There are many references from earliest recorded history, that demonstrate that even early on, humans recognized that there were certain essentials to life itself, such as breathing, blood, and pulse.
• "And the Lord God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul." Genesis 2:8 (the Bible)
• Hippocrates stated that the heart "supplied the human body with life." (5th century)
• Pneuma (a spirit taken in with each breath) and blood meet in the heart for delivery to all parts of the body (ancient Greek and Roman history)
Even in the early 20th century, there were few assessment tools available to assess the status of a patient. Blood pressure was a measurement taken by physicians as it was "too advanced" for nurses. Rapid progression of new and innovative assessment tools were born in the 20th century along with cures for fatal diseases with the introduction of antibiotics.
• TPR were the only measurements monitored and recorded as part of evaluation for severity of illness 100 years ago.
• BP became a routine measurement in the late 1920's.
• Antibiotics improved patient outcomes in the 1940's in diseases that were usually fatal (i.e. pneumonia, TB, bacterial endocarditis).
The Korean and Vietnam Wars taught us different ways of managing critical illness and trauma. The use of invasive monitors such as pulmonary artery catheters taught us the affects of interventions, such as fluids, and vasoactive medications on hemodynamics.
• Evolution of Intensive Care as a specialty in the 1960's.
• Hemodynamic monitoring techniques vastly improved diagnosis and evaluation of critically ill patients (1960's to 1970's)
• Technology continues to evolve and improve rapidly
Because much was learned through the used of invasive monitoring devices, assessment of the patient has improved to the point that care can be provided without them. Through the understanding of the patient's condition, we can provide therapy without putting the patient at risk using the devices.
What goes around comes around…. Through the use and study of invasive monitoring devices, we know more now than we did in the 1960's and 1970's.
• We now opt for less invasive assessment techniques
• Patient outcomes do not improve with the use of invasive monitoring devices
• Invasive monitoring devices increase the risk for injury and infection
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Date last modified: January 7, 2013.
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