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Aiham Daniel Ghazali, Christophe Choquet, Enrique Casalino
The American Journal of Emergency Medicine June 2018 


A case report from the Emergency Department, University Hospital of Bichat, Paris, details the rapid diagnosis of a cardiogenic pulmonary edema in an elderly patient who was suffering from pneumonia and atrial fibrillation (AF).

The routine use of the Sensium System in this clinical setting allowed a timely clinical intervention and ensured that this patient avoided a potentially serious deterioration that could have led to a cardiac arrest.

Cardiac events occur relatively commonly in patients with acute community-acquired pneumonia. In the elderly, pneumonia can cause heart failure and is proven to be a trigger for AF.

In this particular Emergency Department, patients requiring oxygen for pneumonia are clinically monitored by nurses performing manual observations with a maximum frequency of three or four times per day. These patients are also continuously monitored using the Sensium System. With this wireless monitoring in place, the physicians are proactively notified of abnormal changes in patients' vital signs suggestive of patient deterioration.

The 82-year-old female patient presented with high temperature and tachypnea and was diagnosed with bacterial right lower lobe pneumonia. The patient was treated with oxygen therapy (2 l/min) and a respiratory rate of 18bpm was noted. The patient was monitored with manual observations at 8-hour intervals and also continuously monitored with the Sensium technology.

During the night shift Sensium notified of a sudden increase in heart rate and the following clinical examination found an abnormal left ventricular systolic function and arrhythmia, an electrocardiogram then confirmed a diagnosis of AF.

This case demonstrated that the Sensium System was effective as an aid to early diagnosis. The Sensium notifications and trends allowed the clinician to hypothesise the presence of AF in a context of pneumonia, and to use this information to rapidly diagnose a cardiogenic pulmonary edema.

The prompt treatment allowed the patient to avoid a potentially life-threatening deterioration that could have led to a cardiac arrest.

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Copyright © 2018 Elsevier Ltd. All rights reserved.

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