopus search engines on studies published between 2018–2022 that proposed or tested novel patient monitorint systems with utility in prehospital or resource-limited settings. Two reviewers independently screened studies, and discrepancies were resolved by a senior author. Of 217 studies identified in the search, 40 met the proposed inclusion criteria.

Compared to standard platforms, wearable and contactless systems for patient monitoring demonstrated high accuracy but with delayed responsiveness and less reliable temperature measurements. Artificial intelligence (AI)-based platforms consistently outperformed well-accepted scoring systems in predicting outcomes such as mortality, intensive care unit (ICU) admission, and clinical decompensation. In this review we summarize proposals for prototypes of integrated patient monitoring systems that combine biosensors, AI algorithms, global positioning system, and wireless communication designed to facilitate triage in prehospital settings, and we then compare their components. Various platforms were piloted and demonstrated minimal disruption to workflow and positive user feedback, although most lacked comprehensive cost analyses.

Emerging patient monitoring system technologies may enhance remote triage and care delivery, particularly in resource-limited settings. However, significant barriers remain, including cost, limited testing in real-world environments, and the lack of higher tiers of evidence. Future efforts should prioritize field-based testing, usability in low-resource settings, and cost-effectiveness analyses to guide clinical adoption.

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