748. CoVETED Study: Contactless Vitals for Effective Triaging in Emergency Department – A System to Reduce Cross-Infection
Authors: VARMA D A N T U L U R U M U R A L I D H A R , Abrol Sidharth , Rocque Mukul , Balmaekers Benoit , Krishnan Navaneetha , Gajwani Kunal , Poojary Nagaraj , Bhat Nanda Krishna , Karanth Nisarg , Badagabettu Sulochana , Pai Reshma , Ravindra Prithvishree 
Published: November 2023

Abstract

Background
Accuracy and speed of recording vitals are crucial for emergency department (ED) triaging. Traditionally, vital signs measurements are either skipped or recorded using non-standardized contact-based devices. ED visits sharply dropped during the COVID pandemic due to fear of cross-infection risk among patients and healthcare workers. To address this issue, we developed the "Contactless MONitoring (CMON) Spot-check Health kiosk" as a first-line screening tool to measure body temperature (T), pulse rate (PR), and respiration rate (RR) to triage patients accurately and quickly.

Methods
A prospective observational study with 326 walk-in ED patients was conducted to compare the effectiveness of contactless vitals-based triaging to the current standard of care. After consent, a sitting subject's PR, RR, and T were recorded for 1 minute in a closed kiosk using non-contact cameras. For comparison, the FDA-approved contact-based PR and RR from the Philips Alice NightOne and T from an oral digital thermometer were used. Recorded data was annotated by 3 expert doctors to retrospectively triage subjects and create ground truth based on consensus. Other contact-based vitals (SpO2 and blood pressure, BP) were also included in the data annotated by the doctors. The ED nurse triaged the patients in real-time, which served as the baseline compared to the ground truth. Cohen’s Kappa (K) was used to evaluate triaging accuracy.

Results
Contactless vitals (PR,RR,T) with or without patient history (Figure 1) had better triaging accuracy than the current practice of ED entrance nurse (K=0.42or 0.49 vs K=0.16). Also, patient history, when included with vitals, improves accuracy across all sets annotated, compared to vitals alone. The study also showed that CMON had good accuracy in measuring PR, RR and T (non-contact K=0.42vs contact-based K=0.43), while being acquired 20% faster.Figure 1:Triaging accuracy using vitals (non-contact/contact-based) with and without patient history for various vitals combinations (left), and data available to ED nurse in real-time (right)

Conclusion
Contactless monitoring can improve patient triaging by providing more frequent and accurate vital sign monitoring, allowing for better-informed decisions about patient care. When combined with patient information and integration with Electronic Medical Record systems, it can efficiently manage patient footfall and reduce cross-infection risk.

Disclosures
Sidharth Abrol, PhD, Philips: Employed by Philips|Philips: Stocks/Bonds Mukul Rocque, MS, Philips Electronics Nederland B.V.: Multiple patents in the field of patient monitoring|Philips Electronics Nederland B.V.: Employee|Philips Electronics Nederland B.V.: Stocks/Bonds Benoit Balmaekers, MSc, Philips Electronics Nederland B.V.: Patent in the field of respiration measurement|Philips Electronics Nederland B.V.: Employee|Philips Electronics Nederland B.V.: Stocks/Bonds Navaneetha Krishnan, MS, Philips: Employee Kunal Gajwani, MS, PHILIPS: EMPLOYEE