Monthly Archives: April 2015

Where is Wearable Technology Heading?

This post is from an invited guest blogger. Andrew Randazzo is the Director of Prime Medical Training and is a Nationally Registered Paramedic. Aside from teaching, Andrew’s faith and church play a big role in his life, and he also enjoys backpacking, scuba diving, competing in triathlons, and international travel.

Disclaimer: I am not being compensated in any way for any of the products I talk about in this article.

I find that when people learn about EMS and all the tools we have at our disposal, they are surprised. Even those who are in the healthcare field are surprised, or perhaps just ignorant, about what our monitors are capable of measuring. It may be because so many other facilities have multiple pieces of equipment that do what our one monitor can do.

Now imagine that one monitor being out of date. That’s right, the good ole LifePak 15s and Zoll Xs need to say hello to the Visi Mobile. The Visi is a all-in-one monitor that you wear on your wrist. Not only does it do all your vital signs including respiratory rate, it can also do EKGs.visi-mobile-2

What I find the coolest about the Visi is the built in accelerometer that detects what position you are in in bed, if you’ve been walking around, fallen, etc. That feature alone makes it invaluable for hospitals and nursing homes.

Another breakthrough is Continuous Non-Invasive Blood Pressure. What you do is put a normal BP cuff on the patient that takes their initial BP. Then you can take the cuff off and the Visi is able to measure subsequent blood pressures without the cuff being on the patient.

Everything that is monitored can also be transmitted wirelessly and displayed at the nurse’s station in real-time. The Visi Mobile reduces injuries for the patients first of all, but it also allows more people to be moved to less intensive floors (which frees up beds) due the fact that the patients need less 1-1 monitoring.

By the way, I almost forgot to mention this device costs a few hundred in comparison to the thousands you have to spend on current monitors.

The company also plans in the future to expand, to allow monitoring patients post-discharge, in order to avoid hospital re-admission.

This is the wave of the future. I’m excited to see it coming and what else is out there. What are your thoughts on the Visi Mobile or other things you see coming? Please comment as a reply below.

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Filed under EMS Health & Safety, EMS Topics, News, Opinion, Patient Management, Technology & Communications

In Support of Backboards

ProperPlacement of LBB

“Proper Placement of Backboard”

One of my first really successful posts years ago was “A Short Take on Long Boards” where I found myself piling on the negatives regarding our habitual dependence on the Long Spine Board. I do not feel as though I can take any credit, however, for agencies such as the Palm Beach Florida Fire Department or the New York City Regional Medical Advisory Committee who have since chosen to abandon the practice of its use.  Many others have made their displeasure of the practice clear in endless commentaries on the topic. And the photo above on the “Proper Placement of Backboard” garnered many “Likes” on social media. It is the traditional reliance on the backboard, in an attempt to totally immobilize patients, based predominately on the MOI that has lead some to parody the practice in a clever cartoon episode. As a matter of fact, the only evidence I could find to support the use of the spine board as an immobilization device for transport was this randomized clinical trial setting it up against a vacuum mattress splint in a false dichotomy that I could only hope is a mocking satire. In an even deeper insult to our immobilization practice, Dr. Bryan Bledsoe, emergency physician and EMS textbook author, has also gone on to suggest limiting use of the rigid cervical collar as well. Suddenly, the topic of immobilization seems to be much more fluid.

Still, I fear some may have gone too far in calling for the removal of the LBB from ambulances everywhere. In general, we are often all too willing to jump from one bandwagon to another in an “all or nothing” dance to be more “evidence-based” than the next medic. I have heard colleagues suggest that the KED is the rightful heir to the immobilization throne, but in my mind that is like replacing the standard stretcher with a stair chair. In some cases one may be more appropriate than another, but the recognition that a tool has limitations does not mean it should be replaced in every instance. We simply need to become more aware of when to use it, not just remove the tool from the toolbox altogether. I feel we have done the same thing with response times, if they don’t ALWAYS matter, then they NEVER matter (but that is a topic for another post.)

The backboard remains a flexible extrication tool that is widely available and already well understood by first responders. Furthermore, it can be adapted for other uses. Another topic that is hot in EMS right now is High Performance CPR. While the basics of CPR have been around for decades, we are learning better ways to apply it and even understanding more about the science behind the mechanics of how it works. We know, for instance, that the patient must be on a firm platform for effective compressions and the backboard fits that need very well.  More recent research also suggests that tilting the compression platform to a semi-fowlers’ position decreases ICP for better brain perfusion. Instead of introducing a new device, the backboard can be adapted to this use by raising the head about the height of your bag.

It is great when we can improve the efficacy of our work without adding anything to the expense of it! The most difficult change is in our attitude.

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Filed under Administration & Leadership, EMS Health & Safety, EMS Topics, News, Opinion, Patient Management, Technology & Communications