Use of ReDS Technology to Triage Heart Failure Patients in the Emergency Department

Abstract

Background Reducing heart failure (HF) readmissions has become an important, but elusive, goal for many hospital systems. The Emergency Department (ED) is the final common pathway through which patient stabilization occurs and where disposition decisions are made. Thus, improving triage of HF patients in the ED may provide an effective way to reduce the rate of HF readmissions. The Remote Dielectric Sensing (ReDS) Wearable System is an FDA-approved device developed by Sensible Medical Innovations that allows clinicians and other health care providers to accurately, quickly and non-invasively measure lung fluid. Methods At MCHS, about 88% of patients seeking care for SOB with history of HF are admitted to the hospital for inpatient treatment. This identified a need to develop a tool to assist in risk stratification. The primary outcome was to provide an objective measure to aid in making a disposition decision. The secondary outcome was to determine the percentage of patients who present to the ED with signs and symptoms of acute HF and fall into the mild, moderate, or high risk categories.• ReDS reading of Results We assessed 39 HF patients presenting to the ED with complaints of worsening HF symptoms. Each underwent a ReDS reading during the ED triage process. Conclusion In our pilot study, implementing a ReDS assessment into the ED triage process was feasible. Most patients who present to ED with SOB and history of HF are either significantly volume overloaded and require an inpatient admission for diureses or have SOB from a non-HF cause. Adequate ED treatment and close HF clinic follow up may be a safe and effective resource utilization for those patients with moderately elevated volume to prevent an inpatient admission.