We provide new insights into the performance of camera-based heart and respiration rate extraction and evaluate its usability for replacing spot checks conducted in the general ward. A study was performed comprising of 36 ICU patients recorded for a total time of 699 h. The 5 beats/minute agreement between camera and ECG-based heart rate measurements was 81.5%, with a coverage of 81.9%, where the largest gap between measurements was 239 min. The challenges encountered in heart rate monitoring were limited visibility of the patient’s face and irregular heart rates, which led to poor agreement between camera- and ECG-based heart rate measurements. To prevent non-breathing motion from causing error in respiration rate extraction, we developed a metric which was used to detect non-breathing motion. The 3 breaths/minute agreement between the camera- and contact-based respiration rate measurements was 91.1%, with a coverage of 59.1%, where the largest gap between measurements was 114 min. Encountered challenges were the morphology of the respiration signal and irregular breathing. While a few challenges need to be overcome, the results show promise for the usability of camera-based heart and respiration rate monitoring as a replacement for spot checks of these vital parameters conducted in the general ward.

In the past ferromagnetic cerebral aneurysm clips that are contraindicated for Magnetic Resonance Imaging (MRI) have been implanted. However, the specific clip model is often unknown for older clips, which poses a problem for individual patient management in clinical care. Literature and incident databases were searched, and a survey was performed in the Netherlands that identified time periods at which ferromagnetic and non-ferromagnetic clip models were implanted. Considering this information in combination with a national expert opinion, we describe an approach for risk assessment prior to MRI examinations in patients with aneurysm clips. The manuscript is limited to MRI at 1.5 T or 3 T whole body MRI systems with a horizontal closed bore superconducting magnet, covering the majority of clinical Magnetic Resonance (MR) systems. From the literature a list of ferromagnetic clip models was obtained. The risk of movement or rotation of the clip due to the main magnetic field in case of a ferromagnetic clip is the main concern. In the incident databases records of four serious incidents due to aneurysm clips in MRI were found. The survey in the Netherlands showed that from 2000 onwards, no ferromagnetic clips were implanted in Dutch hospitals. Recommendations are provided to help the MR safety expert assessing the risks when a patient with a cerebral aneurysm clip is referred for MRI, both for known and unknown clip models. This work was part of the development of a guideline by the Dutch Association of Medical Specialists.