{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T10:02:05Z","timestamp":1769853725978,"version":"3.49.0"},"reference-count":51,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Triage is the first interaction between a patient and a nurse\/paramedic. This assessment, usually performed at Emergency departments, is a highly dynamic process and there are international grading systems that according to the patient condition initiate the patient journey. Triage requires an initial rapid assessment followed by routine checks of the patients\u2019 vitals, including respiratory rate, temperature, and pulse rate. Ideally, these checks should be performed continuously and remotely to reduce the workload on triage nurses; optimizing tools and monitoring systems can be introduced and include a wearable patient monitoring system that is not at the expense of the patient\u2019s comfort and can be remotely monitored through wireless connectivity. In this study, we assessed the suitability of a small ceramic piezoelectric disk submerged in a skin-safe silicone dome that enhances contact with skin, to detect wirelessly both respiration and cardiac events at several positions on the human body. For the purposes of this evaluation, we fitted the sensor with a respiratory belt as well as a single lead ECG, all acquired simultaneously. To complete Triage parameter collection, we also included a medical-grade contact thermometer. Performances of cardiac and respiratory events detection were assessed. The instantaneous heart and respiratory rates provided by the proposed sensor, the ECG and the respiratory belt were compared via statistical analyses. In all considered sensor positions, very high performances were achieved for the detection of both cardiac and respiratory events, except for the wrist, which provided lower performances for respiratory rates. These promising yet preliminary results suggest the proposed wireless sensor could be used as a wearable, hands-free monitoring device for triage assessment within emergency departments. Further tests are foreseen to assess sensor performances in real operating environments.<\/jats:p>","DOI":"10.3390\/s21227586","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T20:46:47Z","timestamp":1637009207000},"page":"7586","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Wearable Bluetooth Triage Healthcare Monitoring System"],"prefix":"10.3390","volume":"21","author":[{"given":"Caitlin","family":"Polley","sequence":"first","affiliation":[{"name":"School of Engineering, Design and Built Environment, Western Sydney University, Kingwoods, NSW 2751, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-4235","authenticated-orcid":false,"given":"Titus","family":"Jayarathna","sequence":"additional","affiliation":[{"name":"MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Milperra, NSW 2560, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0932-5306","authenticated-orcid":false,"given":"Upul","family":"Gunawardana","sequence":"additional","affiliation":[{"name":"School of Engineering, Design and Built Environment, Western Sydney University, Kingwoods, NSW 2751, Australia"}]},{"given":"Ganesh","family":"Naik","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2630-7011","authenticated-orcid":false,"given":"Tara","family":"Hamilton","sequence":"additional","affiliation":[{"name":"School of Electrical and Data Engineering, University of Technology Sydney, Ultimo, NSW 2007, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4829-3941","authenticated-orcid":false,"given":"Emilio","family":"Andreozzi","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138 Naples, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-971X","authenticated-orcid":false,"given":"Paolo","family":"Bifulco","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138 Naples, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-8431","authenticated-orcid":false,"given":"Daniele","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138 Naples, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3422-8727","authenticated-orcid":false,"given":"Jessica","family":"Centracchio","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80138 Naples, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2616-2804","authenticated-orcid":false,"given":"Gaetano","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"School of Engineering, Design and Built Environment, Western Sydney University, Kingwoods, NSW 2751, Australia"},{"name":"MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Milperra, NSW 2560, Australia"},{"name":"Ingham Institute of Applied Medical Research, University of New South Wales, Liverpool, NSW 2052, Australia"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1136\/emj.2005.030270","article-title":"Evolution of triage systems","volume":"23","year":"2006","journal-title":"Emerg. Med. J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Australasian College for Emergency Medicine (2002). The Australasian Triage Scale. Emerg. Med. (Fremantle W.A.), 14, 335\u2013336.","DOI":"10.1046\/j.1442-2026.2002.00371.x"},{"key":"ref_3","unstructured":"(2020, May 28). Emergency Department Care: Australian Hospital Statistics, Available online: https:\/\/nla.gov.au\/nla.obj-767401731."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.aenj.2010.08.302","article-title":"How relevant is the Australasian Triage Scale to the modern Emergency Department?","volume":"13","author":"Luther","year":"2010","journal-title":"Australas. Emerg. Nurs. J."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Albahri, O., Albahri, A., Mohammed, K., Zaidan, A., Zaidan, B., Hashim, M., and Salman, O.H. (2018). Systematic review of real-time remote health monitoring system in triage and priority-based sensor technology: Taxonomy, open challenges, motivation and recommendations. J. Med. Syst., 42.","DOI":"10.1007\/s10916-018-0943-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1097\/DMP.0b013e3181844d43","article-title":"A brief history of triage","volume":"2","author":"Mitchell","year":"2008","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Christ, M., Grossmann, F., Winter, D., Bingisser, R., and Platz, E. (2010). Modern triage in the emergency department. Dtsch. \u00c4rzteblatt Int., 107.","DOI":"10.3238\/arztebl.2010.0892"},{"key":"ref_8","first-page":"157","article-title":"Development and experimentation of a telemedicine solution built around a digital stethoscope. the \u201cBluehealth\u201d project","volume":"2","author":"Andres","year":"2016","journal-title":"Int. J. Eng. Res. Sci. (IJOER)"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Klum, M., Urban, M., Tigges, T., Pielmus, A.-G., Feldheiser, A., Schmitt, T., and Orglmeister, R. (2020). Wearable Cardiorespiratory Monitoring Employing a Multimodal Digital Patch Stethoscope: Estimation of ECG, PEP, LVET and Respiration Using a 55 mm Single-Lead ECG and Phonocardiogram. Sensors, 20.","DOI":"10.3390\/s20072033"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2147\/MDER.S135882","article-title":"Digital stethoscope: Technology update","volume":"11","author":"Swarup","year":"2018","journal-title":"Med. Devices Evid. Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Szymanowska, O., Zagrodny, B., Ludwicki, M., and Awrejcewicz, J. (2016). Development of an Electronic Stethoscope, Springer International Publishing. [1st ed.].","DOI":"10.1007\/978-3-319-26886-6_12"},{"key":"ref_12","unstructured":"Webster, J.G., and Clark, J.W. (2008). Medical Instrumentation: Application and Design, John Wiley & Sons Inc.. [3rd ed.]."},{"key":"ref_13","unstructured":"Northrop, R.B.A. (2018). Noninvasive Instrumentation and Measurement in Medical Diagnosis, CRC Press. [2nd ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1161\/01.CIR.34.5.889","article-title":"Stethoscope acoustics: I. The doctor and his stethoscope","volume":"34","author":"Ertel","year":"1966","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhang, G., Liu, M., Guo, N., and Zhang, W. (2016). Design of the MEMS Piezoresistive Electronic Heart Sound Sensor. Sensors, 16.","DOI":"10.3390\/s16111728"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ou, D., Ouyang, L., Tan, Z., Mo, H., Tian, X., and Xu, X. (2017, January 24\u201326). An electronic stethoscope for heart diseases based on micro-electro-mechanical-system microphone. Proceedings of the IEEE International Conference on Industrial Informatics (INDIN), Emden, Germany.","DOI":"10.1109\/INDIN.2016.7819285"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1161\/01.CIR.34.5.899","article-title":"Stethoscope acoustics: II. Transmission and filtration patterns","volume":"34","author":"Ertel","year":"1966","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Aguilera-Astudillo, C., Chavez-Campos, M., Gonzalez-Suarez, A., and Garcia-Cordero, J.L. (2016, January 16\u201320). A low-cost 3-D printed stethoscope connected to a smartphone. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, Orlando, FL, USA.","DOI":"10.1109\/EMBC.2016.7591694"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Pinto, C., Pereira, D., Ferreira-Coimbra, J., Portugues, J., Gama, V., and Coimbra, M. (2017, January 11\u201315). A comparative study of electronic stethoscopes for cardiac auscultation. Proceedings of the 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Jeju Island, Korea.","DOI":"10.1109\/EMBC.2017.8037392"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Elfaramawy, T., Fall, C.L., Morissette, M., Lellouche, F., and Gosselin, B. (2017, January 25\u201328). Wireless respiratory monitoring and coughing detection using a wearable patch sensor network. Proceedings of the 2017 15th IEEE International New Circuits and Systems Conference (NEWCAS), Strasbourg, France.","DOI":"10.1109\/NEWCAS.2017.8010139"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yu, F., Bilberg, A., and Voss, F. (2008, January 12\u201315). The Development of an Intelligent Electronic Stethoscope. Proceedings of the 2008 IEEE\/ASME International Conference on Mechtronic and Embedded Systems and Applications, Beijing, China.","DOI":"10.1109\/MESA.2008.4735682"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Leng, S., Tan, R.S., Chai, K.T.C., Wang, C., Ghista, D., and Zhong, L. (2015). The electronic stethoscope. Biomed. Eng. Online, 14.","DOI":"10.1186\/s12938-015-0056-y"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Astono, J., Purwanto, A., and Agustika, D.K. (2017, January 19\u201321). The improvement of phonocardiograph signal (PCG) representation through the electronic stethoscope. Proceedings of the 2017 4th International Conference on Electrical Engineering, Computer Science and Informatics (EECSI), Yogyakarta, Indonesia.","DOI":"10.11591\/eecsi.v4.1008"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Liu, H., Allen, J., Zheng, D., and Chen, F. (2019). Recent development of respiratory rate measurement technologies. Physiol. Meas., 40.","DOI":"10.1088\/1361-6579\/ab299e"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dias, D., and Paulo Silva Cunha, J. (2018). Wearable Health Devices-Vital Sign Monitoring, Systems and Technologies. Sensors, 18.","DOI":"10.3390\/s18082414"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1136\/bmjinnov-2019-000354","article-title":"Wearable devices for remote vital signs monitoring in the outpatient setting: An overview of the field","volume":"6","author":"Soon","year":"2020","journal-title":"BMJ Innov."},{"key":"ref_27","unstructured":"PUI Audio (2013, April 29). \u201cBender AB1290B-LW100-R\u201d Datasheet. Available online: https:\/\/www.digikey.com\/en\/products\/detail\/pui-audio-inc\/AB1290B-LW100-R\/4147326."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Esposito, D., Andreozzi, E., Fratini, A., Gargiulo, G.D., Savino, S., Niola, V., and Bifulco, P. (2018). A piezoresistive sensor to measure muscle contraction and mechanomyography. Sensors, 18.","DOI":"10.3390\/s18082553"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Esposito, D., Andreozzi, E., Gargiulo, G.D., Fratini, A., D\u2019Addio, G., Naik, G.R., and Bifulco, P. (2020). A Piezoresistive Array Armband With Reduced Number of Sensors for Hand Gesture Recognition. Front. Neurorobotics, 13.","DOI":"10.3389\/fnbot.2019.00114"},{"key":"ref_30","unstructured":"(2016, September 01). FORMEROL\u00ae F.10\/SUGRU\u00ae TECHNICAL DATA SHEET. Available online: https:\/\/sugru.com\/pdfs\/tds.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Polley, C., Andreozzi, E., Bifulco, P., Esposito, D., Naik, G., Gunawardana, U., and Gargiulo, G. (2019, January 24\u201328). Low Cost Analogue Front End for Electronic Stethoscopes Application with Silicone Enclosure. Proceedings of the 2019 International Conference on Electrical Engineering Research & Practice (ICEERP), Sydney, Australia.","DOI":"10.1109\/ICEERP49088.2019.8956972"},{"key":"ref_32","unstructured":"Pallas-Areny, R., and Webster, J.G. (2001). Sensors and Signal Conditioning, John Wiley & Sons."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Gargiulo, G.D., O\u2019Loughlin, A., and Breen, P.P. (2015). Electro-resistive bands for non-invasive cardiac and respiration monitoring, a feasibility study. Physiol. Meas., 36.","DOI":"10.1088\/0967-3334\/36\/2\/N35"},{"key":"ref_34","unstructured":"(2021, September 01). BM10_AN R2 BLE Single Mode Module. Available online: https:\/\/fccid.io\/YAIBM10R2\/User-Manual\/Manual-3614427."},{"key":"ref_35","unstructured":"Texas Instruments (2021, September 01). CC2640R2F SimpleLink\u2122 Bluetooth\u00ae Low Energy Wireless MCU. Available online: https:\/\/www.avnet.com\/wps\/portal\/apac\/products\/product-aac\/201803-ti\/!ut\/p\/z0\/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zi3S1NPQ2dnQ183UNMTAwCLbz9PA39vAwD_I30g6sy4kPC9QuyHRUBwJ6srQ!!\/."},{"key":"ref_36","unstructured":"(2021, September 01). MAX30003, Ultra-Low Power, Single-Channel Integrated Biopotential (ECG, R-to-R Detection) AFE. Available online: https:\/\/datasheetspdf.com\/pdf\/1346415\/MaximIntegrated\/MAX30003\/1."},{"key":"ref_37","unstructured":"(2021, September 01). ADS124x 24-Bit, 2-kSPS, Analog-to-Digital Converters With Programmable Gain Amplifier (PGA) For Sensor Measurement. Available online: https:\/\/www.ti.com\/lit\/ds\/symlink\/ads1247.pdf?ts=1636949941174&ref_url=https%253A%252F%252Fwww.google.com%252F."},{"key":"ref_38","unstructured":"(2021, September 01). MAX30205 Human Body Temperature Sensor. Available online: https:\/\/www.avnet.com\/wps\/portal\/ebv\/products\/new-products\/npi\/2017\/maxim-max30205\/."},{"key":"ref_39","unstructured":"(2021, September 01). LIS2DH-MEMS Digital Output Motion Sensor: Ultra Low-Power High Performance 3-Axis \u201cFemto\u201d Accelerometer. Available online: https:\/\/www.st.com\/en\/mems-and-sensors\/lis2dh.html."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Jayarathna, T., Gargiulo, G.D., and Breen, P.P. (2020). Continuous Vital Monitoring During Sleep and Light Activity Using Carbon-Black Elastomer Sensors. Sensors, 20.","DOI":"10.3390\/s20061583"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Arja, S.E., Jayarathna, T., Ulloa, F., Gargiulo, G., and Breen, P. (2019, January 24\u201328). Characterization of Coated Piezo-resistive Fabric for Respiration Sensing. Proceedings of the 2019 International Conference on Electrical Engineering Research & Practice (ICEERP), Sydney, Australia.","DOI":"10.1109\/ICEERP49088.2019.8956989"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Jayarathna, T., Gargiulo, G.D., and Breen, P.P. (2019, January 17\u201319). Live Demonstration: Invisible Vital Monitoring. Proceedings of the 2019 IEEE Biomedical Circuits and Systems Conference (BioCAS), Nara, Japan.","DOI":"10.1109\/BIOCAS.2019.8918983"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.jelectrocard.2014.07.020","article-title":"Development of three methods for extracting respiration from the surface ECG: A review","volume":"47","author":"Helfenbein","year":"2014","journal-title":"J. Electrocardiol."},{"key":"ref_44","unstructured":"BioPac Systems Inc. (2021, September 01). MP160 Product Sheet. Available online: https:\/\/www.biopac.com\/."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/jpc.12744","article-title":"Intermittent midline suprasternal neck mass caused by superior herniation of the thymus","volume":"51","author":"Su","year":"2015","journal-title":"J. Paediatr. Child Health"},{"key":"ref_46","unstructured":"Proakis, J.G.A. (2007). Digital Signal Processing, Pearson\/Prentice Hall. [4th ed.]."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Sedghamiz, H. (2018). BioSigKit: A Matlab Toolbox and Interface for Analysis of BioSignals Software \u2022 Review \u2022 Repository Archive. J. Open Source Softw., 3.","DOI":"10.21105\/joss.00671"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1109\/TBME.1985.325532","article-title":"A real-time QRS detection algorithm","volume":"32","author":"Pan","year":"1985","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_49","unstructured":"Klein, R. (2020, May 28). Bland-Altman and Correlation Plot. Available online: https:\/\/www.mathworks.com\/matlabcentral\/fileexchange\/45049-bland-altman-and-correlation-plot."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3390\/vibration2010005","article-title":"Recent Advances in Seismocardiography","volume":"2","author":"Taebi","year":"2019","journal-title":"Vibration"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Andreozzi, E., Fratini, A., Esposito, D., Naik, G., Polley, C., Gargiulo, G.D., and Bifulco, P. (2020). Forcecardiography: A Novel Technique to Measure Heart Mechanical Vibrations onto the Chest Wall. Sensors, 20.","DOI":"10.3390\/s20143885"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/22\/7586\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:30:33Z","timestamp":1760167833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/22\/7586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":51,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["s21227586"],"URL":"https:\/\/doi.org\/10.3390\/s21227586","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]}}}