What are some causes and fixes for when a patient monitor will not appear on the central station?
This might seem like a clear-cut, easy issue, but if you have ever been left standing in a patient room trying to figure out why a patient monitor will not show up on the central station, you know it is not. This problem has left many a good technician scratching his or her head.
I have encountered a variety of issues that have caused a patient monitor to not show up on the central station. Here are some examples:
Network cable unplugged from the wall
Network cable damaged and not making connection
Changes were made to the router in the patient's room, resulting in data not being transmitted
The IP address being used for the server and central to talk was changed
The server lost connection to the network
The server lost connection with one room
The KVM lost connection with one room
The central station lost a setting
The information technology (IT) clinical apps team made a change to the patient record that affected one room
The monitor in the patient's room lost a setting
The MAC address of the monitor got booted off the network
The first piece of advice is to follow your troubleshooting steps: gather information, analyze the problem, implement a solution, verify the solution was effective, and document the issue. Not deviating from the steps we learned early in our training will help to ensure our success.
Begin by consulting with the staff member who called you, asking them to explain how the problem arose. Many times, what we infer to be the problem does not align with the staff member's description. In other words, don't go on a “wild goose chase” if you don't have to.
Verify whether patient information is going to the central station. This can be done by going to the patient's room and checking whether the monitors are on. Verify if the patient has the appropriate accessory equipment (e.g., blood pressure cuff, electrocardiogram leads). Check if the information is going to the room monitor. See if the network cables are plugged into the network jacks, or if the monitor is wireless, verify whether the wireless connection is working.
Next, you will need to verify if other rooms in the same area have information going to the central station. Having only one room affected involves an entirely different set of issues than if vitals for the entire unit are not crossing to central.
Knowing your system is critical. You should be aware of the network accessories, such as keyboard, video, mouse (KVM) switches, KVM switch extenders, and servers, as well as the IP and MAC addresses for the various pieces of the system. If the system has servers (most do), where are they located, what are their names, who takes care of them, who has access to them, how do they have access to them, and when can you notify the appropriate people responsible? Although getting to know your system is hard work, it will be worth it in the long run.
The next step is involving the appropriate people in solving the problem, which can be easier said than done. Sometimes the red tape with an IT department can be quite daunting, so doing some preincident homework for this step can also be useful. Considerations at this stage include whether you can solve the problem yourself or if other technicians are needed. Do you need assistance from the manufacturer? If IT should be involved, does the problem require someone from, for example, the server team or the apps team?
Having problem-solving matrices established prior to an incident is always a good idea. Additional important information is whether you have back-up equipment available, such as a spare server, hard drive, computer, or KVM switch. Knowing whether you can simply swap out equipment can save you a lot of time.
Implementing a solution is the next step. Replacing a hard drive, KVM switch, or patient monitor may take minutes, hours, or days. Regardless of the time frame needed, make sure that the appropriate people are apprised of the situation as it unfolds.
After the solution has been implemented, verify that is has been properly completed by testing the monitor and central station. Verify whether information can be seen at the central station and in the patient record (if it is tied to the record). When the solution has been verified, be sure to document the entire issue.