Improved patient safety through accurate and continuous breathing rate measurements

Breathing — the most vital parameter we measure

Surveillance and following up of vital signs (breathing rate, blood pressure, heart rate and more) in patients is important to keep them safe. We want to uncover rising sicknesses and catch potential health status declines early. This may be due to the underlying sickness itself or the side-effect or complication of a certain treatment. The goal is to catch changes in health status so early that counteracting therapy can be administered before further deterioration of the health of the patient occurs.

Some exemplary situations are listed here:

• Development of blood poisoning

• Failing antibiotics treatment

• Blood loss after surgery

• Respiration changes after strong pain killer medication

Breathing rate changes first

The biggest challenge measuring vital signs is that a one-time assessment only provides a snapshot, while changes detected over longer periods of time are more valuable for clinical decision making. This is why vital signs are being taken multiple times during the day. In the general ward this may even be as often as every half hour for the sickest patients, while the intensive care unit often measures continuously with various instruments attached to the body. All vital signs are important. The big picture is often what it means to assess a health status, but breathing rate especially has repeatedly shown to be the most sensitive parameter in multiple studies. Breathing is often the first parameter affected upon deterioration [1].

Breathing rate is special in another regard from the other vital signs as well: it is most often recorded manually by sitting next to the patient and counting the actual breaths. Breathing movements can be hard to see and touching the thorax or stomach might be necessary to count the breaths more accurately. Therefore, breathing rate measurements are prone to what is called subjective bias (varying from tester to tester) in addition to the fact that breathing is often controlled or changed by the patient involuntarily during the assessment.

It is naturally very difficult to «breathe as you normally would» when someone is sitting next to you counting. The measurement is time-consuming, too. Ideally it should be recorded for over one minute each time. These reasons add up to the fact that breathing rate was never recorded in 76% of cases during a routine check of the registration forms for vital signs in hospitalized patients [2].

The future is contactless

We strongly believe that breathing rate will be recorded through a continuous and contactless solution. The constant data stream helps catch changes quicker, delivers more detailed trends which aid clinical reasoning and frees up healthcare resources.

Contactless solutions which are not dependent on attaching anything to your body are clearly more convenient for patients. The ongoing Covid-19 pandemic has also made painfully obvious the need to follow up patients without having to subject healthcare personnel to infection risk through unnecessary direct contact and contamination of medical equipment.

The accuracy of the measurements increases when healthcare workers are not relying on manual counting and when the patient’s natural breathing rate is captured. Data we collected shows that we are able to collect the breathing rate with extreme accuracy. How accurate exactly, is what we will measure among other things when we formally document our systems for the medical accreditation we are working towards as you read this.

The judicial framework of health tech

There is a strict and fairly bureaucratic set of rules regulating the development and sale of technical equipment for medical use. Before we can provide a medical device and service, the company and the product both need to undergo rigorous accreditation processes which are time intensive. But yet again, the common denominator is patient safety. Medical equipment measuring vital signs like breathing rate are actually especially strictly regulated, since errors of any source can have serious negative consequences. Therefore, new equipment aiming to be used for this purpose must have formal documentation for both quality and effectiveness, equal to the development of new types of medication.

We collaborate with healthcare providers

Together with our pilot customers in healthcare, we are now working towards the refining development of machine learning algorithms, software and the sensor technology itself with the aim to cater to the needs of monitoring breathing rate of in-house patients, nursing homes or at their own homes. Simultaneously, IT security, data protection protocols and adjustments of the software to healthcare use with various types of alert functionality for very sick patients are necessary. Clinical studies are to be planned, applied for and performed exactly following the detailed regulations and the whole company needs to get assessed including the quality insurance systems in place. This is therefore a demanding, but extremely exciting period we are in right now.

Our competent and highly motivated staff is looking forward to the day we can deliver the first ever contactless sensor for measuring breathing rate — our most important vital si


This article is translated by Lukas Krondorf.

N.I.C.E., Acutely ill patients in hospital : recognition of and response to acute illness in adults in hospital 2007. (NICE clinical guideline No 50.). 2007.

Ludikhuize, J., et al., Identification of deteriorating patients on general wards; measurement of vital parameters and potential effectiveness of the Modified Early Warning Score. J Crit Care, 2012. 27(4): p. 424 e7-13.