2.1 

Hello and welcome to the second lesson about Oxevision. Here we will be introducing the Oxevision vital signs medical device. This lesson will take approximately 15 minutes, and once completed you will be able to move onto lesson 3: How to monitor a patient's activity using Oxevision.

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2.2 

During this lesson we will cover:

• How do Vital Signs work on Oxevision?
• How to take a patient’s Vital Signs using Oxevision. 
• What are ‘Blobs’, and how do they work?  
• The Vital Signs Trends Chart.

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2.3 

Introducing Oxevision’s Vital Signs.This supports staff to perform observations and improve physical health monitoring. The Oxevision Vital Signs is a FDA Class II medical device in the US. It's important to note: Oxevision does not provide warnings or alerts associated with vital signs; they are designed to be used as spot check measurements that require the user to complete the workflow. Oxevision vital signs is designed to measure pulse rate and breathing rate (chest wall movements) in the ranges specified:

• Pulse Rate: 50 to 130 ± 3 beats per minute
• Breathing Rate (chest wall movements): 8 to 31 ± 2 breaths per minute, 

Oxevision will not give measurements outside these ranges.

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2.4 

 How are contact-free vital signs obtained using Oxevision?

 Vital signs are to be used as spot check measurements only. The system will not alert or warn you to abnormal pulse and breathing rates (chest wall movements). To obtain either a pulse rate or breathing rate (chest wall movements), the patient must be still or resting. Pulse rate readings are as accurate as a pulse oximeter +/- 3 beats per minute, and breathing rate (chest wall movements) readings are accurate to +/- 2 breaths per minute.

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How does Oxevision detect an individual’s pulse rate? 

When your heart beats, minute blushing of the skin, undetectable by the human eye is detected by the Oxevision system. Oxevision vital signs count these micro blushes to calculate pulse rate. In order to obtain a pulse rate reading, some portion of the patient’s skin must be visible.

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Breathing rate (chest wall movements) measurements can be collected when a patient is covered, even when they are under a sheet or blanket. Visible skin is not needed to obtain breathing rate (chest wall movements) measurements. The system collects breathing rates (chest wall movements) by counting the rise and fall of the individual’s chest similar to a nurse or other qualified staff member completing an in person observation.

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2.5 

Now, let's go through step-by-step on taking vital signs using Oxevision.

Step 1: On the room overview screen, select the room tile of the patient from whom you wish to take vitals. Once selected, the action menu will be displayed. On this action menu you can access different Oxevision features, but for now, let's focus on ‘take vital signs’. By selecting the ‘take vital signs’ button, you are using the registered medical device. 

Note: For patient privacy reasons, please proceed with caution if taking a Vital Signs observation when the room tile is orange and displaying ‘In Bathroom’.

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2.6 

Step 2: During this step you will see a clear live video feed into the patient's room that will automatically time out after 15 seconds. Use the live video feed to confirm you are taking the reading from the correct person, the patient is not in any visible distress, and they are still or resting. If the patient is moving, please select ‘cancel’, and you will be taken back to the room overview screen. If the individual is not the correct person, is in visible distress, or is moving, proceed according to your organization's protocol. If the patient is still, proceed to click “yes”. 

Note: If Oxevision displays “acquiring vitals”, you may be unable to complete the observation.

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2.7 

Step 3: You will see a paused image of the clear live feed where you will notice that the system has placed two bright blue circles onto the image. We call these ‘blobs’. Blobs indicate where the system wants to take its measurements.
In this step you will need to answer the question “Are there blobs which do not touch the body?”. You will need to check the image to see where the blobs are located. You may see one or two blobs on the screen, either is normal. Please Note:  If the system has placed one blob on the screen you are likely to obtain either pulse rate or breathing rate (chest wall movements) only. If the system places 2 blobs on the screen, you will obtain both pulse rate and breathing rate (chest wall movements).

Only proceed with the workflow if all blobs are touching the body.
If all blobs are located on the body,  select “No '' as it is safe to continue. If the system has placed blobs that are located off of the body, select “Yes” and the screen will return to the room overview screen. If this occurs, proceed in accordance with your organization's protocol.

Please note, the blobs must be located on the intended person’s body to acquire a reliable reading. If the patient is completely covered, and you are unable to identify them, proceed with caution.

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2.8 

Step 4. Once you have selected “No" confirming all blobs are touching the body, a pulse and/or breathing rate (chest wall movements) measurement will be displayed on the screen. A ‘vitals saved’ message will appear, and you can select ‘done’,

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If you receive one measurement, either pulse or breathing rate (chest wall movements) only, and would like to obtain both, ensure the patient is still, the blobs are located on the body, and visible skin is present. Then, retry the observation.

Please note, you must physically record these readings, as per your organization's protocols, as Oxevision does not currently link to your Electronic Medical Records. 

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2.9 

(Demonstration Video)

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2.10 

Now we will go through some examples of where blobs do and don’t touch the body and what you should do based on those placements.

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• In the first example, are there blobs which do not touch the body?

Yes, the system has placed a blob on the floor to the right of the individual's foot. it is not touching the body, and it is not suitable to continue. In this example you would select “Yes” and be taken back to the overview screen.
 

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• In the second example, are there blobs which do not touch the body?

Yes, the system has placed 1 blob on the patient's body, which would be safe; however, if you look closely, the system has placed a second blob on the ceiling light. One of the two blobs is not touching the body so it is not safe to continue since both blobs must be located on the patient's body.
In this example you would select “Yes” and be taken back to the overview screen.

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• In the third example, are there blobs which do not touch the body?
  No, the system has placed two blobs, and both are on the patient's body. Therefore, it is suitable to obtain the reading. In this example you would select “No” and proceed to obtain the individual's pulse and breathing rates (chest wall movements). 

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• In the final example, are there blobs which do not touch the body?
  No, the system has placed one blob touching the individual's body. If you remember from earlier on in the lesson, we mentioned you are still able to obtain a patient's breathing rate (chest wall movements) even if a patient is completely covered. In this example, you would select “No” and proceed to get the individual's breathing rate (chest wall movements). You will need to ensure you are obtaining the reading from the correct person, and that there is only one person underneath the cover.

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2.11 

We will now introduce one of the reports you will have access to called the Vital Signs Trends Chart. It was created to provide additional insights which can inform care planning and physical health monitoring. The Vital Signs Trends Chart is part of the FDA Class II medical device.

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2.12 

You can view each room’s Vital Signs Trends Chart by selecting the vital signs trends button on a room’s action menu. 

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On the screen is an example of the Vital Signs Trends Chart. There are two separate charts representing each of the vital signs (pulse and breathing rates (chest wall movements)). Within each chart, the colored dots represent all of the completed vital signs observations you and other qualified staff members have obtained over the last 24 hours using Oxevision. Red dots represent pulse rate measurements, and blue dots represent breathing rate (chest wall movements) measurements. If you hover over the colored dots, you will be able to see the specific measurement that was obtained, including the date and time it was taken. 

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You will also notice gray diamonds plotted along both charts. Oxevision is constantly working in the background, calculating 5 minute averages of the individual’s vital signs. The individual's vital signs must be recognised by Oxevision for at least 75 seconds of that 5 minute period to show you trends. These  provide additional insight into the patient’s recent physical health and may bring to light any underlying trends which may be of interest. If no trends are shown for a particular time, the system was unable to measure any vital signs which may be due to excessive  movement detected in the room or to the room being unoccupied. 

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Please note: Room occupancy may vary so more than one person’s vital signs may be shown.The Vital Signs Trends Chart may show multiple people’s data if more than one person has been in the room during the last 24 hours.
The Oxehealth Vital Signs device is designed to measure pulse rate and breathing rate (chest wall movements) in the ranges specified in the Instructions for Use and will not give measurements outside these ranges.

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You are able to export the Vital Signs Trends Chart, and in Lesson 3, we will teach you how.

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2.13 

Saving vital signs. As mentioned earlier on in this lesson, Oxevision does not link to your EMR; however, you are able to view the last 24 hours of vital signs observations in the Vital Signs Trends Chart. 

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Vital signs will save automatically. When saved, they will be visible on the respective Vital Signs Trends Chart within the Oxevision system.

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If your Wi-Fi connectivity drops, Oxevision will try to resave the vital signs and display a “Please wait…” message as shown on the first image.

If the device continues to have insufficient Wi-Fi connectivity, the “Vital Signs Failed to Submit” message will be shown, and a “Retry” button will appear.

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At this point, you can choose to exit. However, if you choose to exit, please note that the vital signs you have just obtained will not be recorded in the relevant Vital Signs Trends Chart. 

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Note: You will need to move into an area with stronger Wi-Fi connectivity before selecting ‘Retry’.

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2.14 

Here are some key messages for you to remember about Vital Signs on Oxevision:

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• You can take contact-free spot check measurements of patients’ vital signs. However, Oxevision will not alert to abnormal pulse rate, breathing rate (chest wall movements) or those outside the stated ranges in the Oxevision Instructions for Use.  
• The patient must be still and all blobs must be located on the body
• The system cannot verify a patient’s identity. It is your responsibility to ensure that vitals are taken from the intended individual. 
• Oxevision must not be used as the sole basis for making clinical decisions or recommendations.
• Some products or environmental factors (vibrations/flashes/light) can interfere with the Oxevision system by creating other signals in the room  which the software can misinterpret. If you remember, when we went through the examples of blobs earlier in this lesson, Example 2 had a blob placed on the ceiling light. The flashes from the ceiling light may have caused the system to misinterpret those signals and caused the blob to appear.  Other devices where this can happen include: lifts, sleep apnea devices, cell phones and tablets, fans, airflow mattresses, sunlight and curtains. If these devices are present, please be cautious when using the system and ensure the blobs only appear on the patient's body when you are taking vital signs observations. For more information, please refer to the Instructions for Use.
• If anything looks wrong, select “Cancel”, and revert to another means of observation.

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2.15 

Thank you. You've now completed lesson 2: How to take a patient's vital signs using Oxevision.

Please take some time to read the key messages below the video then mark the lesson as complete.

Please continue to lesson 3: How to monitor a patient's activity using Oxevision.