Determination of the Clinical Impact of Continuous Surveillance Monitoring (SM) and Utility of IPI.

Single site observational study of alarms and workflow on the general care floor where
continuous surveillance monitoring (SM) with capnography and pulse oximetry is the standard
of care before and after the Integrated Pulmonary Index is enabled within the context of a
historical review of frequency of escalation of care as a function of the frequency and
method of monitoring respiratory status. Observation of alarms will be electronically
recorded on a Clinical Observation Tool (COT or iPad) that will have a virtual view of the
CS20p measurements and alarm alerts for 24 hours on several patients at the same time.
Patients will only be enrolled for 24 hours of observation of alarm status with associated
patient activity and clinical interventions. Observation data with IPI disabled prior to
implementation of IPI/IPI alarms will be used to evaluate optimal alarm alert settings
including an IPI alert when enabled. Observation will continue with IPI enabled and alarms
adjusted to study clinical utility of IPI on the GCF.

Inclusion Criteria:

1. Spontaneous breathing adults ≥ 18 years of age, both male and female

2. On dual parameter CS20p monitoring with both capnography and pulse oximetry per
Vanderbilt standard of care to monitor patients for respiratory compromise.

3. Expected minimum duration of 24 hours of continued capnography and pulse oximetry
monitoring.

Exclusion Criteria:

1. Those patients who are expected to be discharged within six hours on the randomly
selected observation floor.

2. Those patients not on the randomly selected floor for observation.

3. Those subjects randomly removed from the selected floor for observation pool in order
to limit the number of subjects to be observed.

4. Those subjects in rooms with limited Wi-Fi signal quality as per VUMC IT.