Real-Time Patient Monitoring Dashboard Microservice

Create a scalable WebSocket-based microservice using Laravel Echo and Laravel Websockets that streams real-time patient vital signs from IoT medical devices. Develop a fault-tolerant architecture that can handle simultaneous connections from multiple hospital monitoring stations, with built-in rate limiting, connection pooling, and automatic reconnection strategies. Include robust error handling for device disconnections and implement a circuit breaker pattern to prevent system overload.