When it comes to patient safety, perhaps no instrument in your OR is as essential as your vital signs monitor. That little black screen should tell you in the blink of an eye how the patient is faring before, during and after surgery, and if he is exhibiting early warning signs of potential complications.

At the very basic level, monitors help doctors, nurses and anesthesia providers continuously track the patient's oxygenation, ventilation, circulation and body temperature. The key to efficient patient monitoring is simplicity, but determining which monitor will best suit the needs of your facility isn't always so simple. With more than a dozen machines on the market, you're faced with a host of options ranging from bare-bones monitors that track blood pressure, EKG, pulse oximetry and temperature (the most vital vitals), to more advanced systems that offer capnography and easily interface with your facility's electronic medical records.

Like any electronic equipment, vital signs monitors are becoming increasingly compact, portable and easy to use. Portability is a feature that may seem inconsequential in an ambulatory facility, but San Diego, Calif.-based anesthesiologist Adam F. Dorin, MD, MBA, cautions against monitors that are built into anesthesia machines. Individual or removable monitors are easier to upgrade and transport, he says, and they won't be susceptible to malfunctions in the larger equipment.

A fairly new monitoring parameter available on the market is capnography, the measurement of CO2 exhaled by the patient. Larry Snyder, CRNA, of Taylorville, Ill., is a strong proponent of using end tidal CO2 monitoring whenever sedation is administered, saying it's a good early warning sign for airway obstruction. Mr. Snyder notes that EtCO2 readings can often detect breathing problems in a patient before they're apparent to the naked eye. The American Society of Anesthesiologists only mandates capnography for procedures involving general anesthesia.

In addition to what your machines are monitoring, you should also consider how they deliver vital patient information to users. Kenneth Elmassian, DO, director of cardiac anesthesia services at Ingham Regional Medical Center in Lansing, Mich., says you should be able to navigate easily through your monitor's screens and alarms and customize display features. Because he is colorblind, Dr. Elmassian can't see waveforms displayed in red. He prefers monitors that let you easily change display features, such as color, to suit individual preferences.

In the end, remember that the most important vital signs monitors in your facility are the people administering care to patients. If they aren't happy with the equipment they use, patient care could suffer. Share the information on the following pages with your staff and involve them in the decision-making process next time you're in the market for new vital signs monitors.