The Shine 2011 team at Birmingham Children’s Hospital is working in partnership with the McLaren Formula 1 racing team to translate expertise used to monitor racing cars into a system that will predict deterioration in very sick children.
McLaren Electronic Systems continuously monitor the performance and ‘health’ of racing cars by streaming huge amounts of continuous data, enabling real-time analysis and the modelling of hundreds of parameters simultaneously. This innovative project will adapt Formula 1 monitoring to enable large volumes of data to be analysed in order to accurately identify deterioration in sick children.
Once the system is developed, children who become ill and present to primary care will have one or two small adhesive sensors attached to them. Their physiological parameters will be checked against the population normal values and the analysis will be presented to the practice nurse and doctor, with a decision support system to advise escalation to hospital or reassurance that the child can be returned home.
Children who require an ambulance will have the sensors applied by the paramedics. When they are in hospital, the information will go with them at each handover and will help clinicians make decisions about timing and levels of care.
Early warning signs often precede life threatening events in children. However, these signs are frequently missed or not acted upon because existing monitoring systems do not provide the accuracy required in paediatrics, nor can they provide the continuous monitoring necessary to detect transient or combined vital sign indicators.
The National Patient Safety Agency, the National Institute for Health and Clinical Excellence and the Centre for Maternal and Child Enquiries have all recommended the implementation of early warning systems to identify clinical deterioration and initiate early treatment. Existing paediatric scoring systems show reduced mortality, and cardiac and respiratory arrest rates. However, there remain predictable, potentially preventable, acute life threatening events, some of which lead to unnecessary and avoidable deaths.
Many children are admitted to hospital ‘for observation’ because it is unclear whether they are stable or deteriorating. These children remain hospitalised for intermittent observations. If these observations could be performed more accurately and quickly, some children could be observed in the community and be discharged sooner.
There is currently no early warning system for children who rely on breathing tubes and machines, because they do not fit into the ‘normal’ parameters. These children need an adaptive system that can learn what is normal for these individuals to ensure that deterioration is identified and timely treatment is given.